/// <summary>
/// Variances the claim report.
/// </summary>
/// <param name="nodeId">The node unique identifier.</param>
/// <param name="datetype">The datetype.</param>
/// <param name="startDate">The start date.</param>
/// <param name="endDate">The end date.</param>
/// <param name="criteria">The criteria.</param>
/// <param name="reportType">Type of the report.</param>
/// <param name="fileType">type of file. Either pdf or excel</param>
/// <param name="currentDateTime"></param>
/// <returns></returns>
public ActionResult VarianceReport(long?nodeId, int?datetype, DateTime?startDate, DateTime?endDate, string criteria, int reportType, int fileType, string currentDateTime)
{
string fileName;
Enums.DownloadFileType reportFormat = fileType == 1 ? Enums.DownloadFileType.Pdf : Enums.DownloadFileType.Xls;
//If the Report Type is Claim Level and report format is PDF
if (reportType == Constants.One && fileType == Constants.One)
{
ClaimAdjudicationReport claimAdjudicationReport = new ClaimAdjudicationReport
{
ModelId = nodeId,
NodeId = nodeId,
DateType = Convert.ToInt32(datetype),
StartDate = Convert.ToDateTime(startDate),
EndDate = Convert.ToDateTime(endDate),
ClaimSearchCriteria = criteria,
FacilityId = GetCurrentFacilityId(),
//Added RequestedUserID and RequestedUserName with reference to HIPAA logging feature
RequestedUserId =
string.IsNullOrEmpty(GetCurrentUserName()) ? Guid.Empty.ToString() : GetUserKey(),
RequestedUserName = GetCurrentUserName(),
CommandTimeoutForClaimAdjudication =
Convert.ToInt32(GlobalConfigVariable.CommandTimeoutForClaimAdjudication),
MaxLinesForPdfReport =
GlobalConfigVariable.MaxRecordLimitForTelericReport,
};
ClaimAdjudicationReport claimAdjudicationReportDetails =
PostApiResponse <ClaimAdjudicationReport>(Constants.ClaimAdjudicationReport,
Constants.GetClaimAdjudicationReport,
claimAdjudicationReport);
ClaimAdjudicationReportViewModel adjudicationList =
Mapper.Map <ClaimAdjudicationReport, ClaimAdjudicationReportViewModel>(
claimAdjudicationReportDetails);
// Gets the current CST time.
adjudicationList.CurrentDateTime = Utilities.GetLocalTimeString(currentDateTime);
adjudicationList.LoggedInUser = GetCurrentUserName();
fileName = new ClaimAdjudicationReportUtil().GetExportedFileName(adjudicationList,
Enums.DownloadFileType.Pdf, GlobalConfigVariable.ReportsFilePath, currentDateTime);
}
else
{
VarianceReport varianceReport = new VarianceReport
{
NodeId = nodeId,
DateType = datetype,
StartDate = Convert.ToDateTime(startDate),
EndDate = Convert.ToDateTime(endDate),
ClaimSearchCriteria = criteria,
ReportLevel = reportType,
FacilityId = GetCurrentFacilityId(),
RequestedUserId = string.IsNullOrEmpty(GetCurrentUserName()) ? Guid.Empty.ToString() : GetUserKey(),
RequestedUserName = GetCurrentUserName(),
FileType = fileType,
MaxLinesForPdfReport = GlobalConfigVariable.MaxRecordLimitForTelericReport
};
//Added RequestedUserID and RequestedUserName with reference to HIPAA logging feature
VarianceReport varianceReportInfo = PostApiResponse <VarianceReport>(Constants.VarianceReport,
Constants.GetVarianceReport, varianceReport);
VarianceReportViewModel varianceReportlist =
Mapper.Map <VarianceReport, VarianceReportViewModel>(varianceReportInfo);
varianceReportlist.LoggedInUser = GetCurrentUserName();
// Gets the local time zone.
varianceReportlist.CurrentDateTime = Utilities.GetLocalTimeString(currentDateTime);
fileName = new VarianceReportUtil().GetExportedFileName(reportType, reportFormat,
varianceReportlist, GlobalConfigVariable.ReportsFilePath, currentDateTime);
}
return(Json(new { fileName, reportFormat }, JsonRequestBehavior.AllowGet));
}
/// <summary>
/// Gets the selected claim.
/// </summary>
/// <param name="claimAdjudicationReport">The claim adjudication report.</param>
/// <returns></returns>
public ClaimAdjudicationReport GetSelectedClaim(ClaimAdjudicationReport claimAdjudicationReport)
{
return(_adjudicationReportRepository.GetSelectedClaim(claimAdjudicationReport, GlobalConfigVariable.MaxRecordLimitForExcelReport));
}
public ClaimAdjudicationReport GetSelectedClaim(ClaimAdjudicationReport claimAdjudicationReport)
{
return(_adjudicationReportLogic.GetSelectedClaim(claimAdjudicationReport));
}
public ClaimAdjudicationReport GetOpenClaimColumnNamesBasedOnUserId(ClaimAdjudicationReport data)
{
return(_adjudicationReportLogic.GetOpenClaimColumnNamesBasedOnUserId(data));
}
public ClaimAdjudicationReport GetClaimAdjudicationReport(ClaimAdjudicationReport claimAdjudicationReport)
{
return(_adjudicationReportLogic.GetClaimAdjudicationReport(claimAdjudicationReport));
}
/// <summary>
/// Set claim columns
/// </summary>
/// <param name="claimDataRow"></param>
/// <param name="claimAdjudicationReport"></param>
/// <param name="claimDataList"></param>
private static void SetClaimColumns(DataRow claimDataRow, ClaimAdjudicationReport claimAdjudicationReport,
List <EvaluateableClaim> claimDataList)
{
EvaluateableClaim claimData = new EvaluateableClaim
{
PatientAccountNumber = SetColumnData(claimDataRow, "PatientAccountNumber", string.Empty),
AdjudicatedDateValue = SetDateColumnValue(claimDataRow, "AdjudicatedDate", claimAdjudicationReport.CurrentDateTime),
Ssinumber =
IsColumnExists(claimDataRow, "SSINumber")
? GetValue <int?>(claimDataRow["SSINumber"], typeof(int))
: null,
ClaimType = SetColumnData(claimDataRow, "ClaimType", string.Empty),
ClaimState = SetColumnData(claimDataRow, "ClaimState", string.Empty),
PayerSequence =
IsColumnExists(claimDataRow, "PayerSequence")
? GetValue <int?>(claimDataRow["PayerSequence"], typeof(int))
: null,
ClaimTotal =
IsColumnExists(claimDataRow, "ClaimTotal")
? GetValue <double?>(claimDataRow["ClaimTotal"], typeof(double))
: null,
StatementFromValue = SetDateColumn(claimDataRow, "StatementFrom"),
StatementThruValue = SetDateColumn(claimDataRow, "StatementThru"),
ClaimDateValue = SetDateColumn(claimDataRow, "ClaimDate"),
BillDateValue = SetDateColumn(claimDataRow, "BillDate"),
LastFiledDateValue = SetDateColumn(claimDataRow, "LastFiledDate"),
BillType = SetColumnData(claimDataRow, "BillType", null),
Drg = SetColumnData(claimDataRow, "DRG", null),
PriIcdpCode = SetColumnData(claimDataRow, "PriICDPCode", null),
PriIcddCode = SetColumnData(claimDataRow, "PriICDDCode", null),
PriPayerName = SetColumnData(claimDataRow, "PriPayerName", null),
SecPayerName = SetColumnData(claimDataRow, "SecPayerName", null),
TerPayerName = SetColumnData(claimDataRow, "TerPayerName", null),
IsRemitLinked = SetColumnData(claimDataRow, "IsRemitLinked", null),
ClaimStat = SetColumnData(claimDataRow, "ClaimStatus", null),
AdjudicatedValue =
IsColumnExists(claimDataRow, "AdjudicatedValue")
? GetValue <double?>(claimDataRow["AdjudicatedValue"], typeof(double))
: null,
ActualPayment =
IsColumnExists(claimDataRow, "ActualPayment")
? GetValue <double?>(claimDataRow["ActualPayment"], typeof(double))
: null,
PatientResponsibility =
IsColumnExists(claimDataRow, "PatientResponsibility")
? GetValue <double?>(claimDataRow["PatientResponsibility"], typeof(double))
: null,
RemitAllowedAmt =
IsColumnExists(claimDataRow, "RemitAllowedAmt")
? GetValue <double?>(claimDataRow["RemitAllowedAmt"], typeof(double))
: null,
RemitNonCovered =
IsColumnExists(claimDataRow, "RemitNonCovered")
? GetValue <double?>(claimDataRow["RemitNonCovered"], typeof(double))
: null,
Icn = SetColumnData(claimDataRow, "ICN", null),
ClaimLink =
IsColumnExists(claimDataRow, "ClaimLink")
? GetValue <long?>(claimDataRow["ClaimLink"], typeof(long))
: null,
LinkedRemitId = SetColumnData(claimDataRow, "LinkedRemitID", null),
ClaimId =
IsColumnExists(claimDataRow, "ClaimId")
? DBNull.Value == claimDataRow["ClaimId"]
? 0
: GetValue <long>(claimDataRow["ClaimId"], typeof(long))
: 0,
ContractualVariance =
IsColumnExists(claimDataRow, "ContractualVariance")
? GetValue <double?>(claimDataRow["ContractualVariance"], typeof(double))
: null,
PaymentVariance =
IsColumnExists(claimDataRow, "PaymentVariance")
? GetValue <double?>(claimDataRow["PaymentVariance"], typeof(double))
: null,
ActualAdjustment =
IsColumnExists(claimDataRow, "ActualContractualAdjustment")
? GetValue <double?>(claimDataRow["ActualContractualAdjustment"], typeof(double))
: null,
CalculatedAdjustment =
IsColumnExists(claimDataRow, "ExpectedContractualAdjustment")
? GetValue <double?>(claimDataRow["ExpectedContractualAdjustment"],
typeof(double))
: null,
DischargeStatus = SetColumnData(claimDataRow, "DischargeStatus", null),
CustomField1 = SetColumnData(claimDataRow, "CustomField1", null),
CustomField2 = SetColumnData(claimDataRow, "CustomField2", null),
CustomField3 = SetColumnData(claimDataRow, "CustomField3", null),
CustomField4 = SetColumnData(claimDataRow, "CustomField4", null),
CustomField5 = SetColumnData(claimDataRow, "CustomField5", null),
CustomField6 = SetColumnData(claimDataRow, "CustomField6", null),
Npi = SetColumnData(claimDataRow, "NPI", null),
MemberId = SetColumnData(claimDataRow, "MemberID", null),
Mrn = SetColumnData(claimDataRow, "MRN", null),
IsReviewed = IsColumnExists(claimDataRow, "IsReviewed") &&
GetValue <bool>(claimDataRow["IsReviewed"], typeof(bool)),
IsAllReviewed = IsColumnExists(claimDataRow, "IsAllReviewed") &&
GetValue <bool>(claimDataRow["IsAllReviewed"], typeof(bool)),
Los =
IsColumnExists(claimDataRow, "Los")
? GetValue <int>(claimDataRow["Los"], typeof(int))
: 0,
Age =
IsColumnExists(claimDataRow, "Age")
? GetValue <byte>(claimDataRow["Age"], typeof(byte))
: default(byte),
CheckDate = SetDateColumn(claimDataRow, "CheckDate"),
CheckNumber = IsColumnExists(claimDataRow, "CheckNumber")
? GetValue <string>(claimDataRow["CheckNumber"], typeof(string))
: default(string),
AdjudicatedContractName =
IsColumnExists(claimDataRow, "AdjudicatedContractName")
? GetStringValue(claimDataRow["AdjudicatedContractName"])
: null,
InsuredsGroupNumber =
IsColumnExists(claimDataRow, "InsuredsGroupNumber")
? GetStringValue(claimDataRow["InsuredsGroupNumber"])
: null
};
claimDataList.Add(claimData);
}
/// <summary>
/// Gets all claim adjudication.
/// </summary>
/// <param name="claimAdjudicationReport">The claim adjudication report.</param>
/// <returns>
/// ClaimAdjudicationReport.
/// </returns>
public ClaimAdjudicationReport GetClaimAdjudicationReport(ClaimAdjudicationReport claimAdjudicationReport)
{
ClaimAdjudicationReport claimAdjudicationReportList = new ClaimAdjudicationReport
{
ClaimAdjudicationReports = new List <ClaimAdjudicationReport>()
};
if (claimAdjudicationReport != null)
{
// Initialize the Stored Procedure
_databaseCommandObj = _databaseObj.GetStoredProcCommand("GetClaimAdjudicationReport");
// Pass parameters to Stored Procedure(i.e., @ParamName), add values for
_databaseObj.AddInParameter(_databaseCommandObj, "@ModelID", DbType.Int64,
claimAdjudicationReport.NodeId);
_databaseObj.AddInParameter(_databaseCommandObj, "@DateType", DbType.Int32,
claimAdjudicationReport.DateType);
_databaseObj.AddInParameter(_databaseCommandObj, "@DateFrom", DbType.DateTime,
claimAdjudicationReport.StartDate);
_databaseObj.AddInParameter(_databaseCommandObj, "@DateTo", DbType.DateTime,
claimAdjudicationReport.EndDate);
_databaseObj.AddInParameter(_databaseCommandObj, "@SelectCriteria", DbType.String,
claimAdjudicationReport.ClaimSearchCriteria);
_databaseObj.AddInParameter(_databaseCommandObj, "@PageSize", DbType.Int32,
claimAdjudicationReport.PageSize);
_databaseObj.AddInParameter(_databaseCommandObj, "@PageIndex", DbType.Int32,
claimAdjudicationReport.PageIndex);
//Added RequestedUserID and RequestedUserName with reference to HIPAA logging feature
_databaseObj.AddInParameter(_databaseCommandObj, "@RequestedUserID", DbType.String,
claimAdjudicationReport.RequestedUserId);
_databaseObj.AddInParameter(_databaseCommandObj, "@RequestedUserName", DbType.String,
claimAdjudicationReport.RequestedUserName);
_databaseObj.AddInParameter(_databaseCommandObj, "@MaxRecordLimit", DbType.Int32,
claimAdjudicationReport.MaxLinesForPdfReport);
// Retrieve the results of the Stored Procedure in Data table=====================================================================
_databaseCommandObj.CommandTimeout = claimAdjudicationReport.CommandTimeoutForClaimAdjudication;
//============================================================================
DataSet claimAdjudicationReportResult = _databaseObj.ExecuteDataSet(_databaseCommandObj);
if (claimAdjudicationReportResult.IsTableDataPopulated(0))
{
if (claimAdjudicationReportResult.Tables.Count == 2)
{
ClaimAdjudicationReport reportInfoCrossedThreshold = new ClaimAdjudicationReport
{
ReportThreshold = -1
};
return(reportInfoCrossedThreshold);
}
if (claimAdjudicationReportResult.Tables.Count >= 6)
{
DataTable claimAdjudicationReportData = claimAdjudicationReportResult.Tables[6];
List <Contract> contracts = new List <Contract>();
//Set Columns
SetColumnsValues(claimAdjudicationReportList, claimAdjudicationReportData, claimAdjudicationReportResult);
DataTable varianceSummaryDataTable = claimAdjudicationReportResult.Tables[7];
contracts.AddRange(varianceSummaryDataTable.Rows.Cast <object>().Select((t, indexCount) => new Contract
{
ContractName = GetStringValue(varianceSummaryDataTable.Rows[indexCount]["ContractName"]),
ClaimCount =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["ClaimCount"]
? 0
: Convert.ToInt64(varianceSummaryDataTable.Rows[indexCount]["ClaimCount"].ToString()),
TotalClaimCharges =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["ClaimTotalCharges"]
? (double?)null
: Math.Round(double.Parse(varianceSummaryDataTable.Rows[indexCount]["ClaimTotalCharges"].ToString()), 2),
CalculatedAllowed =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["CalculatedAllowed"]
? (double?)null
: Math.Round(double.Parse(varianceSummaryDataTable.Rows[indexCount]["CalculatedAllowed"].ToString()), 2),
PatientResponsibility =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["PatientResponsibility"]
? (double?)null
: Math.Round(double.Parse(varianceSummaryDataTable.Rows[indexCount]["PatientResponsibility"].ToString()), 2),
ActualPayment =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["ActualPmt"]
? (double?)null
: Math.Round(double.Parse(varianceSummaryDataTable.Rows[indexCount]["ActualPmt"].ToString()), 2),
PaymentVariance =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["PaymentVariance"]
? (double?)null
: Math.Round(double.Parse(varianceSummaryDataTable.Rows[indexCount]["PaymentVariance"].ToString()), 2),
CalculatedAdjustment =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["CalculatedAdj"]
? (double?)null
: Math.Round(double.Parse(varianceSummaryDataTable.Rows[indexCount]["CalculatedAdj"].ToString()), 2),
ActualAdjustment =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["ActulAdj"]
? (double?)null
: Math.Round(double.Parse(varianceSummaryDataTable.Rows[indexCount]["ActulAdj"].ToString()), 2),
ContractualVariance =
DBNull.Value == varianceSummaryDataTable.Rows[indexCount]["ContractualVariance"]
? (double?)null
: Math.Round(double.Parse(varianceSummaryDataTable.Rows[indexCount]["ContractualVariance"].ToString()), 2)
}));
Contract unadjudicatedContract = contracts.FirstOrDefault(a => a.ContractName == "Un-adjudicated");
//Removes the unadjudicated contract from the list and add tto the bottom
if (unadjudicatedContract != null)
{
contracts.Remove(unadjudicatedContract);
contracts.Add(unadjudicatedContract);
}
claimAdjudicationReportList.Contracts = contracts;
claimAdjudicationReportList.ClaimsAdjudicated =
GetClaimsAdjudicated(claimAdjudicationReportResult.Tables[1]);
//FIXED-OCT15 -- Read 2, C2, "-" from Constant
claimAdjudicationReportList.PaymentsLinked =
GetPaymentsLinked(claimAdjudicationReportResult.Tables[2]);
claimAdjudicationReportList.ClaimCharges =
GetClaimCharges(claimAdjudicationReportResult.Tables[3]);
claimAdjudicationReportList.ClaimVariances =
GetClaimVariances(claimAdjudicationReportResult.Tables[4]);
claimAdjudicationReportList.VarianceRanges =
GetVarianceRanges(claimAdjudicationReportResult.Tables[5]);
// ReSharper disable once ConditionIsAlwaysTrueOrFalse
if (claimAdjudicationReportData != null && claimAdjudicationReportData.Rows != null &&
claimAdjudicationReportData.Rows.Count > 0)
{
claimAdjudicationReportList.FacilityName = GetStringValue(claimAdjudicationReportData.Rows[0]["FacilityName"]);
claimAdjudicationReportList.TotalRecords = GetValue <int>(claimAdjudicationReportResult.Tables[0].Rows[0]["TotalClaims"], typeof(int));
}
}
}
}
return(claimAdjudicationReportList);
}
/// <summary>
/// Get claims by request name from procedure GetClaimsByRequestName
/// </summary>
/// <param name="claimAdjudicationReport"></param>
/// <param name="maxRecordLimitForExcelReport"></param>
/// <returns></returns>
private DataSet GetClaimsByRequestName(ClaimAdjudicationReport claimAdjudicationReport,
int maxRecordLimitForExcelReport)
{
string filterSetting = string.Empty;
//Checks for Payers, if payers exists stores it in DB
if (claimAdjudicationReport.PageSetting != null &&
claimAdjudicationReport.PageSetting.SearchCriteriaList != null &&
claimAdjudicationReport.PageSetting.SearchCriteriaList.Any())
{
filterSetting = claimAdjudicationReport.XmlSerialize();
}
// Initialize the Stored Procedure
_databaseCommandObj = _databaseObj.GetStoredProcCommand("GetClaimsByRequestName");
// Pass parameters to Stored Procedure(i.e., @ParamName), add values for
_databaseObj.AddInParameter(_databaseCommandObj, "@SelectCriteria ", DbType.String,
claimAdjudicationReport.ClaimSearchCriteria);
_databaseObj.AddInParameter(_databaseCommandObj, "@ModelId", DbType.Int64,
claimAdjudicationReport.ModelId);
_databaseObj.AddInParameter(_databaseCommandObj, "@DateType", DbType.Int32,
claimAdjudicationReport.DateType);
_databaseObj.AddInParameter(_databaseCommandObj, "@StartDate", DbType.DateTime,
claimAdjudicationReport.StartDate);
_databaseObj.AddInParameter(_databaseCommandObj, "@EndDate", DbType.DateTime,
claimAdjudicationReport.EndDate);
_databaseObj.AddInParameter(_databaseCommandObj, "@MaxRecordLimit", DbType.Int32,
maxRecordLimitForExcelReport);
_databaseObj.AddInParameter(_databaseCommandObj, "@IsSelectClaims", DbType.Boolean,
claimAdjudicationReport.IsSelectClaims);
//Added RequestedUserID and RequestedUserName with reference to HIPAA logging feature
_databaseObj.AddInParameter(_databaseCommandObj, "@RequestedUserID", DbType.String,
claimAdjudicationReport.RequestedUserId);
_databaseObj.AddInParameter(_databaseCommandObj, "@RequestedUserName", DbType.String,
claimAdjudicationReport.RequestedUserName);
_databaseObj.AddInParameter(_databaseCommandObj, "@UserId", DbType.Int32, claimAdjudicationReport.UserId);
_databaseObj.AddInParameter(_databaseCommandObj, "@Take", DbType.Int32,
claimAdjudicationReport.PageSetting != null
? claimAdjudicationReport.PageSetting.Take
: 50);
_databaseObj.AddInParameter(_databaseCommandObj, "@Skip", DbType.Int32,
claimAdjudicationReport.PageSetting != null
? claimAdjudicationReport.PageSetting.Skip
: 0);
_databaseObj.AddInParameter(_databaseCommandObj, "@SortField", DbType.String,
claimAdjudicationReport.PageSetting != null
? claimAdjudicationReport.PageSetting.SortField
: string.Empty);
_databaseObj.AddInParameter(_databaseCommandObj, "@SortDirection", DbType.String,
claimAdjudicationReport.PageSetting != null
? claimAdjudicationReport.PageSetting.SortDirection
: string.Empty);
_databaseObj.AddInParameter(_databaseCommandObj, "@FilterSearchCriteria", DbType.Xml, filterSetting);
// Retrieve the results of the Stored Procedure in Datatable
_databaseCommandObj.CommandTimeout = claimAdjudicationReport.CommandTimeoutForClaimAdjudication;
DataSet claimAdjudicationReportDataSet = _databaseObj.ExecuteDataSet(_databaseCommandObj);
return(claimAdjudicationReportDataSet);
}
/// <summary>
/// Set Columns Values
/// </summary>
/// <param name="claimAdjudicationReportList"></param>
/// <param name="claimAdjudicationReportData"></param>
/// <param name="claimAdjudicationReportResult"></param>
private static void SetColumnsValues(ClaimAdjudicationReport claimAdjudicationReportList,
DataTable claimAdjudicationReportData, DataSet claimAdjudicationReportResult)
{
TextInfo textInfo = new CultureInfo("en-US", false).TextInfo;
claimAdjudicationReportList.ClaimAdjudicationReports.AddRange(
claimAdjudicationReportData.Rows.Cast <object>()
.Select((t, indexCount) => new ClaimAdjudicationReport
{
NodeId = GetValue <long>(claimAdjudicationReportData.Rows[indexCount]["ModelID"], typeof(long)),
ModelId = GetValue <long>(claimAdjudicationReportData.Rows[indexCount]["ModelID"], typeof(long)),
ClaimIdentity =
GetValue <long>(claimAdjudicationReportData.Rows[indexCount]["ClaimId"], typeof(long)),
ClaimId = GetStringValue(claimAdjudicationReportData.Rows[indexCount]["ClaimId"]),
PatientAccountNumber =
GetStringValue(claimAdjudicationReportData.Rows[indexCount]["PatAcctNum"]),
ContractId =
GetValue <long>(claimAdjudicationReportData.Rows[indexCount]["ContractID"], typeof(long)),
ClaimContractName =
GetStringValue(claimAdjudicationReportResult.Tables[6].Rows[indexCount]["ContractName"]),
PayerName =
DBNull.Value == claimAdjudicationReportData.Rows[indexCount]["PriPayerName"]
? string.Empty
: textInfo.ToTitleCase(
claimAdjudicationReportData.Rows[indexCount]["PriPayerName"]
.ToString()),
BillType = GetStringValue(claimAdjudicationReportData.Rows[indexCount]["BillType"]),
Drg = GetStringValue(claimAdjudicationReportData.Rows[indexCount]["DRG"]),
ServiceLine =
DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["ClaimServiceLineID"]
? null
: claimAdjudicationReportData.Rows[indexCount]["ClaimServiceLineID"]
.ToString(),
Los = GetValue <int>(claimAdjudicationReportData.Rows[indexCount]["LOS"], typeof(int)),
StatementFrom =
GetValue <DateTime>(claimAdjudicationReportData.Rows[indexCount]["StatementFrom"],
typeof(DateTime)),
StatementThrough =
GetValue <DateTime>(claimAdjudicationReportData.Rows[indexCount]["StatementThru"],
typeof(DateTime)),
ClaimTotal =
DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["ClaimTotalCharges"]
? (double?)null
: Math.Round(
double.Parse(
claimAdjudicationReportData.Rows[indexCount]["ClaimTotalCharges"
].ToString()), 2),
CalculatedAdjustment =
DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["CalculatedAdj"]
? (double?)null
: Math.Round(
double.Parse(
claimAdjudicationReportData.Rows[indexCount]["CalculatedAdj"]
.ToString()), 2),
ActualPayment = DBNull.Value == claimAdjudicationReportData.Rows[indexCount]["ActualPmt"]
? (double?)null
: Math.Round(
double.Parse(
claimAdjudicationReportData.Rows[indexCount]["ActualPmt"]
.ToString()), 2),
Reimbursement =
GetValue <double?>(claimAdjudicationReportData.Rows[indexCount]["ReimbursementAmount"],
typeof(double)),
RevCode = GetStringValue(claimAdjudicationReportData.Rows[indexCount]["RevCode"]),
HcpcsCode = GetStringValue(claimAdjudicationReportData.Rows[indexCount]["HCPCSCode"]),
ServiceFromDate =
DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["ServiceFromDate"]
? new DateTime()
: GetValue <DateTime>(claimAdjudicationReportData.Rows[indexCount]["ServiceFromDate"],
typeof(DateTime)),
ServiceThruDate =
DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["ServiceThruDate"]
? new DateTime()
: GetValue <DateTime>(claimAdjudicationReportData.Rows[indexCount]["ServiceThruDate"],
typeof(DateTime)),
ServUnits = GetValue <int?>(claimAdjudicationReportData.Rows[indexCount]["Units"], typeof(int)),
ServiceType = GetStringValue(claimAdjudicationReportData.Rows[indexCount]["ServiceType"]),
CodeSelection =
DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["CodeSelection"]
? string.Empty
: Convert.ToString(
claimAdjudicationReportData.Rows[indexCount]["CodeSelection"])
.Replace(Environment.NewLine, string.Empty),
Payment =
DBNull.Value == claimAdjudicationReportData.Rows[indexCount]["PaymentType"]
? string.Empty
: Convert.ToString(
claimAdjudicationReportData.Rows[indexCount]["PaymentType"])
.Replace(Environment.NewLine, string.Empty),
AdjudicationStatus =
GetStringValue(claimAdjudicationReportData.Rows[indexCount]["AdjudicationStatus"]),
IsClaimChargeData =
GetValue <bool>(claimAdjudicationReportData.Rows[indexCount]["IsClaimChargeData"],
typeof(bool)),
IsFormulaError =
GetValue <bool>(claimAdjudicationReportData.Rows[indexCount]["IsFormulaError"], typeof(bool)),
PatientResponsibility =
DBNull.Value == claimAdjudicationReportData.Rows[indexCount]["PatientResponsibility"]
? (double?)null
: Math.Round(
double.Parse(
claimAdjudicationReportData.Rows[indexCount]["PatientResponsibility"]
.ToString()), 2),
MedicareSequesterAmount =
DBNull.Value == claimAdjudicationReportData.Rows[indexCount]["MedicareSequesterAmount"]
? (double?)null
: Math.Round(
double.Parse(
claimAdjudicationReportData.Rows[indexCount]["MedicareSequesterAmount"]
.ToString()), 3),
ContractServiceTypeId =
GetValue <long>(claimAdjudicationReportData.Rows[indexCount]["ContractServiceTypeID"],
typeof(long)),
HcpcsModifier =
Regex.Replace(
GetStringValue(claimAdjudicationReportData.Rows[indexCount]["HCPCSModifier"]),
Constants.HcpcsModifierPattern, Constants.WhiteSpace),
PlaceOfService = GetStringValue(claimAdjudicationReportData.Rows[indexCount]["PlaceOfService"]),
ClaimType = GetStringValue(claimAdjudicationReportData.Rows[indexCount]["ClaimType"]),
ActualAdjustment = DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["ActulAdj"]
? (double?)null
: Math.Round(
double.Parse(
claimAdjudicationReportData.Rows[indexCount]["ActulAdj"]
.ToString()), 2),
ContractualVariance =
DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["ContractualVariance"]
? (double?)null
: Math.Round(
double.Parse(
claimAdjudicationReportData.Rows[indexCount]["ContractualVariance"]
.ToString()), 2),
PaymentVariance = DBNull.Value ==
claimAdjudicationReportData.Rows[indexCount]["PaymentVariance"]
? (double?)null
: Math.Round(
double.Parse(
claimAdjudicationReportData.Rows[indexCount]["PaymentVariance"]
.ToString()), 2)
}));
}
