Tyler
61 lines
2.4 KiB
Python
61 lines
2.4 KiB
Python
"""Integration test: load the realistic CO Medicaid 835 fixture and validate it end-to-end."""
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from decimal import Decimal
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from pathlib import Path
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from cyclone.parsers.parse_835 import parse
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from cyclone.parsers.payer import PayerConfig835
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from cyclone.parsers.validator_835 import validate
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FIXTURE = Path(__file__).parent / "fixtures" / "co_medicaid_835.txt"
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def test_co_fixture_two_claims_pass():
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result = parse(FIXTURE.read_text(), PayerConfig835.co_medicaid_835())
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cfg = PayerConfig835.co_medicaid_835()
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report = validate(result, cfg)
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assert result.summary.total_claims == 2
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assert report.passed is True
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assert report.errors == []
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def test_first_claim_has_two_service_lines():
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result = parse(FIXTURE.read_text(), PayerConfig835.co_medicaid_835())
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c1 = result.claims[0]
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assert c1.payer_claim_control_number == "t991102986o1c1d"
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assert len(c1.service_payments) == 2
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assert c1.service_payments[0].procedure_code == "T1019"
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assert c1.service_payments[0].modifiers == ["U2"]
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assert c1.service_payments[1].service_date is not None
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def test_second_claim_has_four_service_lines():
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result = parse(FIXTURE.read_text(), PayerConfig835.co_medicaid_835())
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c2 = result.claims[1]
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assert c2.payer_claim_control_number == "t991102986o1c2d"
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assert len(c2.service_payments) == 4
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assert c2.per_diem_covered_days == Decimal("4")
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def test_payer_and_payee_match_co_config():
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result = parse(FIXTURE.read_text(), PayerConfig835.co_medicaid_835())
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assert result.payer.name == "CO_TXIX"
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assert result.payer.id == "7912900843"
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assert result.financial_info.payer_tax_id in {"81-1725341", "84-0644739"}
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assert result.payee.npi == "1881068062"
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assert result.payee.name == "TOC, Inc."
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def test_bpr_vs_clp_balance_holds():
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"""BPR02 (241.16) = CLP04 sum (85.40 + 155.76)."""
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result = parse(FIXTURE.read_text(), PayerConfig835.co_medicaid_835())
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clp_sum = sum((c.total_paid for c in result.claims), start=Decimal("0"))
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assert result.financial_info.paid_amount == clp_sum
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assert result.financial_info.paid_amount == Decimal("241.16")
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def test_per_claim_clp_vs_svc_balance_holds():
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result = parse(FIXTURE.read_text(), PayerConfig835.co_medicaid_835())
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for c in result.claims:
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svc_sum = sum((sp.payment for sp in c.service_payments), start=Decimal("0"))
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assert c.total_paid == svc_sum, f"claim {c.payer_claim_control_number}: CLP04={c.total_paid} != sum(SVC03)={svc_sum}"
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