/// <summary>
/// Gets the total amount.
/// </summary>
/// <param name="pricerDll">The pricer DLL.</param>
/// <returns></returns>
private double GetTotalAmount(NetPrcM5 pricerDll)
{
double amount = 0.0;
if (!string.IsNullOrEmpty(PaymentTypeMedicareIp.Formula))
{
List <string> formulaProperties = PaymentTypeMedicareIp.Formula.Replace(Constants.Space, string.Empty).Split('+').ToList();
List <string> availableProperties = GetAvailableFormulaProperties();
bool isAllPropertySelected = (formulaProperties.Count == availableProperties.Count) &&
!formulaProperties.Except(availableProperties).Any();
if (isAllPropertySelected)
{
amount = pricerDll.TotalPayment;
}
else
{
Applyformula(formulaProperties, ref amount, pricerDll);
}
}
return(amount);
}
private static void Applyformula(IEnumerable <string> formulaProperties, ref double amount, NetPrcM5 pricerDll)
{
foreach (string formula in formulaProperties)
{
switch (formula.Trim())
{
case Constants.Fsp:
amount += pricerDll.FSP;
break;
case Constants.Hsp:
amount += pricerDll.HSP;
break;
case Constants.Co:
amount += pricerDll.CostOutlier;
break;
case Constants.Ime:
amount += pricerDll.IME;
break;
case Constants.Dsh:
amount += pricerDll.DSH;
break;
case Constants.PassThru:
amount += pricerDll.PassThru;
break;
case Constants.TechAddOnPayment:
amount += pricerDll.TechAddOnPayment;
break;
case Constants.LowVolumeAddOn:
amount += pricerDll.LowVolumeAddOn;
break;
case Constants.Hrr:
amount += pricerDll.HRR;
break;
case Constants.Vbp:
amount += pricerDll.VBP;
break;
case Constants.Ucc:
amount += pricerDll.UCC;
break;
case Constants.Hac:
amount += pricerDll.HACReduction;
break;
case Constants.Cap:
amount += pricerDll.CapitalPayment;
break;
case Constants.CapDsh:
amount += pricerDll.Capital_DSH_Amt;
break;
case Constants.CapExceptionsAmount:
amount += pricerDll.Capital_Exceptions_Amt;
break;
case Constants.CapFsp:
amount += pricerDll.Capital_FSP_Amt;
break;
case Constants.CapHsp:
amount += pricerDll.Capital_HSP_Amt;
break;
case Constants.CapIme:
amount += pricerDll.Capital_IME_Amt;
break;
case Constants.CapOldHarm:
amount += pricerDll.Capital_OldHarm_Amt;
break;
case Constants.CapOutlier:
amount += pricerDll.Capital_Outlier_Amt;
break;
}
}
}
private MedicareInPatientResult GetMedicareInPatientResult(IEvaluateableClaim claim)
{
MedicareInPatientResult medicareInPatientResult = new MedicareInPatientResult();
MedicareInPatient medicarePatient = claim.MedicareInPatient;
_pricerDll = new NetPrcM5
{
Provider = medicarePatient.Npi,
DDate = medicarePatient.DischargeDate.ToString(CultureInfo.InvariantCulture),
DRG = medicarePatient.Drg,
DStat = medicarePatient.DischargeStatus
};
_pricerDll.ReviewCode = _pricerDll.DStat;
_pricerDll.LOS = medicarePatient.LengthOfStay;
_pricerDll.Charges = medicarePatient.Charges;
//A string of diagnosis codes formatted as 7-Byte values.
//Each code is left justified and blank filled to a length of 7 bytes.
//Any decimal point in the diagnosis code should be removed before passing the code to PRICERActive.
_pricerDll.DiagnosisCodes = GetDiagnosisCodeString(claim.DiagnosisCodes, claim.StatementThru);
//A string of procedure codes formatted as 7-Byte values.
//Each code is left justified and blank filled to a length of 7 bytes.
//Any decimal point in the procedure code should be removed before passing the code to PRICERActive.
_pricerDll.ProcedureCodes = GetProcedureCodeString(claim.ProcedureCodes, claim.StatementThru);
//If statementThru Date is equal to or greater than 10/01/2015, then we pass "0" as ICDVersion10 else "9" as ICDVersion 9
_pricerDll.ICDVersion = claim.StatementThru >= DateTime.Parse(Constants.IcdVersionDate, CultureInfo.InvariantCulture) ? Constants.IcdVersion10 : Constants.IcdVersion9;
_pricerDll.DeviceCreditAmount = Constants.DeviceCreditAmount; // 0; // Source unknown.
_pricerDll.DIFICIDOnClaim = Constants.DificidOnClaim; // false;
_pricerDll.HMOClaim = Constants.HmoClaim; // false;
_pricerDll.IncludePassthru = Constants.IncludePassthru; //false;
_pricerDll.AllowTerminatedProvider = Constants.AllowTerminatedProvider; // false;
_pricerDll.AdjustmentFactor = Constants.AdjustmentFactor; // 1;
_pricerDll.AdjustmentOption = Constants.AdjustmentOption; // 0;
if (GlobalConfigVariable.IsMicrodynLogEnabled)
{
XmlSerializer xsSubmit = new XmlSerializer(typeof(NetPrcM5));
StringWriter sww = new StringWriter();
XmlWriter writer = XmlWriter.Create(sww);
xsSubmit.Serialize(writer, _pricerDll);
var xml = sww.ToString();
Log.LogInfo("MedicareInPatient Input : \n" + xml, "MicrodynPriceInputData");
}
if (GlobalConfigVariable.IsMicrodynEnabled)
{
_pricerDll.PRICERCalc();
string message = string.Empty;
medicareInPatientResult.TotalPaymentAmount = _pricerDll.PRICERSuccess ? GetTotalAmount(_pricerDll) : 0.00;
medicareInPatientResult.IsSucess = _pricerDll.PRICERSuccess;
message = GetPricerReturnValue(_pricerDll.ReturnCode, message, _pricerDll.PRICERSuccess);
medicareInPatientResult.ClaimId = claim.ClaimId;
medicareInPatientResult.ReturnCode = _pricerDll.ReturnCode;
medicareInPatientResult.Message = message;
if (GlobalConfigVariable.IsMicrodynLogEnabled)
{
Log.LogInfo(
string.Format(CultureInfo.InvariantCulture, Constants.MedicareIpClaimIdLog, medicareInPatientResult.Message,
medicareInPatientResult.ClaimId), Constants.MicrodynInPatientMessage);
}
}
else
{
medicareInPatientResult.ReturnCode = 0;
medicareInPatientResult.TotalPaymentAmount = 0;
medicareInPatientResult.Message = Constants.MessageMicrodyneOff;
medicareInPatientResult.IsSucess = true;
}
//After processing, destroy the Reimbursement DLL object
_pricerDll.Dispose();
return(medicareInPatientResult);
}
