Creating an Authorization or Referral with QNXT 3.4 SDK

When you install a QNXT EU (Execution Unit), you also get the QNXT SDK. The QNXT SDK is really just a Microsoft Word document that you will find in the \Program Files directory after the install is finished. You do not have to select anything special as part of the install process, the SDK is installed by default.

This Word document lists a series of assemblies that can be used to harness some of the functionality of the Execution Unit. This document does not go into great detail as to how to use these assemblies. Also, no code samples are provided. So you are left more or less to your own devices to figure out how to get what you need out of the SDK.

This blog post describes how we used the SDK to create authorizations/referrals using the QNXT 3.4 SDK. Near as I can tell what I am describing here is not documented anywhere else, including the TriZetto Customer Exchange Website. This is unsupported custom code, but it has passed Trizetto code review, which may not mean much to you unless you are a TriZetto Hosting customer. If you are Hosting customer, then passing code review means that TriZetto will deploy this code to your production environment.

There are two pre-requisites to get the sample code provided in this blog post to run:

1. Install the QNXT 3.4 EU locally
2. Create a QNXT User with (a) the appropriate QEnvironment added i.e. Integrated Dev and (b) with the “Authorization Assignment” role added/granted

Next, you will need to bind in the following reference assemblies to compile this code

• QCSI Globals.dll
• QCSI Internal Proxy.dll
• QCSI Messages Authorization.dll
• QCSI Messages CommonTypes.dll
• QCSI Proxy Authoriztion.dll
• QFrame Common Messages.dll

All of the above are installed into the GAC on the EU. If you are using Visual Studio to build your project, you will need to xcopy these out of the GAC first so that they will show up in your Add References wizard.

Without any further ado - here is a working unit test to create an authorization/referral using the SDK

using System;
using Q.QFrame.Messages;
using Q.Proxy;
using Q.Global;
using MbUnit.Framework;

namespace AuthPosting.Tests
{

[TestFixture]
public class AuthPostingTests
{

[Test]
public void CreateReferralTest()
{
QNXTProxy _proxy = new QNXTProxy();
if (!_proxy.InitQNXT("user", "password", "environment", "plandataAlias")) Assert.Fail();

AuthCreateUpdateRequestMessageType _request = new AuthCreateUpdateRequestMessageType();
_request.Referral = new ReferralMessageType();
_request.Referral.EnrollId = "";      // QNXT Enrollment ID
_request.Referral.MemId = "";       // QNXT Member ID
_request.Referral.ServiceCode = ""; // QNXT Template ID
_request.Referral.Cob = 0;
_request.Referral.ReferTo =""; // QNXT ReferTo Provider Id
_request.Referral.EffDate = DateTime.Today.ToString();
_request.Referral.ReferFrom = ""; // QNXT ReferFrom Provider Id
_request.Referral.Emergency = 0;
_request.Referral.ReferralDate = DateTime.Today.ToString();
_request.Referral.TransferInOut = 0;
_request.Referral.AdmitDate = DateTime.Today.ToString();
_request.Referral.IssueInitial = "webusr";
_request.Referral.DischargeDate = DateTime.Parse("2078-12-31").ToString();
_request.Referral.TermDate = DateTime.Parse("2078-12-31").ToString();
_request.Referral.PayToAffiliationId = ""; // QNXT PayTo Affiliation ID
_request.Referral.AttProvid = ""; // QNXT Attending Provider Id
_request.Referral.AppealDate = DateTime.Parse("2078-12-31").ToString();
_request.Referral.AccChg = Convert.ToDecimal(0.00);
_request.Referral.Acuity =  "Urgent";
_request.Referral.Admit = 1;
_request.Referral.AdmitDate = DateTime.Today.ToString();
_request.Referral.AdmitPhys = "";
_request.Referral.AdmtProvid = ""; // QNXT Admitting Provider Id
_request.Referral.AuthStatus = AuthStatusType.MEDREVIEW;
_request.Referral.Diagnosis = "";
_request.Referral.DisDiagnosis = "";
_request.Referral.Dispositionid = "";
_request.Referral.ProcessLogId = "";
_request.Referral.ReceiptDate = DateTime.Parse("2078-12-31").ToString();;
_request.Referral.ReferToLocation = "";
_request.Referral.ReferToPar = YesNoType.N;
_request.Referral.ReferToProvType = "";
_request.Referral.Source = ReferralMessageTypeSource.Q;
_request.Referral.DecrementType = ReferralMessageTypeDecrementType.SVC;
_request.Referral.Status = AuthStatusType.INPROCESS;

_request.Referral.ReferralText = new ReferralTextMessageType();
_request.Referral.ReferralText.Reason = _referral.Reason;

switch("Auto")
{
case "Auto":
_request.Referral.AccidentCause = ReferralMessageTypeAccidentCause.A;
break;
case "Employment":
_request.Referral.AccidentCause = ReferralMessageTypeAccidentCause.E;
break;
case "Others":
_request.Referral.AccidentCause = ReferralMessageTypeAccidentCause.O;
break;
case "No":
default:
_request.Referral.AccidentCause = ReferralMessageTypeAccidentCause.Item;
break;
}

_request.Referral.AuthDiags = new AuthDiagMessageType[1];
_request.Referral.AuthDiags[0] = new AuthDiagMessageType();
_request.Referral.AuthDiags[0].DiagCode = "100.0";
_request.Referral.AuthDiags[0].Sequence = "1";
_request.Referral.AuthDiags[0].DiagQualifier = AuthDiagMessageTypeDiagQualifier.PRINCIPAL;


AuthCreateUpdateProxy _authProxy = new AuthCreateUpdateProxy(_proxy.Session);

AuthCreateUpdateResponseMessageType _response = authProxy.ProcessMessage(_request);
}



}
}
}

Note that AuthCreateUpdateProxy() method does not perform any data validation. So if this is important to you, you will have to perform this outside of the SDK. Also, the SDK does not support:

• Adding data to custom attributes
• Creating an authorization service
• Creating an authorization alert/memo

These operations will also need to be performed outside of the SDK.

Here are is a list of some other tests we found to be useful in insuring the quality of the SDK interface:

• Add authorization with wrong or missing Member Id
• Add authorization with wrong or missing Enrollment Id
• Add authorization with wrong or missing Auth Template Id
• Add authorization with wrong or missing Refer From Provider Id
• Add authorization with wrong or missing Refer To Provider Id
• Add authorization with wrong or missing Affiliation Id
• Add authorization with wrong or missing Admitting Provider Id
• Add authorization with wrong or missing Admitting Provider Id
• Add authorization with wrong or missing Diagnosis Code
• Add duplicate authorization