public static void CreateLimitation(long planNum, EbenefitCategory category, double amt)
{
Benefit ben = new Benefit();
ben.PlanNum = planNum;
ben.BenefitType = InsBenefitType.Limitations;
ben.CovCatNum = CovCats.GetForEbenCat(category).CovCatNum;
ben.CoverageLevel = BenefitCoverageLevel.Individual;
ben.MonetaryAmt = amt;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
Benefits.Insert(ben);
}
public static void CreateCategoryPercent(long planNum, EbenefitCategory category, int percent)
{
Benefit ben = new Benefit();
ben.PlanNum = planNum;
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(category).CovCatNum;
ben.CoverageLevel = BenefitCoverageLevel.None;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
Benefits.Insert(ben);
}
public static void CreateOrthoFamilyMax(long planNum, double amt)
{
Benefit ben = new Benefit();
ben.PlanNum = planNum;
ben.BenefitType = InsBenefitType.Limitations;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Orthodontics).CovCatNum;
ben.CoverageLevel = BenefitCoverageLevel.Family;
ben.MonetaryAmt = amt;
ben.TimePeriod = BenefitTimePeriod.Lifetime;
Benefits.Insert(ben);
}
public static Benefit CreateExclusionForCategory(long planNum, EbenefitCategory category)
{
Benefit ben = new Benefit();
ben.PlanNum = planNum;
ben.CovCatNum = CovCats.GetForEbenCat(category).CovCatNum;
ben.BenefitType = InsBenefitType.Exclusions;
ben.CoverageLevel = BenefitCoverageLevel.None;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
Benefits.Insert(ben);
return(ben);
}
public static void CreateFrequencyCategory(long planNum, EbenefitCategory category, BenefitQuantity quantityQualifier, Byte quantity)
{
Benefit ben = new Benefit();
ben.PlanNum = planNum;
ben.BenefitType = InsBenefitType.Limitations;
ben.CovCatNum = CovCats.GetForEbenCat(category).CovCatNum;
ben.CoverageLevel = BenefitCoverageLevel.None;
ben.TimePeriod = BenefitTimePeriod.None;
ben.Quantity = quantity;
ben.QuantityQualifier = quantityQualifier;
Benefits.Insert(ben);
}
public static Benefit CreatePercentForProc(long planNum, long codeNum, int percent)
{
Benefit ben = new Benefit();
ben.CodeNum = codeNum;
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Restorative).CovCatNum;
ben.Percent = percent;
ben.PlanNum = planNum;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
Benefits.Insert(ben);
return(ben);
}
///<summary>Converts the text for one plan into an object which will then be processed as needed.</summary>
public static TrojanObject ProcessTextToObject(string text)
{
string[] lines = text.Split(new string[] { "\r\n" }, StringSplitOptions.RemoveEmptyEntries);
string line;
string[] fields;
int percent;
double amt;
string rowVal;
TrojanObject troj = new TrojanObject();
troj.BenefitList = new List <Benefit>();
troj.BenefitNotes = "";
bool usesAnnivers = false;
Benefit ben;
Benefit benCrownMajor = null;
Benefit benCrownOnly = null;
for (int i = 0; i < lines.Length; i++)
{
line = lines[i];
fields = line.Split(new char[] { '\t' });
if (fields.Length != 3)
{
continue;
}
//remove any trailing or leading spaces:
fields[0] = fields[0].Trim();
fields[1] = fields[1].Trim();
fields[2] = fields[2].Trim();
rowVal = fields[2].Trim();
if (fields[2] == "")
{
continue;
}
else //as long as there is data, add it to the notes
{
if (troj.BenefitNotes != "")
{
troj.BenefitNotes += "\r\n";
}
troj.BenefitNotes += fields[1] + ": " + fields[2];
if (fields.Length == 4)
{
troj.BenefitNotes += " " + fields[3];
}
}
switch (fields[0])
{
//default://for all rows that are not handled below
case "TROJANID":
troj.TROJANID = fields[2];
break;
case "ENAME":
troj.ENAME = fields[2];
break;
case "PLANDESC":
troj.PLANDESC = fields[2];
break;
case "ELIGPHONE":
troj.ELIGPHONE = fields[2];
break;
case "POLICYNO":
troj.POLICYNO = fields[2];
break;
case "ECLAIMS":
if (fields[2] == "YES") //accepts eclaims
{
troj.ECLAIMS = true;
}
else
{
troj.ECLAIMS = false;
}
break;
case "PAYERID":
troj.PAYERID = fields[2];
break;
case "MAILTO":
troj.MAILTO = fields[2];
break;
case "MAILTOST":
troj.MAILTOST = fields[2];
break;
case "MAILCITYONLY":
troj.MAILCITYONLY = fields[2];
break;
case "MAILSTATEONLY":
troj.MAILSTATEONLY = fields[2];
break;
case "MAILZIPONLY":
troj.MAILZIPONLY = fields[2];
break;
case "PLANMAX": //eg $3000 per person per year
if (!fields[2].StartsWith("$"))
{
break;
}
fields[2] = fields[2].Remove(0, 1);
fields[2] = fields[2].Split(new char[] { ' ' })[0];
if (CovCats.GetCount(true) > 0)
{
ben = new Benefit();
ben.BenefitType = InsBenefitType.Limitations;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.General).CovCatNum;
ben.MonetaryAmt = PIn.Double(fields[2]);
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
ben.CoverageLevel = BenefitCoverageLevel.Individual;
troj.BenefitList.Add(ben.Copy());
}
break;
case "PLANYR": //eg Calendar year or Anniversary year or month renewal
string monthName = fields[2].Split(new char[] { ' ' })[0];
usesAnnivers = true;
if (fields[2] == "Calendar year" || monthName.In(DateTimeFormatInfo.CurrentInfo.MonthNames))
{
usesAnnivers = false;
troj.MonthRenewal = DateTimeFormatInfo.CurrentInfo.MonthNames.ToList().IndexOf(monthName) + 1;
}
//MessageBox.Show("Warning. Plan uses Anniversary year rather than Calendar year. Please verify the Plan Start Date.");
break;
case "DEDUCT": //eg There is no deductible
if (!fields[2].StartsWith("$"))
{
amt = 0;
}
else
{
fields[2] = fields[2].Remove(0, 1);
fields[2] = fields[2].Split(new char[] { ' ' })[0];
amt = PIn.Double(fields[2]);
}
ben = new Benefit();
ben.BenefitType = InsBenefitType.Deductible;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.General).CovCatNum;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
ben.MonetaryAmt = amt;
ben.CoverageLevel = BenefitCoverageLevel.Individual;
troj.BenefitList.Add(ben.Copy());
ben = new Benefit();
ben.BenefitType = InsBenefitType.Deductible;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Diagnostic).CovCatNum;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
ben.MonetaryAmt = 0; //amt;
ben.CoverageLevel = BenefitCoverageLevel.Individual;
troj.BenefitList.Add(ben.Copy());
ben = new Benefit();
ben.BenefitType = InsBenefitType.Deductible;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.RoutinePreventive).CovCatNum;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
ben.MonetaryAmt = 0; //amt;
ben.CoverageLevel = BenefitCoverageLevel.Individual;
troj.BenefitList.Add(ben.Copy());
break;
case "PREV": //eg 100% or 'Incentive begins at 70%' or '80% Endo Major see notes'
if (rowVal.ToLower() == "not covered")
{
percent = 0;
}
else
{
percent = ConvertPercentToInt(rowVal); //remove %
}
if (percent < 0 || percent > 100)
{
break;
}
ben = new Benefit();
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Diagnostic).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
ben = new Benefit();
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.RoutinePreventive).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
break;
case "BASIC":
if (rowVal.ToLower() == "not covered")
{
percent = 0;
}
else
{
percent = ConvertPercentToInt(rowVal); //remove %
}
if (percent < 0 || percent > 100)
{
break;
}
ben = new Benefit();
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Restorative).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
ben = new Benefit();
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Endodontics).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
ben = new Benefit();
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Periodontics).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
ben = new Benefit();
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.OralSurgery).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
break;
case "MAJOR":
if (rowVal.ToLower() == "not covered")
{
percent = 0;
}
else
{
percent = ConvertPercentToInt(rowVal); //remove %
}
if (percent < 0 || percent > 100)
{
break;
}
ben = new Benefit();
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Prosthodontics).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
benCrownMajor = new Benefit();
benCrownMajor.BenefitType = InsBenefitType.CoInsurance;
benCrownMajor.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Crowns).CovCatNum;
benCrownMajor.Percent = percent;
benCrownMajor.TimePeriod = BenefitTimePeriod.CalendarYear;
//troj.BenefitList.Add(ben.Copy());//later
break;
case "CROWNS": //Examples: Paid Major, or 80%. We will only process percentages.
if (rowVal.ToLower() == "not covered")
{
percent = 0;
}
else
{
percent = ConvertPercentToInt(rowVal); //remove %
}
if (percent < 0 || percent > 100)
{
break;
}
benCrownOnly = new Benefit();
benCrownOnly.BenefitType = InsBenefitType.CoInsurance;
benCrownOnly.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Crowns).CovCatNum;
benCrownOnly.Percent = percent;
benCrownOnly.TimePeriod = BenefitTimePeriod.CalendarYear;
//troj.BenefitList.Add(ben.Copy());
break;
case "ORMAX": //eg $3500 lifetime
if (!fields[2].StartsWith("$"))
{
break;
}
fields[2] = fields[2].Remove(0, 1);
fields[2] = fields[2].Split(new char[] { ' ' })[0];
if (CovCats.GetCount(true) > 0)
{
ben = new Benefit();
ben.BenefitType = InsBenefitType.Limitations;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Orthodontics).CovCatNum;
ben.MonetaryAmt = PIn.Double(fields[2]);
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
}
break;
case "ORPCT":
if (rowVal.ToLower() == "not covered")
{
percent = 0;
}
else
{
percent = ConvertPercentToInt(rowVal); //remove %
}
if (percent < 0 || percent > 100)
{
break;
}
ben = new Benefit();
ben.BenefitType = InsBenefitType.CoInsurance;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Orthodontics).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
troj.BenefitList.Add(ben.Copy());
break;
/*case "FEE":
* if(!ProcedureCodes.IsValidCode(fields[1])) {
* break;//skip
* }
* if(textTrojanID.Text==""){
* break;
* }
* feeSchedNum=Fees.ImportTrojan(fields[1],PIn.PDouble(fields[3]),textTrojanID.Text);
* //the step above probably created a new feeschedule, requiring a reset of the three listboxes.
* resetFeeSched=true;
* break;*/
case "NOTES": //typically multiple instances
if (troj.PlanNote != null && troj.PlanNote != "")
{
troj.PlanNote += "\r\n";
}
troj.PlanNote += fields[2];
break;
} //switch
} //for
//Set crowns
if (benCrownOnly != null)
{
troj.BenefitList.Add(benCrownOnly.Copy());
}
else if (benCrownMajor != null)
{
troj.BenefitList.Add(benCrownMajor.Copy());
}
//set calendar vs serviceyear
if (usesAnnivers)
{
for (int i = 0; i < troj.BenefitList.Count; i++)
{
troj.BenefitList[i].TimePeriod = BenefitTimePeriod.ServiceYear;
}
}
return(troj);
}
///<summary>Returns the number of plans updated.</summary>
private static int ProcessTrojanPlan(string trojanPlan)
{
//MessageBox.Show(trojanPlan);
string[] lines = trojanPlan.Split(new string[] { "\r\n" }, StringSplitOptions.RemoveEmptyEntries);
//MessageBox.Show(lines[0]);
//MessageBox.Show(lines.Length.ToString());
string line;
string[] fields;
int percent;
string[] splitField; //if a field is a sentence with more than one word, we can split it for analysis
InsPlan plan = new InsPlan(); //many fields will be absent. This is a conglomerate.
Carrier carrier = new Carrier();
ArrayList benefitList = new ArrayList();
bool usesAnnivers = false;
Benefit ben;
for (int i = 0; i < lines.Length; i++)
{
line = lines[i];
fields = line.Split(new char[] { '\t' });
if (fields.Length != 3)
{
continue;
}
//remove any trailing or leading spaces:
fields[0] = fields[0].Trim();
fields[1] = fields[1].Trim();
fields[2] = fields[2].Trim();
if (fields[2] == "")
{
continue;
}
else //as long as there is data, add it to the notes
{
if (plan.BenefitNotes != "")
{
plan.BenefitNotes += "\r\n";
}
plan.BenefitNotes += fields[1] + ": " + fields[2];
}
switch (fields[0])
{
//default://for all rows that are not handled below
case "TROJANID":
plan.TrojanID = fields[2];
break;
case "ENAME":
plan.EmployerNum = Employers.GetEmployerNum(fields[2]);
break;
case "PLANDESC":
plan.GroupName = fields[2];
break;
case "ELIGPHONE":
carrier.Phone = fields[2];
break;
case "POLICYNO":
plan.GroupNum = fields[2];
break;
case "ECLAIMS":
if (fields[2] == "YES") //accepts eclaims
{
carrier.NoSendElect = false;
}
else
{
carrier.NoSendElect = true;
}
break;
case "PAYERID":
carrier.ElectID = fields[2];
break;
case "MAILTO":
carrier.CarrierName = fields[2];
break;
case "MAILTOST":
carrier.Address = fields[2];
break;
case "MAILCITYONLY":
carrier.City = fields[2];
break;
case "MAILSTATEONLY":
carrier.State = fields[2];
break;
case "MAILZIPONLY":
carrier.Zip = fields[2];
break;
case "PLANMAX": //eg $3000 per person per year
if (!fields[2].StartsWith("$"))
{
break;
}
fields[2] = fields[2].Remove(0, 1);
fields[2] = fields[2].Split(new char[] { ' ' })[0];
if (CovCatB.ListShort.Length > 0)
{
ben = new Benefit();
ben.BenefitType = InsBenefitType.Limitations;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.General).CovCatNum;
ben.MonetaryAmt = PIn.PDouble(fields[2]);
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
benefitList.Add(ben.Copy());
}
break;
case "PLANYR": //eg Calendar year or Anniversary year
if (fields[2] != "Calendar year")
{
usesAnnivers = true;
//MessageBox.Show("Warning. Plan uses Anniversary year rather than Calendar year. Please verify the Plan Start Date.");
}
break;
case "DEDUCT": //eg There is no deductible
ben = new Benefit();
ben.BenefitType = InsBenefitType.Deductible;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.General).CovCatNum;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
if (!fields[2].StartsWith("$"))
{
ben.MonetaryAmt = 0;
}
else
{
fields[2] = fields[2].Remove(0, 1);
fields[2] = fields[2].Split(new char[] { ' ' })[0];
ben.MonetaryAmt = PIn.PDouble(fields[2]);
}
benefitList.Add(ben.Copy());
break;
case "PREV": //eg 100%
splitField = fields[2].Split(new char[] { ' ' });
if (splitField.Length == 0 || !splitField[0].EndsWith("%"))
{
break;
}
splitField[0] = splitField[0].Remove(splitField[0].Length - 1, 1); //remove %
percent = PIn.PInt(splitField[0]);
if (percent < 0 || percent > 100)
{
break;
}
ben = new Benefit();
ben.BenefitType = InsBenefitType.Percentage;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.RoutinePreventive).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
benefitList.Add(ben.Copy());
break;
case "BASIC":
splitField = fields[2].Split(new char[] { ' ' });
if (splitField.Length == 0 || !splitField[0].EndsWith("%"))
{
break;
}
splitField[0] = splitField[0].Remove(splitField[0].Length - 1, 1); //remove %
percent = PIn.PInt(splitField[0]);
if (percent < 0 || percent > 100)
{
break;
}
ben = new Benefit();
ben.BenefitType = InsBenefitType.Percentage;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Restorative).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
benefitList.Add(ben.Copy());
ben = new Benefit();
ben.BenefitType = InsBenefitType.Percentage;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Endodontics).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
benefitList.Add(ben.Copy());
ben = new Benefit();
ben.BenefitType = InsBenefitType.Percentage;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Periodontics).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
benefitList.Add(ben.Copy());
break;
case "MAJOR":
splitField = fields[2].Split(new char[] { ' ' });
if (splitField.Length == 0 || !splitField[0].EndsWith("%"))
{
break;
}
splitField[0] = splitField[0].Remove(splitField[0].Length - 1, 1); //remove %
percent = PIn.PInt(splitField[0]);
if (percent < 0 || percent > 100)
{
break;
}
ben = new Benefit();
ben.BenefitType = InsBenefitType.Percentage;
ben.CovCatNum = CovCats.GetForEbenCat(EbenefitCategory.Prosthodontics).CovCatNum;
ben.Percent = percent;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
benefitList.Add(ben.Copy());
//does prosthodontics include crowns?
break;
} //switch
} //for
//now, save this all to the database.
//carrier
if (carrier.CarrierName == null || carrier.CarrierName == "")
{
//if, for some reason, carrier is absent from the file, we can't do a thing with it.
return(0);
}
//Carriers.Cur=carrier;
Carriers.GetCurSame(carrier);
//set calendar vs serviceyear
if (usesAnnivers)
{
for (int i = 0; i < benefitList.Count; i++)
{
((Benefit)benefitList[i]).TimePeriod = BenefitTimePeriod.ServiceYear;
}
}
//plan
plan.CarrierNum = carrier.CarrierNum;
string command = "SELECT PlanNum FROM insplan WHERE TrojanID='" + POut.PString(plan.TrojanID) + "'";
DataTable table = General.GetTable(command);
int planNum;
for (int i = 0; i < table.Rows.Count; i++)
{
planNum = PIn.PInt(table.Rows[i][0].ToString());
//update plan
command = "UPDATE insplan SET "
+ "EmployerNum='" + POut.PInt(plan.EmployerNum) + "', "
+ "GroupName='" + POut.PString(plan.GroupName) + "', "
+ "GroupNum='" + POut.PString(plan.GroupNum) + "', "
+ "CarrierNum='" + POut.PInt(plan.CarrierNum) + "', "
+ "BenefitNotes='" + POut.PString(plan.BenefitNotes) + "' "
+ "WHERE PlanNum=" + POut.PInt(planNum);
General.NonQ(command);
//clear benefits
command = "DELETE FROM benefit WHERE PlanNum=" + POut.PInt(planNum);
General.NonQ(command);
//benefitList
for (int j = 0; j < benefitList.Count; j++)
{
((Benefit)benefitList[j]).PlanNum = planNum;
Benefits.Insert((Benefit)benefitList[j]);
}
InsPlans.ComputeEstimatesForPlan(planNum);
}
return(table.Rows.Count);
//MessageBox.Show(plan.BenefitNotes);
}
