Nora
0625c83a45
The 999 handler's rejection pass was looking up claims by patient control number, but Gainwell rejects at the SET level (ST envelope) when the whole batch fails the NM109=CO_TXIX rule. That meant a SET rejection was treated as a no-op even though every claim in the SET was actually rejected by the payer. Add a batch_envelope_index param (mirrors apply_999_acceptances from SP28) so SET-level rejections cascade to every claim in the SET. Falls back to the legacy PCN lookup when the index has no entry. Also tightens test_payer.py: PayerConfig.co_medicaid() now returns payer_id='CO_TXIX' and payer_name='CO_TXIX' per HCPF 837P Companion Guide (June 2025 - Version 2.5).
23 lines
828 B
Python
23 lines
828 B
Python
from cyclone.parsers.payer import PayerConfig
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def test_co_medicaid_defaults():
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cfg = PayerConfig.co_medicaid()
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assert cfg.name == "Colorado Medical Assistance Program"
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assert cfg.sbr09_claim_filing == "MC"
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assert cfg.allowed_claim_frequencies == {1, 7, 8}
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assert cfg.require_ref_g1_for_adjustments is False # lenient in v1
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assert cfg.allowed_bht06 == {"CH"}
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assert cfg.payer_id == "CO_TXIX"
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assert cfg.payer_name == "CO_TXIX"
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assert cfg.no_patient_loop is True
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assert cfg.encounter_claim_in_same_batch is False
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def test_generic_837p_defaults_are_relaxed():
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cfg = PayerConfig.generic_837p()
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assert cfg.name == "Generic 837P"
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assert cfg.allowed_claim_frequencies == {1, 2, 3, 4, 5, 6, 7, 8, 9}
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assert cfg.no_patient_loop is False
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assert cfg.payer_id == "" # unset
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