Tyler
71 lines
2.5 KiB
Python
71 lines
2.5 KiB
Python
from datetime import date
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from pathlib import Path
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from cyclone.parsers.parse_837 import parse
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from cyclone.parsers.payer import PayerConfig
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FIXTURE = Path(__file__).parent / "fixtures" / "minimal_837p.txt"
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def test_parse_minimal_fixture_returns_one_claim():
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text = FIXTURE.read_text()
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result = parse(text, PayerConfig.co_medicaid())
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assert len(result.claims) == 1
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claim = result.claims[0]
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assert claim.claim_id == "CLM001"
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assert claim.billing_provider.npi == "1234567890"
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assert claim.subscriber.last_name == "Doe"
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assert claim.subscriber.first_name == "John"
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assert claim.subscriber.member_id == "ABC123"
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assert claim.payer.id == "SKCO0"
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assert claim.claim.frequency_code == "1"
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assert claim.claim.place_of_service == "12"
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assert claim.claim.prior_auth == "PA123"
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assert claim.diagnoses[0].code == "Z00"
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assert claim.diagnoses[0].qualifier == "ABK"
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assert len(claim.service_lines) == 1
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sl = claim.service_lines[0]
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assert sl.procedure.code == "99213"
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assert sl.procedure.qualifier == "HC"
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assert sl.charge == 100.00
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def test_parse_envelope_captured():
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result = parse(FIXTURE.read_text(), PayerConfig.co_medicaid())
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assert result.envelope is not None
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assert result.envelope.control_number == "991102977"
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assert result.envelope.transaction_date == date(2026, 6, 11)
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assert result.envelope.sender_id == "11525703"
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def test_parse_summary_counts():
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result = parse(FIXTURE.read_text(), PayerConfig.co_medicaid())
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assert result.summary.total_claims == 1
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assert result.summary.passed == 1
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assert result.summary.failed == 0
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def test_parse_continues_on_malformed_subscriber():
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"""A bad subscriber record must not abort the whole batch."""
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text = FIXTURE.read_text().replace("MI*ABC123", "MI*") # truncate member id segment
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result = parse(text, PayerConfig.co_medicaid())
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# Should still find the claim, but with errors
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assert len(result.claims) == 1
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assert result.claims[0].validation.passed is False
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assert result.summary.failed == 1
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def test_parse_preserves_raw_segments():
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result = parse(FIXTURE.read_text(), PayerConfig.co_medicaid())
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claim = result.claims[0]
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assert any(s[0] == "CLM" for s in claim.raw_segments)
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assert any(s[0] == "SV1" for s in claim.raw_segments)
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def test_parse_uses_generic_config_when_requested():
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result = parse(FIXTURE.read_text(), PayerConfig.generic_837p())
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assert len(result.claims) == 1
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# No patient-loop rule on generic config
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assert result.claims[0].validation.passed is True
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