Ejemplo n.º 1
0
        public void ProcedureCodes_GetSubstituteCodeNum_Posterior()
        {
            //First, setup the test scenario.
            string  suffix  = MethodBase.GetCurrentMethod().Name;
            Patient pat     = PatientT.CreatePatient(suffix);
            Carrier carrier = CarrierT.CreateCarrier(MethodBase.GetCurrentMethod().Name);
            InsPlan plan    = new InsPlan();

            plan.CarrierNum = carrier.CarrierNum;
            plan.PlanType   = "";
            plan.CobRule    = EnumCobRule.Basic;
            plan.PlanNum    = InsPlans.Insert(plan);
            //Add a substitution code on the procedure level.
            ProcedureCode originalProcCode  = ProcedureCodes.GetProcCode("D2740");
            ProcedureCode downgradeProcCode = ProcedureCodes.GetProcCode("D2750");

            originalProcCode.SubstitutionCode = "D2750";
            originalProcCode.SubstOnlyIf      = SubstitutionCondition.Posterior;
            ProcedureCodeT.Update(originalProcCode);
            //Posterior Procedure= ToothNum 4
            Procedure proc       = ProcedureT.CreateProcedure(pat, originalProcCode.ProcCode, ProcStat.C, "4", 100);//Tooth 4
            long      subCodeNum = ProcedureCodes.GetSubstituteCodeNum(originalProcCode.ProcCode, proc.ToothNum, plan.PlanNum);

            //Finally, use one or more asserts to verify the results.
            Assert.AreEqual(downgradeProcCode.CodeNum, subCodeNum);
        }
Ejemplo n.º 2
0
        public void ProcedureCodes_GetSubstituteCodeNum_InsPlanOverrideAlways()
        {
            //First, setup the test scenario.
            string  suffix  = MethodBase.GetCurrentMethod().Name;
            Patient pat     = PatientT.CreatePatient(suffix);
            Carrier carrier = CarrierT.CreateCarrier(MethodBase.GetCurrentMethod().Name);
            InsPlan plan    = new InsPlan();

            plan.CarrierNum = carrier.CarrierNum;
            plan.PlanType   = "";
            plan.CobRule    = EnumCobRule.Basic;
            plan.PlanNum    = InsPlans.Insert(plan);
            //Add a substitution code on the procedure level.
            ProcedureCode originalProcCode  = ProcedureCodes.GetProcCode("D2330");
            ProcedureCode downgradeProcCode = ProcedureCodes.GetProcCode("D2140");

            originalProcCode.SubstitutionCode = "D2140";
            originalProcCode.SubstOnlyIf      = SubstitutionCondition.Always;
            ProcedureCodeT.Update(originalProcCode);
            //Add an override for the inplan above for the originalProcCode
            ProcedureCode downgradeProcCodeForIns = ProcedureCodes.GetProcCode("D2150");

            SubstitutionLinkT.CreateSubstitutionLink(originalProcCode.CodeNum, downgradeProcCodeForIns.ProcCode, SubstitutionCondition.Always, plan.PlanNum);
            //Next, perform the thing you're trying to test.
            Procedure proc       = ProcedureT.CreateProcedure(pat, originalProcCode.ProcCode, ProcStat.C, "9", 100);//Tooth 9
            long      subCodeNum = ProcedureCodes.GetSubstituteCodeNum(originalProcCode.ProcCode, proc.ToothNum, plan.PlanNum);

            //Finally, use one or more asserts to verify the results.
            Assert.AreEqual(downgradeProcCodeForIns.CodeNum, subCodeNum);
        }
Ejemplo n.º 3
0
        public void ProcedureCodes_GetSubstituteCodeNum_InsPlanOverridePosterior()
        {
            //First, setup the test scenario.
            string  suffix  = MethodBase.GetCurrentMethod().Name;
            Patient pat     = PatientT.CreatePatient(suffix);
            Carrier carrier = CarrierT.CreateCarrier(MethodBase.GetCurrentMethod().Name);
            InsPlan plan    = new InsPlan();

            plan.CarrierNum = carrier.CarrierNum;
            plan.PlanType   = "";
            plan.CobRule    = EnumCobRule.Basic;
            plan.PlanNum    = InsPlans.Insert(plan);
            //Procedure code does not have a substitution code
            ProcedureCode originalProcCode = ProcedureCodes.GetProcCode("D2740");

            //clear out any substitution codes on this procedure
            originalProcCode.SubstitutionCode = "";
            ProcedureCodeT.Update(originalProcCode);
            //Add an override for the inplan above for the originalProcCode to substitute if posterior
            ProcedureCode downgradeProcCodeForIns = ProcedureCodes.GetProcCode("D2750");

            SubstitutionLinkT.CreateSubstitutionLink(originalProcCode.CodeNum, downgradeProcCodeForIns.ProcCode, SubstitutionCondition.Posterior, plan.PlanNum);
            //Posterior procedure
            Procedure proc       = ProcedureT.CreateProcedure(pat, originalProcCode.ProcCode, ProcStat.C, "4", 100);//Tooth 4
            long      subCodeNum = ProcedureCodes.GetSubstituteCodeNum(originalProcCode.ProcCode, proc.ToothNum, plan.PlanNum);

            //The ins override is set to substitute only if posterior.
            Assert.AreEqual(downgradeProcCodeForIns.CodeNum, subCodeNum);
        }
Ejemplo n.º 4
0
        public void ProcedureCodes_GetSubstituteCodeNum_InsPlanOverrideNever()
        {
            //First, setup the test scenario.
            string  suffix  = MethodBase.GetCurrentMethod().Name;
            Patient pat     = PatientT.CreatePatient(suffix);
            Carrier carrier = CarrierT.CreateCarrier(MethodBase.GetCurrentMethod().Name);
            InsPlan plan    = new InsPlan();

            plan.CarrierNum = carrier.CarrierNum;
            plan.PlanType   = "";
            plan.CobRule    = EnumCobRule.Basic;
            plan.PlanNum    = InsPlans.Insert(plan);
            //Add a substitution code on the procedure level that has SubstitutionCondition.Never.
            ProcedureCode originalProcCode = ProcedureCodes.GetProcCode("D2330");

            //clear out any substitution codes on this procedure
            originalProcCode.SubstitutionCode = "";
            ProcedureCodeT.Update(originalProcCode);
            //Add an override for the inplan above for the originalProcCode to never substitute
            ProcedureCode downgradeProcCodeForIns = ProcedureCodes.GetProcCode("D2150");

            SubstitutionLinkT.CreateSubstitutionLink(originalProcCode.CodeNum, downgradeProcCodeForIns.ProcCode, SubstitutionCondition.Never, plan.PlanNum);
            //Next, perform the thing you're trying to test.
            Procedure proc       = ProcedureT.CreateProcedure(pat, originalProcCode.ProcCode, ProcStat.C, "9", 100);//Tooth 9
            long      subCodeNum = ProcedureCodes.GetSubstituteCodeNum(originalProcCode.ProcCode, proc.ToothNum, plan.PlanNum);

            //The procedure level and ins override is set SubstitutionCondition.Never so it should use originalProcCode.CodeNum
            Assert.AreEqual(originalProcCode.CodeNum, subCodeNum);
        }
Ejemplo n.º 5
0
        public void InsPlan_PpoNoSubWriteoffsNoSub()
        {
            string        suffix         = MethodBase.GetCurrentMethod().Name;
            Patient       pat            = PatientT.CreatePatient(suffix);
            long          ucrFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "UCR Fees" + suffix);
            long          ppoFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "PPO " + suffix);
            InsuranceInfo ins            = InsuranceT.AddInsurance(pat, suffix, planType: "p", feeSchedNum: ppoFeeSchedNum);

            ins.PriInsPlan.HasPpoSubstWriteoffs = false;
            InsPlans.Update(ins.PriInsPlan);
            BenefitT.CreateCategoryPercent(ins.PriInsPlan.PlanNum, EbenefitCategory.Restorative, 50);
            ProcedureCode originalProcCode  = ProcedureCodes.GetProcCode("D2330");
            ProcedureCode downgradeProcCode = ProcedureCodes.GetProcCode("D2140");

            originalProcCode.SubstitutionCode = "";          //NOT substituting
            originalProcCode.SubstOnlyIf      = SubstitutionCondition.Always;
            ProcedureCodeT.Update(originalProcCode);
            FeeT.CreateFee(ucrFeeSchedNum, originalProcCode.CodeNum, 100);
            FeeT.CreateFee(ucrFeeSchedNum, downgradeProcCode.CodeNum, 80);
            FeeT.CreateFee(ppoFeeSchedNum, originalProcCode.CodeNum, 60);
            FeeT.CreateFee(ppoFeeSchedNum, downgradeProcCode.CodeNum, 50);
            Procedure        proc           = ProcedureT.CreateProcedure(pat, "D2330", ProcStat.C, "9", 100);//Tooth 9
            List <ClaimProc> listClaimProcs = ClaimProcs.Refresh(pat.PatNum);
            List <Procedure> listProcs      = Procedures.Refresh(pat.PatNum);

            ins.RefreshBenefits();
            Claim     claim  = ClaimT.CreateClaim("P", ins.ListPatPlans, ins.ListInsPlans, listClaimProcs, listProcs, pat, listProcs, ins.ListBenefits, ins.ListInsSubs);
            ClaimProc clProc = ClaimProcs.Refresh(pat.PatNum)[0];          //Should only be one

            Assert.AreEqual(50, clProc.Percentage);
            Assert.AreEqual(30, clProc.BaseEst);
            Assert.AreEqual(30, clProc.InsPayEst);
            Assert.AreEqual(40, clProc.WriteOffEst);
        }
Ejemplo n.º 6
0
        public void Fees_GetListFromObjects_ProviderProcCodeDefault()
        {
            string        suffix        = MethodBase.GetCurrentMethod().Name;
            ProcedureCode procedureCode = ProcedureCodeT.CreateProcCode("D1110");
            Fee           fee           = CreateSingleFee(suffix, (_defaultFeeAmt * _rand.NextDouble()), hasProv: true, codeNum: procedureCode.CodeNum);
            //Update our new provider so that they are associated to the new fee schedule that was just created.
            Provider prov = Providers.GetProv(fee.ProvNum);

            prov.FeeSched = fee.FeeSched;
            ProviderT.Update(prov);
            //Make the default provider associated to the procedure code our new provider.
            procedureCode.ProvNumDefault = prov.ProvNum;
            ProcedureCodeT.Update(procedureCode);
            //The fees associated to the fee schedule of the procedure code's default provider should be returned by GetListFromObjects().
            List <Fee> listFees = Fees.GetListFromObjects(new List <ProcedureCode>()
            {
                procedureCode
            },
                                                          null,
                                                          null,
                                                          0,
                                                          0,
                                                          0,
                                                          null,
                                                          null,
                                                          null,
                                                          null,
                                                          0);

            Assert.IsTrue(listFees.Exists(x => x.FeeNum == fee.FeeNum));
        }
Ejemplo n.º 7
0
        public void ProcedureCodes_GetProcCodesByTreatmentArea_MouthCodes()
        {
            string suffix = MethodBase.GetCurrentMethod().Name;
            List <ProcedureCode> listMouthProcCodesOld = ProcedureCodes.GetProcCodesByTreatmentArea(false, TreatmentArea.Mouth);
            int i = 0;

            do
            {
                i++;                //Add a nonexisting proc code.
            }while(!ProcedureCodeT.AddIfNotPresent("D" + i.ToString().PadLeft(4, '0')) && i < 10000);
            ProcedureCode newProc = ProcedureCodes.GetOne("D" + i.ToString().PadLeft(4, '0'));

            newProc.TreatArea = TreatmentArea.Mouth;
            newProc.Descript  = suffix;
            ProcedureCodeT.Update(newProc);
            List <ProcedureCode> listMouthProcCodesNew = ProcedureCodes.GetProcCodesByTreatmentArea(false, TreatmentArea.Mouth);

            Assert.IsFalse(listMouthProcCodesNew.Any(x => x.TreatArea != TreatmentArea.Mouth));
            Assert.IsTrue((listMouthProcCodesOld.Count + 1) == listMouthProcCodesNew.Count);
            Assert.IsTrue(listMouthProcCodesNew.Exists(x => x.CodeNum == newProc.CodeNum));
        }