Add CMS-0057-F compliance end-to-end demo script for HIMSS#482
Merged
aurelianware merged 2 commits intomainfrom Mar 16, 2026
Merged
Add CMS-0057-F compliance end-to-end demo script for HIMSS#482aurelianware merged 2 commits intomainfrom
aurelianware merged 2 commits intomainfrom
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Scripted demo that exercises the full CMS-0057-F compliance workflow against a running docker-compose stack: 834 enrollment, 270/271 eligibility, 278 prior auth, 837P claim submission, adjudication, FHIR Patient Access API, Provider Directory, and compliance check. Includes JSON fixture payloads in scripts/demo/fixtures/ and colored narration for live prospect demos. https://claude.ai/code/session_01GZof5oKD4pfMpXwAr3Au91
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Pull request overview
Adds a scripted, end-to-end CMS-0057-F compliance demo intended to exercise multiple Cloud Health Office services (enrollment, eligibility, prior auth, claims, adjudication, and FHIR endpoints) using local HTTP calls and JSON fixtures.
Changes:
- Added
cms-0057-f-demo.shorchestration script with narrated/colored output. - Added JSON fixture payloads for 834 enrollment, 270 eligibility, 278 authorization, 837P claim submission, and adjudication request.
Reviewed changes
Copilot reviewed 6 out of 6 changed files in this pull request and generated 14 comments.
Show a summary per file
| File | Description |
|---|---|
| scripts/demo/cms-0057-f-demo.sh | New end-to-end demo script that calls service endpoints in sequence. |
| scripts/demo/fixtures/enrollment-834.json | New sample 834 enrollment import payload. |
| scripts/demo/fixtures/eligibility-270.json | New sample 270 eligibility inquiry payload. |
| scripts/demo/fixtures/authorization-278.json | New sample 278 prior authorization request payload. |
| scripts/demo/fixtures/claim-837p.json | New sample 837P claim submission payload. |
| scripts/demo/fixtures/adjudication-request.json | New sample adjudication request payload with claim-line details. |
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| RESPONSE=$(curl -s -w "\n%{http_code}" \ | ||
| -X GET "${FHIR_URL}/fhir/r4/ExplanationOfBenefit?patient=SUB900112345" \ | ||
| -H "Accept: application/fhir+json" \ | ||
| -H "X-Tenant-ID: ${TENANT_ID}") | ||
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| "firstName": "Maria", | ||
| "lastName": "Santos", | ||
| "dateOfBirth": "19880422", |
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| { | ||
| "memberId": "SUB900112345", | ||
| "subscriberId": "SUB900112345", | ||
| "patientFirstName": "Maria", | ||
| "patientLastName": "Santos", |
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| "claimLines": [ | ||
| { | ||
| "lineNumber": 1, | ||
| "procedureCode": "99214", | ||
| "modifiers": ["25"], |
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| HTTP_CODE=$(echo "$RESPONSE" | tail -1) | ||
| BODY=$(echo "$RESPONSE" | sed '$d') | ||
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| show_response "$HTTP_CODE" "$BODY" | ||
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| "serviceProviderNPI": "1234567890", | ||
| "facilityNPI": "9876543210", | ||
| "placeOfService": "11", | ||
| "diagnosisCodes": ["M54.5", "M54.16"], |
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| RESPONSE=$(curl -s -w "\n%{http_code}" \ | ||
| -X POST "${AUTH_URL}/api/authorizations" \ | ||
| -H "Content-Type: application/json" \ | ||
| -H "X-Tenant-ID: ${TENANT_ID}" \ | ||
| -d @"${FIXTURES_DIR}/authorization-278.json") |
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| RESPONSE=$(curl -s -w "\n%{http_code}" \ | ||
| -X GET "${FHIR_URL}/fhir/r4/Practitioner/1234567890" \ | ||
| -H "Accept: application/fhir+json" \ | ||
| -H "X-Tenant-ID: ${TENANT_ID}") | ||
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| { | ||
| "memberId": "SUB900112345", | ||
| "requestingProviderNPI": "1234567890", | ||
| "requestingProviderName": "Dr. James Wilson", | ||
| "facilityNPI": "9876543210", |
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| # Prerequisites: | ||
| # - docker compose up -d (all CHO services running) | ||
| # - curl and jq installed |
…dling - Fix eligibility fixture: use subscriberFirstName/subscriberLastName/ subscriberDOB (DateTime) to match EligibilityInquiry model binding - Fix claims fixture: add required tenantId and claimNumber fields, restructure diagnosisCodes as objects with code/codeQualifier/ pointerNumber, add serviceDateFrom/serviceDateTo to claim lines, change diagnosisPointers from strings to integers - Add FHIR Bearer token auth: FHIR_TOKEN env var, Authorization header passed to all FHIR endpoint calls (steps 6-8) - Add check_response helper that halts the demo on non-2xx HTTP status to prevent later steps from executing with invalid IDs https://claude.ai/code/session_01GZof5oKD4pfMpXwAr3Au91
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Scripted demo that exercises the full CMS-0057-F compliance workflow
against a running docker-compose stack: 834 enrollment, 270/271
eligibility, 278 prior auth, 837P claim submission, adjudication,
FHIR Patient Access API, Provider Directory, and compliance check.
Includes JSON fixture payloads in scripts/demo/fixtures/ and colored
narration for live prospect demos.
https://claude.ai/code/session_01GZof5oKD4pfMpXwAr3Au91