public void InsPlan_GetPendingDisplay_LimitationsOverrideGeneralLimitations()
{
string suffix = "31";
Patient pat = PatientT.CreatePatient(suffix);
long patNum = pat.PatNum;
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
long planNum = plan.PlanNum;
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, planNum); //guarantor is subscriber
long subNum = sub.InsSubNum;
long patPlanNum = PatPlanT.CreatePatPlan(1, pat.PatNum, subNum).PatPlanNum;
BenefitT.CreateAnnualMax(planNum, 1000);
BenefitT.CreateCategoryPercent(planNum, EbenefitCategory.RoutinePreventive, 100);
BenefitT.CreateLimitation(planNum, EbenefitCategory.RoutinePreventive, 1000); //Changing this amount would affect patient portion vs ins portion. But regardless of the amount, this should prevent any pending from showing in the box, which is for general pending only.
Procedure proc = ProcedureT.CreateProcedure(pat, "D1110", ProcStat.C, "", 125); //Prophy
//Lists
List <ClaimProc> claimProcs = ClaimProcs.Refresh(pat.PatNum);
Family fam = Patients.GetFamily(patNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlans = PatPlans.Refresh(patNum);
List <Benefit> benefitList = Benefits.Refresh(patPlans, subList);
List <Procedure> ProcList = Procedures.Refresh(pat.PatNum);
Claim claim = ClaimT.CreateClaim("P", patPlans, planList, claimProcs, ProcList, pat, ProcList, benefitList, subList);//Creates the claim in the same manner as the account module, including estimates and status NotReceived.
List <ClaimProcHist> histList = ClaimProcs.GetHistList(patNum, benefitList, patPlans, planList, DateTime.Today, subList);
//Validate
Assert.AreEqual(0, InsPlans.GetPendingDisplay(histList, DateTime.Today, plan, patPlanNum, -1, patNum, subNum, benefitList));
}
///<summary>Converts a DataTable to a list of objects.</summary>
public static List <InsSub> TableToList(DataTable table)
{
List <InsSub> retVal = new List <InsSub>();
InsSub insSub;
foreach (DataRow row in table.Rows)
{
insSub = new InsSub();
insSub.InsSubNum = PIn.Long(row["InsSubNum"].ToString());
insSub.PlanNum = PIn.Long(row["PlanNum"].ToString());
insSub.Subscriber = PIn.Long(row["Subscriber"].ToString());
insSub.DateEffective = PIn.Date(row["DateEffective"].ToString());
insSub.DateTerm = PIn.Date(row["DateTerm"].ToString());
insSub.ReleaseInfo = PIn.Bool(row["ReleaseInfo"].ToString());
insSub.AssignBen = PIn.Bool(row["AssignBen"].ToString());
insSub.SubscriberID = PIn.String(row["SubscriberID"].ToString());
insSub.BenefitNotes = PIn.String(row["BenefitNotes"].ToString());
insSub.SubscNote = PIn.String(row["SubscNote"].ToString());
insSub.SecUserNumEntry = PIn.Long(row["SecUserNumEntry"].ToString());
insSub.SecDateEntry = PIn.Date(row["SecDateEntry"].ToString());
insSub.SecDateTEdit = PIn.DateT(row["SecDateTEdit"].ToString());
retVal.Add(insSub);
}
return(retVal);
}
public void InsPlan_GetInsUsedDisplay_OrthoProcsNotAffectInsUsed()
{
string suffix = "13";
Patient pat = PatientT.CreatePatient(suffix);
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, plan.PlanNum);
long subNum = sub.InsSubNum;
PatPlan patPlan = PatPlanT.CreatePatPlan(1, pat.PatNum, subNum);
BenefitT.CreateAnnualMax(plan.PlanNum, 100);
BenefitT.CreateOrthoMax(plan.PlanNum, 500);
BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Diagnostic, 100);
BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Orthodontics, 100);
Procedure proc1 = ProcedureT.CreateProcedure(pat, "D0140", ProcStat.C, "", 59); //limEx
Procedure proc2 = ProcedureT.CreateProcedure(pat, "D8090", ProcStat.C, "", 348); //Comprehensive ortho
ClaimProcT.AddInsPaid(pat.PatNum, plan.PlanNum, proc1.ProcNum, 59, subNum, 0, 0);
ClaimProcT.AddInsPaid(pat.PatNum, plan.PlanNum, proc2.ProcNum, 348, subNum, 0, 0);
//Lists
Family fam = Patients.GetFamily(pat.PatNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlans = PatPlans.Refresh(pat.PatNum);
List <Benefit> benefitList = Benefits.Refresh(patPlans, subList);
List <ClaimProcHist> histList = ClaimProcs.GetHistList(pat.PatNum, benefitList, patPlans, planList, DateTime.Today, subList);
//Validate
double insUsed = InsPlans.GetInsUsedDisplay(histList, DateTime.Today, plan.PlanNum, patPlan.PatPlanNum, -1, planList, benefitList, pat.PatNum, subNum);
Assert.AreEqual(59, insUsed);
}
///<summary>Inserts one InsSub into the database. Returns the new priKey.</summary>
public static long Insert(InsSub insSub)
{
if (DataConnection.DBtype == DatabaseType.Oracle)
{
insSub.InsSubNum = DbHelper.GetNextOracleKey("inssub", "InsSubNum");
int loopcount = 0;
while (loopcount < 100)
{
try {
return(Insert(insSub, true));
}
catch (Oracle.ManagedDataAccess.Client.OracleException ex) {
if (ex.Number == 1 && ex.Message.ToLower().Contains("unique constraint") && ex.Message.ToLower().Contains("violated"))
{
insSub.InsSubNum++;
loopcount++;
}
else
{
throw ex;
}
}
}
throw new ApplicationException("Insert failed. Could not generate primary key.");
}
else
{
return(Insert(insSub, false));
}
}
public void InsPlans_ComputeEstimatesForSubscriber_CanadianLabFees()
{
string suffix = MethodBase.GetCurrentMethod().Name;
CultureInfo curCulture = CultureInfo.CurrentCulture;
Thread.CurrentThread.CurrentCulture = new CultureInfo("en-CA"); //Canada
try {
//Create a patient and treatment plan a procedure with a lab fee.
Patient pat = PatientT.CreatePatient();
ProcedureCodeT.AddIfNotPresent("14611");
ProcedureCodeT.AddIfNotPresent("99111", isCanadianLab: true);
Procedure proc = ProcedureT.CreateProcedure(pat, "14611", ProcStat.TP, "", 250);
Procedure procLab = ProcedureT.CreateProcedure(pat, "99111", ProcStat.TP, "", 149, procNumLab: proc.ProcNum);
//Create a new primary insurance plan for this patient.
//It is important that we add the insurance plan after the procedure has already been created for this particular scenario.
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, plan.PlanNum);
PatPlan patPlan = PatPlanT.CreatePatPlan(1, pat.PatNum, sub.InsSubNum);
//Invoking ComputeEstimatesForAll() will simulate the logic of adding a new insurance plan from the Family module.
//The bug that this unit test is preventing is that a duplicate claimproc was being created for the lab fee.
//This was causing a faux line to show up when a claim was created for the procedure in question.
//It ironically doesn't matter if the procedures above are even covered by insurance because they'll get claimprocs created regardless.
InsPlans.ComputeEstimatesForSubscriber(sub.Subscriber);
//Check to see how many claimproc enteries there are for the current patient. There should only be two.
List <ClaimProc> listClaimProcs = ClaimProcs.Refresh(pat.PatNum);
Assert.AreEqual(2, listClaimProcs.Count);
}
finally {
Thread.CurrentThread.CurrentCulture = curCulture;
}
}
public void InsPlan_GetInsUsedDisplay_LimitationsOverride()
{
string suffix = "6";
Patient pat = PatientT.CreatePatient(suffix);
long patNum = pat.PatNum;
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
long planNum = plan.PlanNum;
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, planNum); //guarantor is subscriber
long subNum = sub.InsSubNum;
long patPlanNum = PatPlanT.CreatePatPlan(1, pat.PatNum, subNum).PatPlanNum;
BenefitT.CreateAnnualMax(planNum, 1000);
BenefitT.CreateLimitation(planNum, EbenefitCategory.Diagnostic, 1000);
Procedure proc = ProcedureT.CreateProcedure(pat, "D0120", ProcStat.C, "", 50); //An exam
long procNum = proc.ProcNum;
Procedure proc2 = ProcedureT.CreateProcedure(pat, "D2750", ProcStat.C, "8", 830); //create a crown
ClaimProcT.AddInsPaid(patNum, planNum, procNum, 50, subNum, 0, 0);
ClaimProcT.AddInsPaid(patNum, planNum, proc2.ProcNum, 400, subNum, 0, 0);
//Lists
Family fam = Patients.GetFamily(patNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlans = PatPlans.Refresh(patNum);
List <Benefit> benefitList = Benefits.Refresh(patPlans, subList);
List <ClaimProcHist> histList = ClaimProcs.GetHistList(patNum, benefitList, patPlans, planList, DateTime.Today, subList);
//Validate
double insUsed = InsPlans.GetInsUsedDisplay(histList, DateTime.Today, planNum, patPlanNum, -1, planList, benefitList, patNum, subNum);
Assert.AreEqual(400, insUsed);
}
///<summary></summary>
public FormInsPlanSelect(long patNum)
{
InitializeComponent();
PatNum = patNum;
//usage: eg. from coverage. Since can be totally new subscriber, get all plans for them.
FamCur = Patients.GetFamily(PatNum);
PatCur = FamCur.GetPatient(PatNum);
SubList = InsSubs.RefreshForFam(FamCur);
PlanList = InsPlans.RefreshForSubList(SubList);
_listPatCurPatPlans = PatPlans.Refresh(PatNum);
if (_listPatCurPatPlans.Count == 1)
{
try {
PatRelat = _listPatCurPatPlans[0].Relationship;
SelectedSub = SubList.FirstOrDefault(x => x.InsSubNum == _listPatCurPatPlans[0].InsSubNum);
SelectedPlan = InsPlans.GetPlan(SelectedSub.PlanNum, PlanList);
if (SelectedSub == null || SelectedPlan == null)
{
throw new ApplicationException();
}
}
catch {
PatRelat = 0;
SelectedSub = null;
SelectedPlan = null;
}
}
//tbPlans.CellDoubleClicked += new OpenDental.ContrTable.CellEventHandler(tbPlans_CellDoubleClicked);
Lan.F(this);
}
public void X834_ImportInsurancePlans_ReplacePatPlan()
{
Patient pat = Createx834Patient();
string suffix = MethodBase.GetCurrentMethod().Name;
//Create old insurance plan and associate it to them.
InsuranceInfo insuranceOld = InsuranceT.AddInsurance(pat, "Old Carrier" + suffix);
//Create x834
X834 x834 = new X834(new X12object(Properties.Resources.x834Test));
int createdPatsCount, updatedPatsCount, skippedPatsCount, createdCarrierCount, createdInsPlanCount, updatedInsPlanCount, createdInsSubCount,
updatedInsSubCount, createdPatPlanCount, droppedPatPlanCount, updatedPatPlanCount;
StringBuilder sbErrorMessages;
//Pass in true for dropExistingInsurance
EtransL.ImportInsurancePlans(x834, new List <Patient> {
pat
}, true, true, out createdPatsCount,
out updatedPatsCount, out skippedPatsCount, out createdCarrierCount, out createdInsPlanCount, out updatedInsPlanCount, out createdInsSubCount,
out updatedInsSubCount, out createdPatPlanCount, out droppedPatPlanCount, out updatedPatPlanCount, out sbErrorMessages);
//Get the pat plans for this patient from the database.
List <PatPlan> listPatPlans = PatPlans.GetPatPlansForPat(pat.PatNum);
Assert.AreEqual(1, listPatPlans.Count);
Assert.AreEqual(1, droppedPatPlanCount);
InsSub subForPatPlan = InsSubs.GetOne(listPatPlans[0].InsSubNum);
//These should be different as a new plan was created and the old plan was dropped.
Assert.AreNotEqual(insuranceOld.PriInsPlan.PlanNum, subForPatPlan.PlanNum);
}
public static InsPlan GetPlanForPriSecMed(PriSecMed priSecMed, List <PatPlan> listPatPlans, List <InsPlan> listPlans, List <InsSub> listSubs)
{
long subNum = PatPlans.GetInsSubNum(listPatPlans, PatPlans.GetOrdinal(priSecMed, listPatPlans, listPlans, listSubs));
InsSub sub = InsSubs.GetSub(subNum, listSubs);
return(InsPlans.GetPlan(sub.PlanNum, listPlans));
}
///<summary>Updates one InsSub in the database.</summary>
public static void Update(InsSub insSub)
{
string command = "UPDATE inssub SET "
+ "PlanNum = " + POut.Long(insSub.PlanNum) + ", "
+ "Subscriber = " + POut.Long(insSub.Subscriber) + ", "
+ "DateEffective = " + POut.Date(insSub.DateEffective) + ", "
+ "DateTerm = " + POut.Date(insSub.DateTerm) + ", "
+ "ReleaseInfo = " + POut.Bool(insSub.ReleaseInfo) + ", "
+ "AssignBen = " + POut.Bool(insSub.AssignBen) + ", "
+ "SubscriberID = '" + POut.String(insSub.SubscriberID) + "', "
+ "BenefitNotes = " + DbHelper.ParamChar + "paramBenefitNotes, "
+ "SubscNote = " + DbHelper.ParamChar + "paramSubscNote "
//SecUserNumEntry excluded from update
//SecDateEntry not allowed to change
//SecDateTEdit can only be set by MySQL
+ "WHERE InsSubNum = " + POut.Long(insSub.InsSubNum);
if (insSub.BenefitNotes == null)
{
insSub.BenefitNotes = "";
}
OdSqlParameter paramBenefitNotes = new OdSqlParameter("paramBenefitNotes", OdDbType.Text, POut.StringParam(insSub.BenefitNotes));
if (insSub.SubscNote == null)
{
insSub.SubscNote = "";
}
OdSqlParameter paramSubscNote = new OdSqlParameter("paramSubscNote", OdDbType.Text, POut.StringParam(insSub.SubscNote));
Db.NonQ(command, paramBenefitNotes, paramSubscNote);
}
public static string RunFour(bool showForms)
{
string retVal = "";
long provNum = ProviderC.ListShort[1].ProvNum; //dentist #2
Patient pat = Patients.GetPat(PatientTC.PatNum6); //patient#6
if (pat.PriProv != provNum)
{
Patient oldPat = pat.Copy();
pat.PriProv = provNum; //this script uses the primary provider for the patient
Patients.Update(pat, oldPat);
}
PatPlan patplan = PatPlans.GetPatPlan(pat.PatNum, 1);
InsSub sub = InsSubs.GetOne(patplan.InsSubNum);
InsPlan plan = InsPlans.GetPlan(sub.PlanNum, new List <InsPlan>());
long etransNum = CanadianOutput.SendElegibility(pat.PatNum, plan, new DateTime(1999, 1, 1), patplan.Relationship, patplan.PatID, showForms, sub);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseStatus = formData.GetValue("G05");
if (responseStatus != "M")
{
throw new Exception("Should be M");
}
retVal += "Eligibility #4 successful.\r\n";
return(retVal);
}
public static InsuranceInfo AddInsurance(Patient pat, string carrierName, string planType = "", long feeSchedNum = 0, int ordinal = 1, bool isMedical = false,
EnumCobRule cobRule = EnumCobRule.Basic, long copayFeeSchedNum = 0)
{
Carrier carrier = CarrierT.CreateCarrier(carrierName);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum, cobRule);
InsPlan planOld = plan.Copy();
plan.PlanType = planType;
plan.FeeSched = feeSchedNum;
plan.IsMedical = isMedical;
plan.CopayFeeSched = copayFeeSchedNum;
InsPlans.Update(plan, planOld);
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, plan.PlanNum);
PatPlan patPlan = PatPlanT.CreatePatPlan((byte)ordinal, pat.PatNum, sub.InsSubNum);
return(new InsuranceInfo {
ListCarriers = new List <Carrier> {
carrier
},
ListInsPlans = new List <InsPlan> {
plan
},
ListInsSubs = new List <InsSub> {
sub
},
ListPatPlans = new List <PatPlan> {
patPlan
},
});
}
public static string RunOne(bool showForms)
{
string retVal = "";
long provNum = ProviderC.ListShort[0].ProvNum; //dentist #1
Patient pat = Patients.GetPat(PatientTC.PatNum1); //patient#1
if (pat.PriProv != provNum)
{
Patient oldPat = pat.Copy();
pat.PriProv = provNum; //this script uses the primary provider for the patient
Patients.Update(pat, oldPat);
}
PatPlan patplan = PatPlans.GetPatPlan(pat.PatNum, 1);
InsSub sub = InsSubs.GetOne(patplan.InsSubNum);
InsPlan plan = InsPlans.GetPlan(sub.PlanNum, new List <InsPlan>());
//the UI would block this due to carrier not supporting this transaction type.
Clearinghouse clearinghouseHq = Clearinghouses.GetDefaultDental();
Clearinghouse clearinghouseClin = Clearinghouses.OverrideFields(clearinghouseHq, Clinics.ClinicNum);
long etransNum = CanadianOutput.SendElegibility(clearinghouseClin, pat.PatNum, plan, new DateTime(1999, 1, 1), patplan.Relationship, patplan.PatID, showForms, sub);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseStatus = formData.GetValue("G05");
if (responseStatus != "R")
{
throw new Exception("Should be R");
}
retVal += "Eligibility #1 successful.\r\n";
return(retVal);
}
///<summary>Inserts one InsSub into the database. Provides option to use the existing priKey.</summary>
internal static long Insert(InsSub insSub,bool useExistingPK)
{
if(!useExistingPK && PrefC.RandomKeys) {
insSub.InsSubNum=ReplicationServers.GetKey("inssub","InsSubNum");
}
string command="INSERT INTO inssub (";
if(useExistingPK || PrefC.RandomKeys) {
command+="InsSubNum,";
}
command+="PlanNum,Subscriber,DateEffective,DateTerm,ReleaseInfo,AssignBen,SubscriberID,BenefitNotes,SubscNote) VALUES(";
if(useExistingPK || PrefC.RandomKeys) {
command+=POut.Long(insSub.InsSubNum)+",";
}
command+=
POut.Long (insSub.PlanNum)+","
+ POut.Long (insSub.Subscriber)+","
+ POut.Date (insSub.DateEffective)+","
+ POut.Date (insSub.DateTerm)+","
+ POut.Bool (insSub.ReleaseInfo)+","
+ POut.Bool (insSub.AssignBen)+","
+"'"+POut.String(insSub.SubscriberID)+"',"
+DbHelper.ParamChar+"paramBenefitNotes,"
+"'"+POut.String(insSub.SubscNote)+"')";
if(insSub.BenefitNotes==null) {
insSub.BenefitNotes="";
}
OdSqlParameter paramBenefitNotes=new OdSqlParameter("paramBenefitNotes",OdDbType.Text,insSub.BenefitNotes);
if(useExistingPK || PrefC.RandomKeys) {
Db.NonQ(command,paramBenefitNotes);
}
else {
insSub.InsSubNum=Db.NonQ(command,true,paramBenefitNotes);
}
return insSub.InsSubNum;
}
public void PaymentEdit_Init_AutoSplitWithClaimPayments() //Legacy_TestFortyEight
{
string suffix = "48";
Patient pat = PatientT.CreatePatient(suffix);
long patNum = pat.PatNum;
InsPlan insPlan = InsPlanT.CreateInsPlan(CarrierT.CreateCarrier(suffix).CarrierNum);
InsSub insSub = InsSubT.CreateInsSub(patNum, insPlan.PlanNum);
PatPlan patPlan = PatPlanT.CreatePatPlan(1, patNum, insSub.InsSubNum);
Procedure procedure1 = ProcedureT.CreateProcedure(pat, "D1110", ProcStat.C, "", 50, DateTime.Now.AddDays(-1));
Procedure procedure2 = ProcedureT.CreateProcedure(pat, "D0120", ProcStat.C, "", 40, DateTime.Now.AddDays(-2));
Procedure procedure3 = ProcedureT.CreateProcedure(pat, "D0220", ProcStat.C, "", 60, DateTime.Now.AddDays(-3));
ClaimProcT.AddInsPaid(patNum, insPlan.PlanNum, procedure1.ProcNum, 20, insSub.InsSubNum, 0, 0);
ClaimProcT.AddInsPaid(patNum, insPlan.PlanNum, procedure2.ProcNum, 5, insSub.InsSubNum, 5, 0);
ClaimProcT.AddInsPaid(patNum, insPlan.PlanNum, procedure3.ProcNum, 20, insSub.InsSubNum, 0, 10);
Payment payment = PaymentT.MakePaymentNoSplits(patNum, 150, DateTime.Today);
Family famForPat = Patients.GetFamily(patNum);
List <Patient> listFamForPat = famForPat.ListPats.ToList();
PaymentEdit.InitData init = PaymentEdit.Init(listFamForPat, famForPat, new Family {
}, payment, new List <PaySplit>(), new List <Procedure>(), patNum);
//Auto Splits will be in opposite order from least recent to most recent.
//ListSplitsCur should contain four splits, 30, 35, and 30, then one unallocated for the remainder of the payment 55.
Assert.AreEqual(4, init.AutoSplitData.ListSplitsCur.Count);
Assert.IsFalse(init.AutoSplitData.ListSplitsCur[0].SplitAmt != 40 || init.AutoSplitData.ListSplitsCur[0].ProcNum != procedure3.ProcNum ||
init.AutoSplitData.ListSplitsCur[0].PatNum != patNum);
Assert.IsFalse(init.AutoSplitData.ListSplitsCur[1].SplitAmt != 35 || init.AutoSplitData.ListSplitsCur[1].ProcNum != procedure2.ProcNum ||
init.AutoSplitData.ListSplitsCur[1].PatNum != patNum);
Assert.IsFalse(init.AutoSplitData.ListSplitsCur[2].SplitAmt != 30 || init.AutoSplitData.ListSplitsCur[2].ProcNum != procedure1.ProcNum ||
init.AutoSplitData.ListSplitsCur[2].PatNum != patNum);
Assert.IsFalse(init.AutoSplitData.ListSplitsCur[3].SplitAmt != 45 || init.AutoSplitData.ListSplitsCur[3].ProcNum != 0);
}
///<summary>Inserts one InsSub into the database. Returns the new priKey.</summary>
internal static long Insert(InsSub insSub)
{
if(DataConnection.DBtype==DatabaseType.Oracle) {
insSub.InsSubNum=DbHelper.GetNextOracleKey("inssub","InsSubNum");
int loopcount=0;
while(loopcount<100){
try {
return Insert(insSub,true);
}
catch(Oracle.DataAccess.Client.OracleException ex){
if(ex.Number==1 && ex.Message.ToLower().Contains("unique constraint") && ex.Message.ToLower().Contains("violated")){
insSub.InsSubNum++;
loopcount++;
}
else{
throw ex;
}
}
}
throw new ApplicationException("Insert failed. Could not generate primary key.");
}
else {
return Insert(insSub,false);
}
}
//1. Find claiprocs for current plan
//2. Find EO and C procs for claimprocs on current plan
//3. Only have procs on this insplan that are EO and C
//4. Fill in date info based on EO or C proc list
//5. On OK click, fetch all claimprocs for EO and C procs
//5a. Date filled, no matching EO or C proc - User entered date themselves, make new proc with claimproc status inshist
//5b. Date filled, matching EO or C proc and user changed the date.-
//Modify proc and claimproc for that category ONLY if the proc has a status of EO to be the date specified
//If the proc has a status of C and the new date is greater than the the current ProcDate, create a new EO procedure and InsHist ClaimProc with the new date entered.
//5c. No date, no proc - Do nothing
//5d. No date, matching EO or C proc - User erased the date, delete proc/claimproc ONLY if proc has a status of EO.
public FormInsHistSetup(long patNum, InsSub insSub)
{
InitializeComponent();
Lan.F(this);
_patCur = Patients.GetPat(patNum);
_insSubCur = insSub;
_dictInsHistProcs = Procedures.GetDictInsHistProcs(patNum, insSub.InsSubNum, out _listClaimProcsForInsHistProcs);
}
private static Claim CreatePredetermination(Patient pat, List <Procedure> procList, long provTreat)
{
Family fam = Patients.GetFamily(pat.PatNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlanList = PatPlans.Refresh(pat.PatNum);
List <Benefit> benefitList = Benefits.Refresh(patPlanList, subList);
List <ClaimProc> claimProcList = ClaimProcs.Refresh(pat.PatNum);
List <Procedure> procsForPat = Procedures.Refresh(pat.PatNum);
InsSub sub = InsSubs.GetSub(PatPlans.GetInsSubNum(patPlanList, 1), subList);
InsPlan insPlan = InsPlans.GetPlan(sub.PlanNum, planList);
Claim claim = new Claim();
Claims.Insert(claim); //to retreive a key for new Claim.ClaimNum
claim.PatNum = pat.PatNum;
claim.DateService = procList[0].ProcDate;
claim.DateSent = DateTime.Today;
claim.ClaimStatus = "W";
claim.InsSubNum = PatPlans.GetInsSubNum(patPlanList, 1);
claim.InsSubNum2 = PatPlans.GetInsSubNum(patPlanList, 2);
InsSub sub1 = InsSubs.GetSub(claim.InsSubNum, subList);
InsSub sub2 = InsSubs.GetSub(claim.InsSubNum, subList);
claim.PlanNum = sub1.PlanNum;
claim.PlanNum2 = sub2.PlanNum;
claim.PatRelat = PatPlans.GetRelat(patPlanList, 1);
claim.PatRelat2 = PatPlans.GetRelat(patPlanList, 2);
claim.ClaimType = "PreAuth";
claim.ProvTreat = provTreat;
claim.IsProsthesis = "N";
claim.ProvBill = Providers.GetBillingProvNum(claim.ProvTreat, 0);
claim.EmployRelated = YN.No;
ClaimProc cp;
List <Procedure> procListClaim = new List <Procedure>(); //this list will exclude lab fees
for (int i = 0; i < procList.Count; i++)
{
if (procList[i].ProcNumLab == 0)
{
procListClaim.Add(procList[i]);
}
}
for (int i = 0; i < procListClaim.Count; i++)
{
cp = new ClaimProc();
ClaimProcs.CreateEst(cp, procListClaim[i], insPlan, sub);
cp.ClaimNum = claim.ClaimNum;
cp.Status = ClaimProcStatus.NotReceived;
cp.CodeSent = ProcedureCodes.GetProcCode(procListClaim[i].CodeNum).ProcCode;
cp.LineNumber = (byte)(i + 1);
ClaimProcs.Update(cp);
}
claimProcList = ClaimProcs.Refresh(pat.PatNum);
ClaimL.CalculateAndUpdate(procsForPat, planList, claim, patPlanList, benefitList, pat.Age, subList);
return(claim);
}
///<summary></summary>
public static InsSub CreateInsSub(long subscriberNum, long planNum, string subscriberID = "1234")
{
InsSub sub = new InsSub();
sub.Subscriber = subscriberNum;
sub.PlanNum = planNum;
sub.SubscriberID = subscriberID;
InsSubs.Insert(sub);
return(sub);
}
public void X271_EB271_SetInsuranceHistoryDates()
{
Patient pat = PatientT.CreatePatient(lName: "Doe", fName: "John");
Carrier carrier = CarrierT.CreateCarrier("X271Test");
InsPlan insPlan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
InsSub insSub = InsSubT.CreateInsSub(pat.PatNum, insPlan.PlanNum);
List <EB271> listEb = _x271.GetListEB(true, carrier.IsCoinsuranceInverted);
int countValidInsHist = EB271.SetInsuranceHistoryDates(listEb, pat.PatNum, insSub);
Assert.AreEqual(3, countValidInsHist); //There are 4 valid fields but 1 has an invalid date.
}
public static void SetAssignBen(bool assignBen, long subNum)
{
InsSub sub = InsSubs.GetOne(subNum);
if (sub.AssignBen == assignBen)
{
return; //no change needed
}
sub.AssignBen = assignBen;
InsSubs.Update(sub);
}
///<summary>Inserts one InsSub into the database. Provides option to use the existing priKey. Doesn't use the cache.</summary>
public static long InsertNoCache(InsSub insSub, bool useExistingPK)
{
bool isRandomKeys = Prefs.GetBoolNoCache(PrefName.RandomPrimaryKeys);
string command = "INSERT INTO inssub (";
if (!useExistingPK && isRandomKeys)
{
insSub.InsSubNum = ReplicationServers.GetKeyNoCache("inssub", "InsSubNum");
}
if (isRandomKeys || useExistingPK)
{
command += "InsSubNum,";
}
command += "PlanNum,Subscriber,DateEffective,DateTerm,ReleaseInfo,AssignBen,SubscriberID,BenefitNotes,SubscNote,SecUserNumEntry,SecDateEntry) VALUES(";
if (isRandomKeys || useExistingPK)
{
command += POut.Long(insSub.InsSubNum) + ",";
}
command +=
POut.Long(insSub.PlanNum) + ","
+ POut.Long(insSub.Subscriber) + ","
+ POut.Date(insSub.DateEffective) + ","
+ POut.Date(insSub.DateTerm) + ","
+ POut.Bool(insSub.ReleaseInfo) + ","
+ POut.Bool(insSub.AssignBen) + ","
+ "'" + POut.String(insSub.SubscriberID) + "',"
+ DbHelper.ParamChar + "paramBenefitNotes,"
+ DbHelper.ParamChar + "paramSubscNote,"
+ POut.Long(insSub.SecUserNumEntry) + ","
+ DbHelper.Now() + ")";
//SecDateTEdit can only be set by MySQL
if (insSub.BenefitNotes == null)
{
insSub.BenefitNotes = "";
}
OdSqlParameter paramBenefitNotes = new OdSqlParameter("paramBenefitNotes", OdDbType.Text, POut.StringParam(insSub.BenefitNotes));
if (insSub.SubscNote == null)
{
insSub.SubscNote = "";
}
OdSqlParameter paramSubscNote = new OdSqlParameter("paramSubscNote", OdDbType.Text, POut.StringParam(insSub.SubscNote));
if (useExistingPK || isRandomKeys)
{
Db.NonQ(command, paramBenefitNotes, paramSubscNote);
}
else
{
insSub.InsSubNum = Db.NonQ(command, true, "InsSubNum", "insSub", paramBenefitNotes, paramSubscNote);
}
return(insSub.InsSubNum);
}
private void gridMain_CellDoubleClick(object sender, OpenDental.UI.ODGridClickEventArgs e)
{
if (listRelat.SelectedIndex == -1)
{
MessageBox.Show(Lan.g(this, "Please select a relationship first."));
return;
}
PatRelat = (Relat)listRelat.SelectedIndex;
SelectedSub = (InsSub)gridMain.ListGridRows[e.Row].Tag;
SelectedPlan = InsPlans.GetPlan(SelectedSub.PlanNum, PlanList);
DialogResult = DialogResult.OK;
}
///<summary>Inserts one InsSub into the database. Returns the new priKey. Doesn't use the cache.</summary>
public static long InsertNoCache(InsSub insSub)
{
if (DataConnection.DBtype == DatabaseType.MySql)
{
return(InsertNoCache(insSub, false));
}
else
{
if (DataConnection.DBtype == DatabaseType.Oracle)
{
insSub.InsSubNum = DbHelper.GetNextOracleKey("inssub", "InsSubNum"); //Cacheless method
}
return(InsertNoCache(insSub, true));
}
}
public void InsPlan_GetDedRemainDisplay_IndividualAndFamilyDeductiblesInsRemaining()
{
string suffix = "20";
Patient pat = PatientT.CreatePatient(suffix); //guarantor
long patNum = pat.PatNum;
Patient pat2 = PatientT.CreatePatient(suffix);
PatientT.SetGuarantor(pat2, pat.PatNum);
Patient pat3 = PatientT.CreatePatient(suffix);
PatientT.SetGuarantor(pat3, pat.PatNum);
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
long planNum = plan.PlanNum;
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, planNum); //guarantor is subscriber
long subNum = sub.InsSubNum;
PatPlan patPlan = PatPlanT.CreatePatPlan(1, pat.PatNum, subNum); //all three patients have the same plan
PatPlan patPlan2 = PatPlanT.CreatePatPlan(1, pat2.PatNum, subNum); //all three patients have the same plan
PatPlan patPlan3 = PatPlanT.CreatePatPlan(1, pat3.PatNum, subNum); //all three patients have the same plan
BenefitT.CreateDeductibleGeneral(planNum, BenefitCoverageLevel.Individual, 75);
BenefitT.CreateDeductibleGeneral(planNum, BenefitCoverageLevel.Family, 150);
ClaimProcT.AddInsUsedAdjustment(pat3.PatNum, planNum, 0, subNum, 75); //Adjustment goes on the third patient
Procedure proc = ProcedureT.CreateProcedure(pat2, "D2750", ProcStat.C, "20", 1280); //proc for second patient with a deductible already applied.
ClaimProcT.AddInsPaid(pat2.PatNum, planNum, proc.ProcNum, 304, subNum, 50, 597);
proc = ProcedureT.CreateProcedure(pat, "D4355", ProcStat.TP, "", 135); //proc is for the first patient
long procNum = proc.ProcNum;
//Lists
List <ClaimProc> claimProcs = ClaimProcs.Refresh(patNum);
Family fam = Patients.GetFamily(patNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlans = PatPlans.Refresh(patNum);
List <Benefit> benefitList = Benefits.Refresh(patPlans, subList);
List <ClaimProcHist> histList = ClaimProcs.GetHistList(patNum, benefitList, patPlans, planList, DateTime.Today, subList);
List <ClaimProcHist> loopList = new List <ClaimProcHist>();
//Validate
List <ClaimProcHist> HistList = ClaimProcs.GetHistList(pat.PatNum, benefitList, patPlans, planList, DateTime.Today, subList);
double dedFam = Benefits.GetDeductGeneralDisplay(benefitList, planNum, patPlan.PatPlanNum, BenefitCoverageLevel.Family);
double ded = Benefits.GetDeductGeneralDisplay(benefitList, planNum, patPlan.PatPlanNum, BenefitCoverageLevel.Individual);
double dedRem = InsPlans.GetDedRemainDisplay(HistList, DateTime.Today, planNum, patPlan.PatPlanNum, -1, planList, pat.PatNum, ded, dedFam); //test family and individual deductible together
Assert.AreEqual(25, dedRem);
dedRem = InsPlans.GetDedRemainDisplay(HistList, DateTime.Today, planNum, patPlan.PatPlanNum, -1, planList, pat.PatNum, ded, -1); //test individual deductible by itself
Assert.AreEqual(75, dedRem);
}
private void pd_PrintPage(object sender, System.Drawing.Printing.PrintPageEventArgs e)
{
Rectangle bounds = e.MarginBounds;
//new Rectangle(50,40,800,1035);//Some printers can handle up to 1042
Graphics g = e.Graphics;
string text;
Font headingFont = new Font("Arial", 12, FontStyle.Bold);
Font subHeadingFont = new Font("Arial", 10, FontStyle.Bold);
int yPos = bounds.Top;
int center = bounds.X + bounds.Width / 2;
#region printHeading
if (!headingPrinted)
{
text = Lan.g(this, "Electronic Benefits Response");
g.DrawString(text, headingFont, Brushes.Black, center - g.MeasureString(text, headingFont).Width / 2, yPos);
yPos += (int)g.MeasureString(text, headingFont).Height;
InsSub sub = InsSubs.GetSub(this.SubNum, new List <InsSub>());
InsPlan plan = InsPlans.GetPlan(this.PlanNum, new List <InsPlan>());
Patient subsc = Patients.GetPat(sub.Subscriber);
text = Lan.g(this, "Subscriber: ") + subsc.GetNameFL();
g.DrawString(text, subHeadingFont, Brushes.Black, center - g.MeasureString(text, subHeadingFont).Width / 2, yPos);
yPos += (int)g.MeasureString(text, subHeadingFont).Height;
Carrier carrier = Carriers.GetCarrier(plan.CarrierNum);
if (carrier.CarrierNum != 0) //not corrupted
{
text = carrier.CarrierName;
g.DrawString(text, subHeadingFont, Brushes.Black, center - g.MeasureString(text, subHeadingFont).Width / 2, yPos);
}
yPos += 20;
headingPrinted = true;
headingPrintH = yPos;
}
#endregion
yPos = gridMain.PrintPage(g, pagesPrinted, bounds, headingPrintH);
pagesPrinted++;
if (yPos == -1)
{
e.HasMorePages = true;
}
else
{
e.HasMorePages = false;
}
g.Dispose();
}
public void Claims_CalculateAndUpdate_ProcedureCodeDowngradeHigherFee()
{
string suffix = "61";
Patient pat = PatientT.CreatePatient(suffix);
long ucrFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "UCR Fees" + suffix);
long ppoFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "PPO Downgrades" + suffix);
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, plan.PlanNum);
long subNum = sub.InsSubNum;
BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Restorative, 100);
PatPlanT.CreatePatPlan(1, pat.PatNum, subNum);
ProcedureCode originalProcCode = ProcedureCodes.GetProcCode("D2391");
ProcedureCode downgradeProcCode = ProcedureCodes.GetProcCode("D2140");
originalProcCode.SubstitutionCode = "D2140";
originalProcCode.SubstOnlyIf = SubstitutionCondition.Always;
ProcedureCodes.Update(originalProcCode);
FeeT.CreateFee(ucrFeeSchedNum, originalProcCode.CodeNum, 140);
FeeT.CreateFee(ucrFeeSchedNum, downgradeProcCode.CodeNum, 120);
FeeT.CreateFee(ppoFeeSchedNum, originalProcCode.CodeNum, 80);
FeeT.CreateFee(ppoFeeSchedNum, downgradeProcCode.CodeNum, 100);
Procedure proc = ProcedureT.CreateProcedure(pat, "D2391", ProcStat.C, "1", 140);//Tooth 1
List <ClaimProc> claimProcs = ClaimProcs.Refresh(pat.PatNum);
List <ClaimProc> claimProcListOld = new List <ClaimProc>();
Family fam = Patients.GetFamily(pat.PatNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlans = PatPlans.Refresh(pat.PatNum);
List <Benefit> benefitList = Benefits.Refresh(patPlans, subList);
List <Procedure> ProcList = Procedures.Refresh(pat.PatNum);
InsPlan insPlan = planList[0];//Should only be one
InsPlan planOld = insPlan.Copy();
insPlan.PlanType = "p";
insPlan.FeeSched = ppoFeeSchedNum;
InsPlans.Update(insPlan, planOld);
//Creates the claim in the same manner as the account module, including estimates.
Claim claim = ClaimT.CreateClaim("P", patPlans, planList, claimProcs, ProcList, pat, ProcList, benefitList, subList);
ClaimProc clProc = ClaimProcs.Refresh(pat.PatNum)[0]; //Should only be one
Assert.AreEqual(80, clProc.InsEstTotal);
Assert.AreEqual(60, clProc.WriteOff);
}
private PatPlan InsertOrUpdatePatPlan(PatPlan patPlan, InsSub insSub, InsPlan insPlan, Hx834_Member member,
Carrier carrier, List <PatPlan> listOtherPatPlans)
{
if (patPlan == null)
{
patPlan = new PatPlan();
patPlan.Ordinal = 0;
for (int p = 0; p < listOtherPatPlans.Count; p++)
{
if (listOtherPatPlans[p].Ordinal > patPlan.Ordinal)
{
patPlan.Ordinal = listOtherPatPlans[p].Ordinal;
}
}
patPlan.Ordinal++; //Greatest ordinal for patient.
patPlan.PatNum = member.Pat.PatNum;
patPlan.InsSubNum = insSub.InsSubNum;
patPlan.Relationship = member.PlanRelat;
if (member.PlanRelat != Relat.Self)
{
//This is not needed yet. If we do this in the future, then we need to mimic the Move tool in the Family module.
//member.Pat.Guarantor=insSubMatch.Subscriber;
//Patient memberPatOld=member.Pat.Copy();
//Patients.Update(member.Pat,memberPatOld);
}
PatPlans.Insert(patPlan);
SecurityLogs.MakeLogEntry(Permissions.InsPlanAddPat, patPlan.PatNum,
"Insurance plan added to patient for carrier '" + carrier.CarrierName + "' and groupnum "
+ "'" + insPlan.GroupNum + "' and subscriber ID '" + insSub.SubscriberID + "' "
+ "from Import Ins Plans 834.", insPlan.PlanNum, LogSources.InsPlanImport834, insPlan.SecDateTEdit);
}
else
{
PatPlan patPlanOld = patPlan.Copy();
patPlan.Relationship = member.PlanRelat;
if (OpenDentBusiness.Crud.PatPlanCrud.UpdateComparison(patPlan, patPlanOld))
{
SecurityLogs.MakeLogEntry(Permissions.InsPlanEdit, patPlan.PatNum, "Insurance plan relationship changed from "
+ member.PlanRelat + " to " + patPlan.Relationship + " for carrier '" + carrier.CarrierName + "' and groupnum "
+ "'" + insPlan.GroupNum + "' from Import Ins Plans 834.", insPlan.PlanNum, LogSources.InsPlanImport834, insPlan.SecDateTEdit);
PatPlans.Update(patPlan);
}
}
return(patPlan);
}
public static string Run(int scriptNum, string responseExpected, Claim claim)
{
string retVal = "";
InsPlan insPlan = InsPlans.GetPlan(claim.PlanNum, null);
InsSub insSub = InsSubs.GetOne(claim.InsSubNum);
long etransNum = CanadianOutput.SendClaimReversal(claim, insPlan, insSub);
Etrans etrans = Etranss.GetEtrans(etransNum);
string message = EtransMessageTexts.GetMessageText(etrans.EtransMessageTextNum);
CCDFieldInputter formData = new CCDFieldInputter(message);
string responseStatus = formData.GetValue("G05");
if (responseStatus != responseExpected)
{
return("G05 should be " + responseExpected + "\r\n");
}
retVal += "Reversal #" + scriptNum.ToString() + " successful.\r\n";
return(retVal);
}
///<summary>Inserts one InsSub into the database. Provides option to use the existing priKey.</summary>
public static long Insert(InsSub insSub, bool useExistingPK)
{
if (!useExistingPK && PrefC.RandomKeys)
{
insSub.InsSubNum = ReplicationServers.GetKey("inssub", "InsSubNum");
}
string command = "INSERT INTO inssub (";
if (useExistingPK || PrefC.RandomKeys)
{
command += "InsSubNum,";
}
command += "PlanNum,Subscriber,DateEffective,DateTerm,ReleaseInfo,AssignBen,SubscriberID,BenefitNotes,SubscNote) VALUES(";
if (useExistingPK || PrefC.RandomKeys)
{
command += POut.Long(insSub.InsSubNum) + ",";
}
command +=
POut.Long(insSub.PlanNum) + ","
+ POut.Long(insSub.Subscriber) + ","
+ POut.Date(insSub.DateEffective) + ","
+ POut.Date(insSub.DateTerm) + ","
+ POut.Bool(insSub.ReleaseInfo) + ","
+ POut.Bool(insSub.AssignBen) + ","
+ "'" + POut.String(insSub.SubscriberID) + "',"
+ DbHelper.ParamChar + "paramBenefitNotes,"
+ "'" + POut.String(insSub.SubscNote) + "')";
if (insSub.BenefitNotes == null)
{
insSub.BenefitNotes = "";
}
OdSqlParameter paramBenefitNotes = new OdSqlParameter("paramBenefitNotes", OdDbType.Text, insSub.BenefitNotes);
if (useExistingPK || PrefC.RandomKeys)
{
Db.NonQ(command, paramBenefitNotes);
}
else
{
insSub.InsSubNum = Db.NonQ(command, true, paramBenefitNotes);
}
return(insSub.InsSubNum);
}
///<summary>Returns true if Update(InsSub,InsSub) would make changes to the database.
///Does not make any changes to the database and can be called before remoting role is checked.</summary>
public static bool UpdateComparison(InsSub insSub, InsSub oldInsSub)
{
if (insSub.PlanNum != oldInsSub.PlanNum)
{
return(true);
}
if (insSub.Subscriber != oldInsSub.Subscriber)
{
return(true);
}
if (insSub.DateEffective.Date != oldInsSub.DateEffective.Date)
{
return(true);
}
if (insSub.DateTerm.Date != oldInsSub.DateTerm.Date)
{
return(true);
}
if (insSub.ReleaseInfo != oldInsSub.ReleaseInfo)
{
return(true);
}
if (insSub.AssignBen != oldInsSub.AssignBen)
{
return(true);
}
if (insSub.SubscriberID != oldInsSub.SubscriberID)
{
return(true);
}
if (insSub.BenefitNotes != oldInsSub.BenefitNotes)
{
return(true);
}
if (insSub.SubscNote != oldInsSub.SubscNote)
{
return(true);
}
//SecUserNumEntry excluded from update
//SecDateEntry not allowed to change
//SecDateTEdit can only be set by MySQL
return(false);
}
///<summary>Converts a DataTable to a list of objects.</summary>
public static List<InsSub> TableToList(DataTable table){
List<InsSub> retVal=new List<InsSub>();
InsSub insSub;
for(int i=0;i<table.Rows.Count;i++) {
insSub=new InsSub();
insSub.InsSubNum = PIn.Long (table.Rows[i]["InsSubNum"].ToString());
insSub.PlanNum = PIn.Long (table.Rows[i]["PlanNum"].ToString());
insSub.Subscriber = PIn.Long (table.Rows[i]["Subscriber"].ToString());
insSub.DateEffective= PIn.Date (table.Rows[i]["DateEffective"].ToString());
insSub.DateTerm = PIn.Date (table.Rows[i]["DateTerm"].ToString());
insSub.ReleaseInfo = PIn.Bool (table.Rows[i]["ReleaseInfo"].ToString());
insSub.AssignBen = PIn.Bool (table.Rows[i]["AssignBen"].ToString());
insSub.SubscriberID = PIn.String(table.Rows[i]["SubscriberID"].ToString());
insSub.BenefitNotes = PIn.String(table.Rows[i]["BenefitNotes"].ToString());
insSub.SubscNote = PIn.String(table.Rows[i]["SubscNote"].ToString());
retVal.Add(insSub);
}
return retVal;
}
public void FeeSchedTools_GlobalUpdateWriteoffEstimates()
{
string suffix = MethodBase.GetCurrentMethod().Name;
string procStr = "D0145";
double procFee = 100;
ProcedureCode procCode = ProcedureCodes.GetProcCode(procStr);
//Set up clinic, prov, pat
Clinic clinic = ClinicT.CreateClinic(suffix);
long feeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.FixedBenefit, suffix);
long provNum = ProviderT.CreateProvider(suffix, feeSchedNum: feeSchedNum);
Fee fee = FeeT.GetNewFee(feeSchedNum, procCode.CodeNum, procFee, clinic.ClinicNum, provNum);
Patient pat = PatientT.CreatePatient(suffix, provNum, clinic.ClinicNum);
//Set up insurance
InsuranceInfo info = InsuranceT.AddInsurance(pat, suffix, "c", feeSchedNum);
List <InsSub> listSubs = info.ListInsSubs;
List <InsPlan> listPlans = info.ListInsPlans;
List <PatPlan> listPatPlans = info.ListPatPlans;
InsPlan priPlan = info.PriInsPlan;
InsSub priSub = info.PriInsSub;
info.ListBenefits.Add(BenefitT.CreatePercentForProc(priPlan.PlanNum, procCode.CodeNum, 90));
//Create the procedure and claimproc
Procedure proc = ProcedureT.CreateProcedure(pat, procStr, ProcStat.TP, "", procFee);
ClaimProc priClaimProc = ClaimProcT.CreateClaimProc(pat.PatNum, proc.ProcNum, priPlan.PlanNum, priSub.InsSubNum, DateTime.Today, -1, -1, -1,
ClaimProcStatus.CapEstimate);
Procedures.ComputeEstimates(proc, pat.PatNum, new List <ClaimProc>(), true, listPlans, listPatPlans, info.ListBenefits, pat.Age, info.ListInsSubs);
priClaimProc = ClaimProcs.Refresh(pat.PatNum).FirstOrDefault(x => x.ProcNum == proc.ProcNum);
Assert.AreEqual(procFee, priClaimProc.WriteOff);
procFee = 50;
Procedure procNew = proc.Copy();
procNew.ProcFee = procFee;
Procedures.Update(procNew, proc);
//GlobalUpdate
long updated = GlobalUpdateWriteoffs(clinic.ClinicNum);
Assert.AreEqual(1, updated);
ClaimProc priClaimProcDb = ClaimProcs.Refresh(pat.PatNum).FirstOrDefault(x => x.ClaimProcNum == priClaimProc.ClaimProcNum);
Assert.AreEqual(procFee, priClaimProcDb.WriteOff);
}
///<summary>Updates one InsSub in the database.</summary>
public static void Update(InsSub insSub){
string command="UPDATE inssub SET "
+"PlanNum = "+POut.Long (insSub.PlanNum)+", "
+"Subscriber = "+POut.Long (insSub.Subscriber)+", "
+"DateEffective= "+POut.Date (insSub.DateEffective)+", "
+"DateTerm = "+POut.Date (insSub.DateTerm)+", "
+"ReleaseInfo = "+POut.Bool (insSub.ReleaseInfo)+", "
+"AssignBen = "+POut.Bool (insSub.AssignBen)+", "
+"SubscriberID = '"+POut.String(insSub.SubscriberID)+"', "
+"BenefitNotes = "+DbHelper.ParamChar+"paramBenefitNotes, "
+"SubscNote = '"+POut.String(insSub.SubscNote)+"' "
+"WHERE InsSubNum = "+POut.Long(insSub.InsSubNum);
if(insSub.BenefitNotes==null) {
insSub.BenefitNotes="";
}
OdSqlParameter paramBenefitNotes=new OdSqlParameter("paramBenefitNotes",OdDbType.Text,insSub.BenefitNotes);
Db.NonQ(command,paramBenefitNotes);
}
///<summary>Only for creating the IN1 segment(s).</summary>
public static string GenerateFieldIN1(HL7Def def,string fieldName,int sequenceNum,PatPlan patplanCur,InsSub inssubCur,InsPlan insplanCur,Carrier carrierCur,int patplanCount,Patient patSub) {
switch(fieldName) {
#region Carrier
case "carrier.addressCityStateZip":
if(carrierCur==null) {
return "";
}
return gConcat(def.ComponentSeparator,carrierCur.Address,carrierCur.Address2,carrierCur.City,carrierCur.State,carrierCur.Zip);
case "carrier.CarrierName":
if(carrierCur==null) {
return "";
}
return carrierCur.CarrierName;
case "carrier.ElectID":
if(carrierCur==null) {
return "";
}
return carrierCur.ElectID;
case "carrier.Phone":
//Example: ^WPN^PH^^^800^3635432
if(carrierCur==null) {
return "";
}
string carrierPh=gXTN(carrierCur.Phone,10);
if(carrierPh=="") {
return "";
}
return gConcat(def.ComponentSeparator,"","WPN","PH","","",carrierPh.Substring(0,3),carrierPh.Substring(3));//carrierPh guaranteed to be 10 digits or blank
#endregion Carrier
#region InsPlan
case "insplan.cob":
if(insplanCur==null) {
return "";
}
if(patplanCount>1) {
return "CO";
}
return "IN";
case "insplan.coverageType":
if(insplanCur==null) {
return "";
}
if(insplanCur.IsMedical) {
return "M";
}
return "D";
case "insplan.empName":
if(insplanCur==null) {
return "";
}
return Employers.GetName(insplanCur.EmployerNum);//will return empty string if EmployerNum=0 or not found
case "insplan.GroupName":
if(insplanCur==null) {
return "";
}
return insplanCur.GroupName;
case "insplan.GroupNum":
if(insplanCur==null) {
return "";
}
return insplanCur.GroupNum;
case "insplan.planNum":
//Example: 2.16.840.1.113883.3.4337.1486.6566.7.1234
//If OID for insplan is not set, then it will be ODInsPlan.1234 (where 1234=PlanNum)
if(insplanCur==null) {
return "";
}
OIDInternal insplanOid=OIDInternals.GetForType(IdentifierType.InsPlan);//returns root+".7" or whatever they have set in their oidinternal table for type InsPlan
string insplanOidRoot="ODInsPlan";
if(insplanOid!=null && insplanOid.IDRoot!="") {
insplanOidRoot=insplanOid.IDRoot;
}
return insplanOidRoot+"."+insplanCur.PlanNum;//tack on "."+PlanNum for extension
case "insplan.PlanType":
if(insplanCur==null) {
return "";
}
if(insplanCur.PlanType=="p") {
return "PPO Percentage";
}
if(insplanCur.PlanType=="f") {
return "Medicaid or Flat Copay";
}
if(insplanCur.PlanType=="c") {
return "Capitation";
}
return "Category Percentage";
#endregion InsPlan
#region InsSub
case "inssub.AssignBen":
if(inssubCur==null) {
return "";
}
if(inssubCur.AssignBen) {
return "Y";
}
return "N";
case "inssub.DateEffective":
if(inssubCur==null || inssubCur.DateEffective==DateTime.MinValue) {
return "";
}
return gDTM(inssubCur.DateEffective,8);
case "inssub.DateTerm":
if(inssubCur==null || inssubCur.DateTerm==DateTime.MinValue) {
return "";
}
return gDTM(inssubCur.DateTerm,8);
case "inssub.ReleaseInfo":
if(inssubCur==null) {
return "";
}
if(inssubCur.ReleaseInfo) {
return "Y";
}
return "N";
case "inssub.subAddrCityStateZip":
if(patSub==null) {
return "";
}
return gConcat(def.ComponentSeparator,patSub.Address,patSub.Address2,patSub.City,patSub.State,patSub.Zip);
case "inssub.subBirthdate":
if(patSub==null) {
return "";
}
return gDTM(patSub.Birthdate,8);
case "inssub.SubscriberID":
if(inssubCur==null) {
return "";
}
return inssubCur.SubscriberID;
case "inssub.subscriberName":
if(patSub==null) {
return "";
}
return gConcat(def.ComponentSeparator,patSub.LName,patSub.FName,patSub.MiddleI);
#endregion InsSub
#region PatPlan
case "patplan.Ordinal":
if(patplanCur==null) {
return "";
}
return patplanCur.Ordinal.ToString();
case "patplan.policyNum":
if(patplanCur==null || inssubCur==null) {
return "";
}
if(patplanCur.PatID!="") {
return patplanCur.PatID;
}
return inssubCur.SubscriberID;
case "patplan.subRelationToPat":
//SEL-Self, SPO-Spouse, DOM-LifePartner, CHD-Child (PAR-Parent), EME-Employee (EMR-Employer)
//DEP-HandicapDep (GRD-Guardian), DEP-Dependent, OTH-SignifOther (OTH-Other), OTH-InjuredPlantiff
//We store relationship to subscriber and they want subscriber's relationship to patient, therefore
//Relat.Child will return "PAR" for Parent, Relat.Employee will return "EMR" for Employer, and Relat.HandicapDep and Relat.Dependent will return "GRD" for Guardian
//Example: |PAR^Parent|
if(patplanCur==null) {
return "";
}
if(patplanCur.Relationship==Relat.Self) {
return gConcat(def.ComponentSeparator,"SEL","Self");
}
if(patplanCur.Relationship==Relat.Spouse) {
return gConcat(def.ComponentSeparator,"SPO","Spouse");
}
if(patplanCur.Relationship==Relat.LifePartner) {
return gConcat(def.ComponentSeparator,"DOM","Life Partner");
}
if(patplanCur.Relationship==Relat.Child) {
return gConcat(def.ComponentSeparator,"PAR","Parent");
}
if(patplanCur.Relationship==Relat.Employee) {
return gConcat(def.ComponentSeparator,"EMR","Employer");
}
if(patplanCur.Relationship==Relat.Dependent || patplanCur.Relationship==Relat.HandicapDep) {
return gConcat(def.ComponentSeparator,"GRD","Guardian");
}
//if Relat.SignifOther or Relat.InjuredPlaintiff or any others
return gConcat(def.ComponentSeparator,"OTH","Other");
#endregion PatPlan
case "sequenceNum":
return sequenceNum.ToString();
default:
return "";
}
}
///<summary>Updates one InsSub in the database. Uses an old object to compare to, and only alters changed fields. This prevents collisions and concurrency problems in heavily used tables. Returns true if an update occurred.</summary>
public static bool Update(InsSub insSub,InsSub oldInsSub){
string command="";
if(insSub.PlanNum != oldInsSub.PlanNum) {
if(command!=""){ command+=",";}
command+="PlanNum = "+POut.Long(insSub.PlanNum)+"";
}
if(insSub.Subscriber != oldInsSub.Subscriber) {
if(command!=""){ command+=",";}
command+="Subscriber = "+POut.Long(insSub.Subscriber)+"";
}
if(insSub.DateEffective != oldInsSub.DateEffective) {
if(command!=""){ command+=",";}
command+="DateEffective = "+POut.Date(insSub.DateEffective)+"";
}
if(insSub.DateTerm != oldInsSub.DateTerm) {
if(command!=""){ command+=",";}
command+="DateTerm = "+POut.Date(insSub.DateTerm)+"";
}
if(insSub.ReleaseInfo != oldInsSub.ReleaseInfo) {
if(command!=""){ command+=",";}
command+="ReleaseInfo = "+POut.Bool(insSub.ReleaseInfo)+"";
}
if(insSub.AssignBen != oldInsSub.AssignBen) {
if(command!=""){ command+=",";}
command+="AssignBen = "+POut.Bool(insSub.AssignBen)+"";
}
if(insSub.SubscriberID != oldInsSub.SubscriberID) {
if(command!=""){ command+=",";}
command+="SubscriberID = '"+POut.String(insSub.SubscriberID)+"'";
}
if(insSub.BenefitNotes != oldInsSub.BenefitNotes) {
if(command!=""){ command+=",";}
command+="BenefitNotes = "+DbHelper.ParamChar+"paramBenefitNotes";
}
if(insSub.SubscNote != oldInsSub.SubscNote) {
if(command!=""){ command+=",";}
command+="SubscNote = '"+POut.String(insSub.SubscNote)+"'";
}
if(command==""){
return false;
}
if(insSub.BenefitNotes==null) {
insSub.BenefitNotes="";
}
OdSqlParameter paramBenefitNotes=new OdSqlParameter("paramBenefitNotes",OdDbType.Text,insSub.BenefitNotes);
command="UPDATE inssub SET "+command
+" WHERE InsSubNum = "+POut.Long(insSub.InsSubNum);
Db.NonQ(command,paramBenefitNotes);
return true;
}
