public void EvaluateIfClaimHasNoPayerTest()
{
// Arrange
_target = new EvaluateableClaimLogic();
IEvaluateableClaim claim = new EvaluateableClaim();
claim.ClaimId = 123;
List <PaymentResult> paymentResults = new List <PaymentResult>();
PaymentResult paymentResult = new PaymentResult {
ClaimId = 123
};
paymentResults.Add(paymentResult);
PaymentResult paymentResultForLine = new PaymentResult {
ClaimId = 123, Line = 1
};
paymentResults.Add(paymentResultForLine);
//Act
List <PaymentResult> actual = _target.Evaluate(claim, paymentResults, false, false);
// Assert
PaymentResult overAllClaimPaymentResult = actual.FirstOrDefault(
payment => payment.Line == null && payment.ServiceTypeId == null);
if (overAllClaimPaymentResult != null)
{
Assert.AreEqual(overAllClaimPaymentResult.ClaimStatus, (byte)Enums.AdjudicationOrVarianceStatuses.ClaimDataError);
}
}
public void IsMatchTest()
{
// Arrange
_target = new EvaluateableClaimLogic();
IEvaluateableClaim claim = new EvaluateableClaim();
Exception expectedExcetpion = null;
// Act
try
{
_target.IsMatch(claim);
}
catch (Exception ex)
{
expectedExcetpion = ex;
}
// Assert
Assert.IsNotNull(expectedExcetpion);
}
public void EvaluateIfClaimHasNoLineTest()
{
// Arrange
_target = new EvaluateableClaimLogic();
IEvaluateableClaim claim = new EvaluateableClaim();
claim.ClaimId = 123;
claim.PriPayerName = "Blue Cross";
claim.BillType = "141";
claim.ClaimState = "Billed";
claim.ClaimType = "hosp";
claim.StatementFrom = DateTime.Now;
claim.StatementThru = DateTime.Now;
claim.ClaimTotal = 200;
List <PaymentResult> paymentResults = new List <PaymentResult>();
PaymentResult paymentResult = new PaymentResult {
ClaimId = 123
};
paymentResults.Add(paymentResult);
PaymentResult paymentResultForLine = new PaymentResult {
ClaimId = 123, Line = 1
};
paymentResults.Add(paymentResultForLine);
// Act
List <PaymentResult> actual = _target.Evaluate(claim, paymentResults, false, false);
// Assert
PaymentResult overAllClaimPaymentResult = actual.FirstOrDefault(
payment => payment.Line == null && payment.ServiceTypeId == null);
if (overAllClaimPaymentResult != null)
{
Assert.AreEqual(overAllClaimPaymentResult.ClaimStatus, (byte)Enums.AdjudicationOrVarianceStatuses.AdjudicationErrorMissingServiceLine);
}
}
public void UpdateEvaluateableClaimsTest()
{
// Arrange
_target = new EvaluateableClaimLogic();
ConditionCode conditionCode = new ConditionCode {
ClaimId = 123, Code = "0300"
};
List <ConditionCode> conditionCodes = new List <ConditionCode> {
conditionCode
};
PatientData patientData = new PatientData {
FirstName = "Jim"
};
DiagnosisCode diagnosisCode = new DiagnosisCode {
Instance = "P", ClaimId = 123, IcddCode = "0800"
};
List <DiagnosisCode> diagnosisCodes = new List <DiagnosisCode> {
diagnosisCode
};
ClaimCharge claimCharge = new ClaimCharge
{
Line = 1,
RevCode = "0123",
Amount = 5556.2,
};
// Act
List <ClaimCharge> claimCharges = new List <ClaimCharge> {
claimCharge
};
EvaluateableClaim evaluateableClaim = new EvaluateableClaim
{
ClaimId = 123,
StatementThru = Convert.ToDateTime("2012-01-12 00:00:00.000"),
StatementFrom = Convert.ToDateTime("2012-01-12 00:00:00.000"),
ConditionCodes = conditionCodes,
PatientData = patientData,
DiagnosisCodes = diagnosisCodes,
ClaimCharges = claimCharges
};
List <EvaluateableClaim> evaluateableClaimLists = new List <EvaluateableClaim> {
evaluateableClaim
};
List <EvaluateableClaim> actual = _target.UpdateEvaluateableClaims(evaluateableClaimLists);
// Assert
EvaluateableClaim updatedEvaluateableClaim = actual.FirstOrDefault();
if (updatedEvaluateableClaim != null)
{
CRecord cRecord = updatedEvaluateableClaim.MicrodynApcEditInput.CRecord;
if (cRecord != null)
{
Assert.AreEqual(cRecord.PatientData, evaluateableClaim.PatientData);
Assert.AreNotEqual(cRecord.ClaimId, evaluateableClaim.ClaimId);
}
DRecord dRecord = updatedEvaluateableClaim.MicrodynApcEditInput.DRecord;
if (dRecord != null)
{
Assert.AreEqual(dRecord.PrincipalDiagnosisCode, evaluateableClaim.DiagnosisCodes.First().IcddCode);
}
LRecord lRecord = updatedEvaluateableClaim.MicrodynApcEditInput.LRecords.FirstOrDefault();
if (lRecord != null)
{
Assert.AreEqual(lRecord.RevenueCode, evaluateableClaim.ClaimCharges.First().RevCode);
Assert.AreEqual(lRecord.LineItemId, evaluateableClaim.ClaimCharges.First().Line);
}
MedicareOutPatient medicareOutPatient =
updatedEvaluateableClaim.MicrodynApcEditInput.MedicareOutPatientRecord;
if (medicareOutPatient != null)
{
Assert.AreEqual(medicareOutPatient.ClaimId, evaluateableClaim.ClaimId);
Assert.AreEqual(medicareOutPatient.BeneDeductible, 0);
}
}
}
