/// <summary>
/// Get the payment type fee schedule details.
/// </summary>
/// <param name="paymentTypeFeeSchedules">The payment type fee schedules.</param>
/// <returns>paymentTypeASCFeeScheduleId</returns>
public PaymentTypeFeeSchedule GetPaymentTypeFeeSchedule(PaymentTypeFeeSchedule paymentTypeFeeSchedules)
{
// Initialize the Stored Procedure
_cmd = _db.GetStoredProcCommand("GetServiceLinesandPaymentTypes");
// Pass parameters to Stored Procedure(i.e., @ParamName), add values for
_db.AddInParameter(_cmd, "@PaymentTypeID ", DbType.Int64, paymentTypeFeeSchedules.PaymentTypeId);
_db.AddInParameter(_cmd, "@ContractID", DbType.Int64, paymentTypeFeeSchedules.ContractId);
_db.AddInParameter(_cmd, "@ContractServiceTypeID", DbType.Int64, paymentTypeFeeSchedules.ServiceTypeId);
_db.AddInParameter(_cmd, "@ServiceLineTypeId", DbType.Int64, 0);
_db.AddInParameter(_cmd, "@UserName", DbType.String, paymentTypeFeeSchedules.UserName);
// Retrieve the results of the Stored Procedure in Datatable
DataSet paymentTypeFeeDataSet = _db.ExecuteDataSet(_cmd);
if (paymentTypeFeeDataSet != null && paymentTypeFeeDataSet.Tables.Count > 0)
{
//populating ContractBasicInfo data
if (paymentTypeFeeDataSet.Tables[0].Rows != null && paymentTypeFeeDataSet.Tables[0] != null && paymentTypeFeeDataSet.Tables[0].Rows.Count > 0)
{
PaymentTypeFeeSchedule paymentTypeSchedules = new PaymentTypeFeeSchedule
{
FeeSchedule = DBNull.Value == paymentTypeFeeDataSet.Tables[0].Rows[0]["FeeSchedule"] ? (double?)null : Convert.ToDouble(paymentTypeFeeDataSet.Tables[0].Rows[0]["FeeSchedule"]),
NonFeeSchedule = DBNull.Value == paymentTypeFeeDataSet.Tables[0].Rows[0]["NonFeeSchedule"] ? (double?)null : Convert.ToDouble(paymentTypeFeeDataSet.Tables[0].Rows[0]["NonFeeSchedule"]),
ClaimFieldDocId = DBNull.Value == paymentTypeFeeDataSet.Tables[0].Rows[0]["ClaimFieldDocID"] ? (long?)null : Convert.ToInt64(paymentTypeFeeDataSet.Tables[0].Rows[0]["ClaimFieldDocID"]),
PaymentTypeDetailId = Convert.ToInt64(paymentTypeFeeDataSet.Tables[0].Rows[0]["PaymentTypeDetailID"]),
IsObserveUnits = Convert.ToBoolean(paymentTypeFeeDataSet.Tables[0].Rows[0]["IsObserveUnits"])
};
return(paymentTypeSchedules);
}
}
//returns response to Business layer
return(null);
}
/// <summary>
/// Payments the type fee schedule details.
/// </summary>
/// <param name="contractId">The contract unique identifier.</param>
/// <param name="serviceTypeId">The service type unique identifier.</param>
/// <param name="paymentTypeId">The payment type unique identifier.</param>
/// <param name="isEdit">if set to <c>true</c> [is edit].</param>
/// <returns></returns>
public ActionResult PaymentTypeFeeSchedule(long?contractId, long?serviceTypeId, int paymentTypeId, bool isEdit)
{
PaymentTypeFeeSchedulesViewModel modelPaymentTypeFeeSchedulesViewMode = new PaymentTypeFeeSchedulesViewModel();
if (isEdit)
{
PaymentTypeFeeSchedule paymentTypeFeeSchedulesForPost = new PaymentTypeFeeSchedule
{
ServiceTypeId = serviceTypeId,
ContractId = contractId,
PaymentTypeId = paymentTypeId,
UserName = GetCurrentUserName()
};
PaymentTypeFeeSchedule paymentTypeFeeSchedulesViewModelInfo =
PostApiResponse <PaymentTypeFeeSchedule>("PaymentTypeFeeSchedule",
"GetPaymentTypeFeeSchedule",
paymentTypeFeeSchedulesForPost);
modelPaymentTypeFeeSchedulesViewMode = AutoMapper.Mapper.Map <PaymentTypeFeeSchedule, PaymentTypeFeeSchedulesViewModel>(paymentTypeFeeSchedulesViewModelInfo);
}
modelPaymentTypeFeeSchedulesViewMode.ContractId = contractId;
modelPaymentTypeFeeSchedulesViewMode.ServiceTypeId = serviceTypeId;
modelPaymentTypeFeeSchedulesViewMode.PaymentTypeId = paymentTypeId;
modelPaymentTypeFeeSchedulesViewMode.IsEdit = isEdit;
return(View(modelPaymentTypeFeeSchedulesViewMode));
}
public void EvaluateWithAdjudicatedLineTest()
{
// Arrange
_mockPaymentTypeFeeScheduleRepository = new Mock <IPaymentTypeFeeScheduleRepository>();
_target = new PaymentTypeFeeScheduleLogic(_mockPaymentTypeFeeScheduleRepository.Object);
var paymentType = new PaymentTypeFeeSchedule
{
ValidLineIds = new List <int> {
1
},
NonFeeSchedule = 50,
ServiceTypeId = 12,
ClaimFieldDoc = new ClaimFieldDoc
{
ClaimFieldDocId = 12,
ClaimFieldValues = new List <ClaimFieldValue> {
new ClaimFieldValue {
Identifier = "J2123", Value = "50"
}
}
},
Conditions = new List <ICondition>()
};
_target.PaymentTypeBase = paymentType;
IEvaluateableClaim evaluateableClaim = new EvaluateableClaim();
evaluateableClaim.ClaimId = 123;
evaluateableClaim.ClaimCharges = new List <ClaimCharge>
{
new ClaimCharge
{
Line = 1,
Amount = 20,
HcpcsCode = "12500",
HcpcsCodeWithModifier = "12500"
}
};
var paymentResults = new List <PaymentResult>
{
new PaymentResult {
Line = 1, AdjudicatedValue = 10, ServiceTypeId = 12
}
};
//Act
List <PaymentResult> actual = _target.Evaluate(evaluateableClaim, paymentResults, true, false);
// Assert
Assert.AreEqual(paymentResults.Count, actual.Count);
}
public void AddNewPaymentTypeDrgPaymentIfNotNull()
{
var mockPaymentTypeDrgPayment = new Mock <IPaymentTypeFeeScheduleRepository>();
mockPaymentTypeDrgPayment.Setup(f => f.AddEditPaymentTypeFeeSchedule(It.IsAny <PaymentTypeFeeSchedule>())).Returns(1);
PaymentTypeFeeScheduleLogic target = new PaymentTypeFeeScheduleLogic(mockPaymentTypeDrgPayment.Object);
PaymentTypeFeeSchedule objAddNewPaymentTypeDrgPayment = new PaymentTypeFeeSchedule {
PaymentTypeDetailId = 1
};
long actual = target.AddEditPaymentType(objAddNewPaymentTypeDrgPayment);
Assert.AreEqual(1, actual);
}
public void EditPaymentTypeFeeScheduleCaseMockTest()
{
var mockAddEditFeeScheduleDocs = new Mock <IPaymentTypeFeeScheduleRepository>();
mockAddEditFeeScheduleDocs.Setup(f => f.AddEditPaymentTypeFeeSchedule(It.IsAny <PaymentTypeFeeSchedule>())).Returns(1);
PaymentTypeFeeScheduleLogic target = new PaymentTypeFeeScheduleLogic(mockAddEditFeeScheduleDocs.Object);
PaymentTypeFeeSchedule objAddNewPaymentTypeFeeSchedule = new PaymentTypeFeeSchedule {
PaymentTypeDetailId = 1
};
long actual = target.AddEditPaymentType(objAddNewPaymentTypeFeeSchedule);
Assert.IsNotNull(actual);
}
public void IsPaymentTypeConditionWithInvalidDataTest()
{
// Arrange
_mockPaymentTypeFeeScheduleRepository = new Mock <IPaymentTypeFeeScheduleRepository>();
_target = new PaymentTypeFeeScheduleLogic(_mockPaymentTypeFeeScheduleRepository.Object);
var paymentType = new PaymentTypeFeeSchedule
{
ValidLineIds = new List <int> {
1
},
NonFeeSchedule = 50,
Conditions = new List <ICondition>
{
new Condition
{
ConditionOperator = (byte)Enums.ConditionOperation.EqualTo,
RightOperand = "K2250",
OperandIdentifier = (byte)Enums.OperandIdentifier.HcpcsCode,
OperandType = (byte)Enums.OperandType.AlphaNumeric,
PropertyColumnName = Constants.PropertyHcpcsCode,
LeftOperands = new List <string> {
"J2250", "12350"
}
}
}
};
IEvaluateableClaim evaluateableClaim = new EvaluateableClaim();
evaluateableClaim.ClaimId = 123;
evaluateableClaim.ClaimCharges = new List <ClaimCharge>
{
new ClaimCharge
{
Line = 1,
Amount = 20,
RevCode = "250",
HcpcsCode = "12545",
HcpcsCodeWithModifier = "12545"
}
};
//Act
bool actual = _target.IsPaymentTypeConditions(paymentType, evaluateableClaim);
// Assert
Assert.AreEqual(false, actual);
}
public void IsMatchTest()
{
// Arrange
_mockPaymentTypeFeeScheduleRepository = new Mock <IPaymentTypeFeeScheduleRepository>();
_target = new PaymentTypeFeeScheduleLogic(_mockPaymentTypeFeeScheduleRepository.Object);
var paymentType = new PaymentTypeFeeSchedule
{
ValidLineIds = new List <int> {
1
},
NonFeeSchedule = 50,
Conditions = new List <ICondition>
{
new Condition
{
ConditionOperator = (byte)Enums.ConditionOperation.EqualTo,
RightOperand = "250",
OperandIdentifier = (byte)Enums.OperandIdentifier.RevCode,
OperandType = (byte)Enums.OperandType.Numeric,
PropertyColumnName = Constants.PropertyRevCode,
LeftOperands = new List <string> {
"250", "350"
}
}
}
};
_target.PaymentTypeBase = paymentType;
IEvaluateableClaim evaluateableClaim = new EvaluateableClaim();
evaluateableClaim.ClaimId = 123;
evaluateableClaim.ClaimCharges = new List <ClaimCharge>
{
new ClaimCharge
{
Line = 1,
Amount = 20,
RevCode = "250"
}
};
//Act
bool actual = _target.IsMatch(evaluateableClaim);
// Assert
Assert.AreEqual(true, actual);
}
public JsonResult AddEditPaymentTypeFeeSchedule(PaymentTypeFeeSchedulesViewModel info)
{
long paymentTypeFeeScheduleId = 0;
if (info.ClaimFieldDocId != null)
{
PaymentTypeFeeSchedule feeSchedule =
AutoMapper.Mapper.Map <PaymentTypeFeeSchedulesViewModel, PaymentTypeFeeSchedule>(info);
feeSchedule.UserName = GetCurrentUserName();
paymentTypeFeeScheduleId = PostApiResponse <long>("PaymentTypeFeeSchedule",
"AddEditPaymentTypeFeeSchedule", feeSchedule);
}
return(paymentTypeFeeScheduleId > 0 ? Json(new { sucess = true, Id = paymentTypeFeeScheduleId, documentId = info.ClaimFieldDocId }) : Json(new { sucess = false, documentId = info.ClaimFieldDocId }));
}
public void GetPaymentTypeFeeScheduleMockTest()
{
PaymentTypeFeeSchedule objGetPaymentTypeFeeSchedule = new PaymentTypeFeeSchedule {
FeeSchedule = 1
};
var mockGetPaymentTypeFeeSchedule = new Mock <IPaymentTypeFeeScheduleRepository>();
mockGetPaymentTypeFeeSchedule.Setup(f => f.GetPaymentTypeFeeSchedule(It.IsAny <PaymentTypeFeeSchedule>()))
.Returns(objGetPaymentTypeFeeSchedule);
PaymentTypeFeeScheduleLogic target = new PaymentTypeFeeScheduleLogic(mockGetPaymentTypeFeeSchedule.Object);
PaymentTypeFeeSchedule actual = (PaymentTypeFeeSchedule)target.GetPaymentType(null);
Assert.AreEqual(1, actual.FeeSchedule);
// Assert.IsNotNull(actual);
}
/// <summary>
/// Gets the payment type fee schedules.
/// </summary>
/// <param name="contractServiceTypeId">The contract service type identifier.</param>
/// <param name="dtFeeScheduleTable">The dt fee schedule table.</param>
/// <param name="dtDoc">The dt document.</param>
/// <param name="dtDocValues">The dt document values.</param>
/// <returns></returns>
public static PaymentTypeFeeSchedule GetPaymentType(long contractServiceTypeId, DataTable dtFeeScheduleTable,
DataTable dtDoc, DataTable dtDocValues)
{
PaymentTypeFeeSchedule paymentTypeFeeSchedule = null;
if (dtFeeScheduleTable != null && dtFeeScheduleTable.Rows.Count > 0)
{
paymentTypeFeeSchedule = (from DataRow row in dtFeeScheduleTable.Rows
where
(row["contractServiceTypeId"] != DBNull.Value &&
Convert.ToInt64(row["contractServiceTypeId"]) == contractServiceTypeId)
select new PaymentTypeFeeSchedule
{
FeeSchedule = DBNull.Value == row["FeeSchedule"]
? (double?)null
: Convert.ToDouble(
row["FeeSchedule"]),
NonFeeSchedule =
DBNull.Value == row["NonFeeSchedule"]
? (double?)null
: Convert.ToDouble(row["NonFeeSchedule"]),
ClaimFieldDocId =
Convert.ToInt64(row["ClaimFieldDocID"]),
ContractId = DBNull.Value == row["ContractId"]
? (long?)null
: Convert.ToInt64(
row["ContractId"]),
ServiceTypeId =
DBNull.Value == row["ContractServiceTypeID"]
? (long?)null
: Convert.ToInt64(
row["ContractServiceTypeID"]),
ClaimFieldDoc = GetClaimFieldDoc(
Convert.ToInt64(row["ClaimFieldDocID"]), dtDoc, dtDocValues),
PaymentTypeDetailId = Convert.ToInt64(row["PaymentTypeDetailID"]),
PaymentTypeId = (byte)Enums.PaymentTypeCodes.FeeSchedule,
IsObserveUnits = Convert.ToBoolean(row["IsObserveUnits"])
}).FirstOrDefault();
}
return(paymentTypeFeeSchedule);
}
/// <summary>
/// Add Edit the payment type fee schedule details.
/// </summary>
/// <param name="paymentTypeFeeSchedules">The payment type fee schedules.</param>
/// <returns>paymentTypeASCFeeScheduleId</returns>
public long AddEditPaymentTypeFeeSchedule(PaymentTypeFeeSchedule paymentTypeFeeSchedules)
{
//Checks if input request is not null
if (paymentTypeFeeSchedules != null)
{
// Initialize the Stored Procedure
_cmd = _db.GetStoredProcCommand("AddEditFeeSchedulePayment");
// Pass parameters to Stored Procedure(i.e., @ParamName), add values for
_db.AddInParameter(_cmd, "@PaymentTypeDetailID", DbType.Int64, paymentTypeFeeSchedules.PaymentTypeDetailId);
_db.AddInParameter(_cmd, "@FeeSchedule ", DbType.Decimal, paymentTypeFeeSchedules.FeeSchedule);
_db.AddInParameter(_cmd, "@NonFeeSchedule ", DbType.Decimal, paymentTypeFeeSchedules.NonFeeSchedule);
_db.AddInParameter(_cmd, "@PaymentTypeID ", DbType.Int64, paymentTypeFeeSchedules.PaymentTypeId);
_db.AddInParameter(_cmd, "@ContractID", DbType.Int64, paymentTypeFeeSchedules.ContractId);
_db.AddInParameter(_cmd, "@ContractServiceTypeID", DbType.Int64, paymentTypeFeeSchedules.ServiceTypeId);
_db.AddInParameter(_cmd, "@ClaimFieldDocID", DbType.Int64, paymentTypeFeeSchedules.ClaimFieldDocId);
_db.AddInParameter(_cmd, "@UserName", DbType.String, paymentTypeFeeSchedules.UserName);
_db.AddInParameter(_cmd, "@IsObserveUnits", DbType.Boolean, paymentTypeFeeSchedules.IsObserveUnits);
// Retrieve the results of the Stored Procedure in Datatable
return(long.Parse(_db.ExecuteScalar(_cmd).ToString()));
}
return(0);
}
public PaymentTypeFeeSchedule GetPaymentTypeFeeSchedule(PaymentTypeFeeSchedule paymentTypeFeeSchedules)
{
return((PaymentTypeFeeSchedule)_feeScheduleLogic.GetPaymentType(paymentTypeFeeSchedules));
}
/// <summary>
/// Adds the new payment type fee schedule.
/// </summary>
/// <param name="paymentTypeFeeSchedules">The payment type fee schedules.</param>
/// <returns></returns>
public long AddEditPaymentTypeFeeSchedule(PaymentTypeFeeSchedule paymentTypeFeeSchedules)
{
return(_feeScheduleLogic.AddEditPaymentType(paymentTypeFeeSchedules));
}
public void EvaluatePaymentTypeWithHcpcsWithoutIsObervervedServiceUnit()
{
List <PaymentResult> paymentResults = new List <PaymentResult>
{
new PaymentResult {
ClaimId = 123, ServiceTypeId = 1, Line = 2
},
new PaymentResult {
ClaimId = 123, Line = 1, ServiceTypeId = 1
}
};
PaymentTypeFeeSchedule paymentTypeFeeSchedule = new PaymentTypeFeeSchedule
{
Conditions = new List <ICondition>
{
new Condition
{
ConditionOperator = (byte)Enums.ConditionOperation.EqualTo,
LeftOperands = new List <string> {
"ABCDE"
},
OperandType = (byte)Enums.OperandIdentifier.HcpcsCode,
RightOperand = "ABCDE"
}
},
ClaimFieldDoc = new ClaimFieldDoc
{
ClaimFieldValues = new List <ClaimFieldValue>
{
new ClaimFieldValue
{
Identifier = "40101",
Value = "100"
},
new ClaimFieldValue
{
Identifier = "3010126",
Value = "100"
}
}
},
ServiceTypeId = 1,
ValidLineIds = new List <int> {
1, 2
},
HcpcsCode = "ABCDE",
NonFeeSchedule = 50,
FeeSchedule = 75,
IsObserveUnits = false
};
// Arrange
var mockContractServiceTypeLogic = new Mock <IContractServiceTypeLogic>();
var mockPaymentResultLogic = new Mock <IPaymentResultLogic>();
mockPaymentResultLogic.Setup(
x =>
x.Evaluate(It.IsAny <EvaluateableClaim>(), It.IsAny <List <PaymentResult> >(), It.IsAny <bool>(),
It.IsAny <bool>())).Returns(paymentResults);
Mock <IPaymentTypeFeeScheduleRepository> paymentTypeFeeScheduleRepository =
new Mock <IPaymentTypeFeeScheduleRepository>();
paymentTypeFeeScheduleRepository.Setup(x => x.GetPaymentTypeFeeSchedule(It.IsAny <PaymentTypeFeeSchedule>()))
.Returns(paymentTypeFeeSchedule);
var target = new PaymentTypeFeeScheduleLogic(paymentTypeFeeScheduleRepository.Object)
{
PaymentTypeBase = paymentTypeFeeSchedule
};
// _target.Contract = contract;
IEvaluateableClaim evaluateableClaim = new EvaluateableClaim();
evaluateableClaim.ClaimId = 123;
evaluateableClaim.ClaimTotal = 100;
evaluateableClaim.ClaimCharges = new List <ClaimCharge>
{
new ClaimCharge
{
Line = 1,
Amount = 20,
RevCode = "250",
HcpcsCode = "3000126",
Units = 2,
HcpcsCodeWithModifier = "3000126",
HcpcsModifiers = "261"
},
new ClaimCharge
{
Line = 2,
Amount = 200,
RevCode = "250",
HcpcsCode = "40101",
Units = 2,
HcpcsCodeWithModifier = "4010126",
HcpcsModifiers = "26"
}
};
List <PaymentResult> updatedPaymentResults = new List <PaymentResult>
{
new PaymentResult {
ClaimId = 123, ContractId = 1, AdjudicatedValue = 110
},
new PaymentResult {
ClaimId = 123, Line = 1, ContractId = 1, AdjudicatedValue = 110
}
};
Mock <ContractBaseLogic> mockContractBaseLogic = new Mock <ContractBaseLogic>();
mockContractServiceTypeLogic.Setup(x => x.IsValidServiceType()).Returns(true);
mockContractServiceTypeLogic.Setup(x => x.Evaluate(evaluateableClaim, paymentResults, false, false))
.Returns(updatedPaymentResults);
mockContractBaseLogic.SetupAllProperties();
//Act
List <PaymentResult> actual = target.EvaluatePaymentType(evaluateableClaim, paymentResults, false, false);
// Assert
var firstOrDefault = paymentResults.FirstOrDefault(x => x.AdjudicatedValue != null);
if (firstOrDefault != null)
{
Assert.AreEqual(75, firstOrDefault.AdjudicatedValue);
}
Assert.AreEqual(2, actual.Count);
}
