Eligibility check sample bot #3
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src/eligibility-check-opkit.ts
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| const coverageEligibilityRequest = await medplum.createResource({ | ||
| resourceType: 'CoverageEligibilityRequest', | ||
| identifier: [{ | ||
| system: 'www.opkit.co/id', //You should choose this |
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The system should be 'https://api.opkit.co/v1/eligibility_inquiries/{id}'
src/eligibility-check-opkit.ts
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| resourceType: 'CoverageEligibilityRequest', | ||
| identifier: [{ | ||
| system: 'www.opkit.co/id', //You should choose this | ||
| value: 'opkit-identifier1234' //Ideally something like opkitRequest.subscriber? |
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This should be opkitRequest.id!
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opkitRequest doesn't have an id (see line 30)?
src/eligibility-check-opkit.ts
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| { | ||
| focal: true, | ||
| coverage: createReference(coverage), | ||
| businessArrangement: 'opkit-identifier1234' //If there is some kind of contract number? |
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Unfortunately the Eligibility responses from insurance companies don't expose contract numbers.
src/eligibility-check-opkit.ts
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| outcome: 'complete', | ||
| purpose: ['validation', 'benefits'], | ||
| request: createReference(coverageEligibilityRequest), | ||
| disposition: 'Policy is currently in-force.', //Won't this come from opkit? |
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Yes! I originally just hardcoded this to see if I could properly create the coverageEligibilityResponse.
Here is the additional code I would add to check for active/inforce insurance:
const isPlanActive = (opkitResult.plan.benefits) => {
const activeStatusBenefit = benefitFeatures.find(
(benefit) =>
benefit.type === "active_coverage" &&
benefit.service === "health_benefit_plan_coverage",
);
return !!activeStatusBenefit;
};
And then we could do something like
disposition: isPlanActive ? "Policy is currently in-force" : "Policy is currently not in-force";
| services: serviceTypes, | ||
| }; | ||
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| const result: any = await fetch('https://api.opkit.co/v1/eligibility_inquiries', { |
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@codyebberson - what do you think about having a convenience wrapper around medplum.post to call out to apis. Thinking it could:
- accept a mime type, but default to JSON
- do the JSON wrapping / unwrapping
- accept a param for {authType, authKey}
| in_network: 'in', | ||
| }; | ||
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| const coverageToBenefitUnitMap: Record<string, string> = { |
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Down the road, it feels like all these maps are probably good candidates for the FHIR Mapping Language functionality (or ConceptMaps, I'm not sure which)
reshmakh
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