refs/refs/mends-on-fhir/whistle-mappings/synthea/whistle-functions/zzPPP_CoverageImpl.wstl

 1// Change Log:
 2// 2022-09-09: Add source_concept to payor.type CodeableConcept
 3// 2022-09-09: Use plan source value as proxy for (mandatory) payor
 4// 2022-09-02: Created PPP.payor-concept-id --> Coverage.type concept map
 5
 6def PPP_CoverageImpl(PPP, context) {
 7   resourceType: "Coverage"
 8
 9// from Resource: id, meta, implicitRules, and language
10   id: PPP.payer_plan_period_id
11   meta.profile[].url: ""
12   implicitRules: ""
13   language:"en-US"
14
15// from DomainResource: text, contained, extension, and modifierExtension
16   text: ""
17   contained[]: ""
18   extension: ""
19   modifierExtension: ""
20
21// from https://www.hl7.org/fhir/coverage.html
22   identifier[]: Identifier(Identifier_System("omop-id"), PPP.payer_plan_period_id)
23   status: "active"
24
25   type: PPP_Type(PPP)
26   policyHolder: ""
27   subscriber: ""
28   subscriberId: ""
29   beneficiary: Reference("Patient",PPP.person_id)
30   dependent: ""
31   relationship: ""
32
33   if context.config.output.phi = "yes" {
34     period.start: ReformatDatetime(PPP.payer_plan_period_start_date)
35     period.end: ReformatDatetime(PPP.payer_plan_period_end_date)
36   } else {
37     period.start: ReformatDatetime("2030-01-01")
38     period.end: ReformatDatetime("2030-01-01")
39   }
40   
41
42   // MANDATORY FIELD
43   // "The program or plan underwriter or payor including both insurance and non-insurance agreements, such as patient-pay agreements"
44   // "Reference (Organization | Patient | RelatedPerson)"
45   // "Need to identify the issuer to target for claim processing and for coordination of benefit procecessing"
46   //" May provide multiple identifiers such as insurance company identifier or business identifier (BIN number)."
47   // "For selfpay it may provide multiple paying persons and/or organizations"
48   // Best approximate proxy in OMOP: plan_source_value
49
50   // Use Reference.display: PPP.plan_source_value
51   payor[].display: PPP.plan_source_value
52
53   class[]: ""
54   order: ""
55   network: ""
56   costToBeneficiary[]: ""
57   subrogation: ""
58   contract[]: ""
59}
60
61// ******* End of PPP_Coverage *************
62
63
64// *************************************************************************
65// *
66// *   All PPP-specific function calls here.
67// *   Function calls useful accross resources are in DataTypes.wstl
68// *
69// *************************************************************************
70
71def PPP_Type(PPP) {
72    $this: CodeableConceptMapNull(PPP.payer_concept_id, "PPP.payor-concept-id--Coverage.type", PPP.payer_source_value)
73        if PPP.payer_concept_id ~= PPP.payer_source_concept_id {
74           coding[]: Coding(Code_System(PPP.payer_source_vocabulary_id), "", PPP.payer_source_concept_code, PPP.payer_source_concept_name)
75        }
76}
77