feature: medicare flow with pverify

.env.example

@@ -92,3 +92,7 @@ VITE_SENTRY_PROJECT=
 # String regex without the "/". Example:
 # ^https:\/\/yourserver\.io\/api
 VITE_SENTRY_TRACE_PROPAGATION_TARGET_REGEX=
+
+PVERIFY_BASE_URL=https://api.pverify.com/API
+PVERIFY_CLIENT_API_ID=
+PVERIFY_CLIENT_SECRET=

config/services.php

@@ -39,6 +39,9 @@
         'base_url' => env('PVERIFY_BASE_URL'),
         'client_api_id' => env('PVERIFY_CLIENT_API_ID'),
         'client_secret' => env('PVERIFY_CLIENT_SECRET'),
+        'sleep_seconds' => env('PVERIFY_SLEEP_SECONDS'),
+        'provider_npi' => env('PVERIFY_PROVIDER_NPI'),
+        'provider_last_name' => env('PVERIFY_PROVIDER_LAST_NAME'),
     ],
 
     'dosespot' => [

cspell.json

@@ -32,6 +32,7 @@
     "Debugbar",
     "Dispatchable",
     "docblocks",
+    "doespots",
     "dosespot",
     "EHLO",
     "Encrypter",

phpstan.neon

@@ -20,6 +20,8 @@ parameters:
     ignoreErrors:
         - '#^PHPUnit tests are not allowed\. Please use Pest PHP instead\. If this is a TestCase, make it abstract to pass validation\.$#'
         - '#^Illuminate\\Support\\Facades\\[a-zA-Z0-9\\_]+ facade should not be used\.$#'
+        - '#^Cannot cast mixed to string\.$#'
+        - '#^Cannot cast mixed to int\.$#'
         -
             message: '#^Undefined variable: \$this$#'
             path: tests/*

routes/api.php

@@ -9,6 +9,7 @@
 use Lightit\Insurance\App\Controllers\GetAvailableDMEProvidersController;
 use Lightit\Insurance\App\Controllers\MedicareAdvantageEligibilityCheckController;
 use Lightit\Insurance\App\Controllers\MedicareEligibilityCheckController;
+use Lightit\Insurance\App\Controllers\RunEligibilityController;
 
 /*
 |--------------------------------------------------------------------------
@@ -43,3 +44,5 @@
 Route::post('/medicare-advantage/eligibility-check', MedicareAdvantageEligibilityCheckController::class);
 
 Route::get('/dme/providers', GetAvailableDMEProvidersController::class);
+
+Route::post('/eligibility', RunEligibilityController::class);

src/Backoffice/Payers/Domain/Models/Payer.php

@@ -33,6 +33,8 @@
  * @method static \Illuminate\Database\Eloquent\Builder|Payer whereDataSyncId($value)
  *
  * @property-read Datasync|null $dataSync
+ * @property-read \Illuminate\Database\Eloquent\Collection<int, PayersDMEProvider> $payerDMEProviders
+ * @property-read int|null $payer_d_m_e_providers_count
  *
  * @mixin \Eloquent
  */

src/Insurance/App/Controllers/RunEligibilityController.php

@@ -0,0 +1,24 @@
+<?php
+
+declare(strict_types=1);
+
+namespace Lightit\Insurance\App\Controllers;
+
+use Illuminate\Http\JsonResponse;
+use Lightit\Insurance\App\Request\EligibilityCheckRequest;
+use Lightit\Insurance\Domain\Actions\RunEligibilityAction;
+
+class RunEligibilityController
+{
+    public function __invoke(
+        EligibilityCheckRequest $request,
+        RunEligibilityAction $runEligibilityAction,
+    ): JsonResponse {
+        $eligibilityData = $request->toDto();
+
+        $response = $runEligibilityAction->execute($eligibilityData);
+        return responder()
+            ->success($response)
+            ->respond();
+    }
+}

src/Insurance/App/Exceptions/NotEligibleException.php

@@ -0,0 +1,24 @@
+<?php
+
+declare(strict_types=1);
+
+namespace Lightit\Insurance\App\Exceptions;
+
+use Flugg\Responder\Exceptions\Http\HttpException;
+
+class NotEligibleException extends HttpException
+{
+    /**
+     * An HTTP status code.
+     *
+     * @var int
+     */
+    protected $status = 422;
+
+    /**
+     * An error code.
+     *
+     * @var string|null
+     */
+    protected $errorCode = 'not_eligible';
+}

src/Insurance/App/Request/EligibilityCheckRequest.php

@@ -0,0 +1,75 @@
+<?php
+
+declare(strict_types=1);
+
+namespace Lightit\Insurance\App\Request;
+
+use Carbon\Carbon;
+use Illuminate\Foundation\Http\FormRequest;
+use Illuminate\Validation\Rules\Enum;
+use Lightit\Insurance\Domain\DataTransferObjects\EligibilityCheckDto;
+use Lightit\Shared\App\Enums\USState;
+
+class EligibilityCheckRequest extends FormRequest
+{
+    public const FIRST_NAME = 'first_name';
+    public const LAST_NAME = 'last_name';
+    public const DOB = 'dob';
+
+    public const STREET = 'street';
+    public const CITY = 'city';
+    public const STATE = 'state';
+    public const ZIP = 'zip';
+
+    public const PLAN_TYPE = 'plan_type';
+    public const DIABETES_TYPE = 'diabetes_type';
+    public const DIABETES_MANAGEMENT = 'diabetes_management';
+
+    /**
+     * @return array<string, mixed>
+     */
+    public function rules(): array
+    {
+        return [
+            self::FIRST_NAME => ['required', 'string'],
+            self::LAST_NAME => ['required', 'string'],
+            self::DOB => ['required', 'date'],
+
+            self::STREET => ['required', 'string'],
+            self::CITY => ['required', 'string'],
+            self::STATE => ['required', new Enum(USState::class)],
+            self::ZIP => ['required', 'string'],
+
+            self::PLAN_TYPE => ['required', 'string'],
+            self::DIABETES_TYPE => ['required', 'string'],
+        ];
+    }
+
+    protected function prepareForValidation()
+    {
+        if ($this->has('state') && is_string($this->state)) {
+            $this->merge([
+                'state' => strtoupper($this->state),
+            ]);
+        }
+    }
+
+    public function toDto(): EligibilityCheckDto
+    {
+        /** @var Carbon $dob */
+        $dob = $this->date(self::DOB);
+
+        return new EligibilityCheckDto(
+            first_name: $this->string(self::FIRST_NAME)->toString(),
+            last_name: $this->string(self::LAST_NAME)->toString(),
+            dob: $dob,
+            street: $this->string(self::STREET)->toString(),
+            city: $this->string(self::CITY)->toString(),
+            state: USState::from($this->string(self::STATE)->toString()),
+            zip: $this->string(self::ZIP)->toString(),
+            plan_type: $this->string(self::PLAN_TYPE)->toString(),
+            diabetes_type: $this->string(self::DIABETES_TYPE)->toString(),
+            diabetes_management: $this->string(self::DIABETES_MANAGEMENT)->toString(),
+        );
+    }
+}

src/Insurance/Domain/Actions/MedicareAdvantageEligibilityCheckAction.php

@@ -4,12 +4,14 @@
 
 namespace Lightit\Insurance\Domain\Actions;
 
+use Carbon\Carbon;
 use Illuminate\Support\Facades\Log;
 use Lightit\Insurance\Domain\DataTransferObjects\MedicareAdvantageEligibilityCheckDto;
 use Lightit\Insurance\Domain\DataTransferObjects\MedicareAdvantageEligibilityResponseDto;
+use Lightit\Shared\Integrations\PVerify\DataTransferObjects\EligibilitySummaryRequestDTO;
 use Lightit\Shared\Integrations\PVerify\DataTransferObjects\PVerifySubscriberDTO;
-use Lightit\Shared\Integrations\PVerify\Requests\EligibilitySummary;
-use Lightit\Shared\Integrations\PVerify\Requests\GetEligibilitySummary;
+use Lightit\Shared\Integrations\PVerify\Requests\EligibilitySummaryRequest;
+use Lightit\Shared\Integrations\PVerify\Requests\GetEligibilitySummaryResultsRequest;
 
 class MedicareAdvantageEligibilityCheckAction
 {
@@ -23,9 +25,14 @@ public function execute(
             memberID: $getAvailableDMEProvidersDto->member_id,
         );
 
-        $eligibilityRequest = new EligibilitySummary(
-            payerCode: $getAvailableDMEProvidersDto->payer,
-            subscriber: $subscriberDTO,
+        $eligibilityRequest = new EligibilitySummaryRequest(
+            new EligibilitySummaryRequestDTO(
+                firstName: $subscriberDTO->firstName,
+                lastName: $subscriberDTO->lastName,
+                dob: Carbon::parse($subscriberDTO->dob),
+                memberID: $subscriberDTO->memberID,
+                payerCode: $getAvailableDMEProvidersDto->payer,
+            )
         );
 
         $response = $eligibilityRequest->send();
@@ -37,7 +44,7 @@ public function execute(
         }
 
         sleep(5);
-        $eligibilityResultRequest = new GetEligibilitySummary(
+        $eligibilityResultRequest = new GetEligibilitySummaryResultsRequest(
             requestId: $eligibilityResponse['RequestID'],
         );
         $eligibilityResultResponse = $eligibilityResultRequest->send()->json();

src/Insurance/Domain/Actions/MedicareEligibilityCheckAction.php

@@ -4,11 +4,13 @@
 
 namespace Lightit\Insurance\Domain\Actions;
 
+use Carbon\Carbon;
 use Illuminate\Support\Facades\Log;
 use Lightit\Insurance\Domain\DataTransferObjects\MedicareEligibilityCheckDto;
 use Lightit\Insurance\Domain\DataTransferObjects\MedicareEligibilityResponseDto;
+use Lightit\Shared\Integrations\PVerify\DataTransferObjects\EligibilitySummaryRequestDTO;
 use Lightit\Shared\Integrations\PVerify\DataTransferObjects\PVerifySubscriberDTO;
-use Lightit\Shared\Integrations\PVerify\Requests\EligibilitySummary;
+use Lightit\Shared\Integrations\PVerify\Requests\EligibilitySummaryRequest;
 
 class MedicareEligibilityCheckAction
 {
@@ -24,9 +26,14 @@ public function execute(MedicareEligibilityCheckDto $getAvailableDMEProvidersDto
             memberID: $getAvailableDMEProvidersDto->member_id,
         );
 
-        $eligibilityRequest = new EligibilitySummary(
-            payerCode: self::MEDICARE_PAYER_CODE,
-            subscriber: $subscriberDTO,
+        $eligibilityRequest = new EligibilitySummaryRequest(
+            new EligibilitySummaryRequestDTO(
+                firstName: $subscriberDTO->firstName,
+                lastName: $subscriberDTO->lastName,
+                dob: Carbon::parse($subscriberDTO->dob),
+                memberID: $subscriberDTO->memberID,
+                payerCode: self::MEDICARE_PAYER_CODE,
+            )
         );
 
         $response = $eligibilityRequest->send();

src/Insurance/Domain/Actions/RunEligibilityAction.php

@@ -0,0 +1,55 @@
+<?php
+
+declare(strict_types=1);
+
+namespace Lightit\Insurance\Domain\Actions;
+
+use Illuminate\Support\Collection;
+use Illuminate\Support\Facades\Log;
+use Lightit\Insurance\Domain\DataTransferObjects\EligibilityCheckDto;
+use Lightit\Insurance\Domain\DataTransferObjects\GetAvailableDMEProvidersDto;
+use Lightit\Shared\Domain\Models\PayersDMEProvider;
+
+class RunEligibilityAction
+{
+    public function __construct(
+        private readonly RunMbiLookupAction $mbiLookupAction,
+        private readonly RunPVerifyEligibilitySummaryAction $pVerifyEligibilitySummaryAction,
+        private readonly GetAvailableDMEProvidersAction $getAvailableDMEProvidersAction,
+    ) {
+    }
+
+    /**
+     * @return Collection<int, PayersDMEProvider>
+     */
+    public function execute(EligibilityCheckDto $eligibilityCheckData): Collection
+    {
+        if ($this->isMedicare($eligibilityCheckData)) {
+            $mbiLookupResponse = $this->mbiLookupAction->execute($eligibilityCheckData);
+            $eligibilityResponse = $this->pVerifyEligibilitySummaryAction->execute(
+                $eligibilityCheckData,
+                $mbiLookupResponse
+            );
+
+            Log::info('Medicare eligible', ['response' => $eligibilityResponse]);
+
+            return $this->getAvailableDMEProvidersAction->execute(
+                new GetAvailableDMEProvidersDto(
+                    payer: $eligibilityResponse['PayerName'],
+                    state: $eligibilityCheckData->state
+                )
+            );
+        }
+
+        //medicare advantage flow
+
+        //doespots flow
+
+        return collect([]);
+    }
+
+    private function isMedicare(EligibilityCheckDto $eligibilityCheckData): bool
+    {
+        return $eligibilityCheckData->dob->diffInYears(now()) >= 65 && $eligibilityCheckData->plan_type === 'medicare';
+    }
+}

src/Insurance/Domain/Actions/RunMbiLookupAction.php

@@ -0,0 +1,33 @@
+<?php
+
+declare(strict_types=1);
+
+namespace Lightit\Insurance\Domain\Actions;
+
+use Lightit\Insurance\Domain\DataTransferObjects\EligibilityCheckDto;
+use Lightit\Insurance\Domain\DataTransferObjects\MbiLookupRequestDto;
+use Lightit\Shared\Integrations\PVerify\PVerifyConnector;
+use Lightit\Shared\Integrations\PVerify\Requests\MbiLookupRequest;
+
+class RunMbiLookupAction
+{
+    public function __construct(
+        private readonly PVerifyConnector $connector,
+    ) {
+    }
+
+    public function execute(EligibilityCheckDto $eligibilityCheckDto): array
+    {
+        $request = new MbiLookupRequest(
+            new MbiLookupRequestDto(
+                firstName: $eligibilityCheckDto->first_name,
+                lastName: $eligibilityCheckDto->last_name,
+                dob: $eligibilityCheckDto->dob,
+            )
+        );
+
+        $response = $this->connector->send($request);
+
+        return $response->json();
+    }
+}