private Service GetServiceJustEntered(string Patid, string EpisodeNumber, DateTime ServiceDate, string ServiceCode, string StaffId)
{
var service = new Service();
var connectionString = ConfigurationManager.ConnectionStrings["CacheODBC"].ConnectionString;
#region CommandText
var commandText = "SELECT TOP(1) billing_tx_history.cost_of_service, " +
"billing_tx_history.date_of_service, " +
"billing_tx_history.duration, " +
"billing_tx_history.end_time, " +
"billing_tx_history.EPISODE_NUMBER, " +
"billing_tx_history.FACILITY, " +
"billing_tx_history.JOIN_TO_TX_HISTORY, " +
"billing_tx_history.location_code, " +
"billing_tx_history.location_value, " +
"billing_tx_history.NOT_uniqueid, " +
"billing_tx_history.ORIG_JOIN_TO_TX_HISTORY, " +
"billing_tx_history.PATID, " +
"billing_guar_table.GUARANTOR_ID, " +
"billing_guar_table.guarantor_name, " +
"billing_tx_history.program_code, " +
"billing_tx_history.program_value, " +
"billing_tx_history.program_X_RRG_code, " +
"billing_tx_history.program_X_RRG_value, " +
"billing_tx_history.PROVIDER_ID, " +
"billing_tx_history.SERVICE_CODE, " +
"billing_tx_history.start_time, " +
"billing_tx_history.units_of_service, " +
"billing_tx_history.v_patient_name, " +
"billing_tx_history.v_PROVIDER_NAME, " +
"billing_tx_history.v_service_value " +
"FROM SYSTEM.billing_tx_history " +
"INNER JOIN SYSTEM.billing_guar_table " +
"ON billing_tx_history.primary_guarantor = billing_guar_table.GUARANTOR_ID " +
"AND billing_tx_history.FACILITY = billing_guar_table.FACILITY " +
"WHERE billing_tx_history.PATID=? " +
"AND billing_tx_history.EPISODE_NUMBER=? " +
"AND billing_tx_history.SERVICE_CODE=? " +
"AND billing_tx_history.PROVIDER_ID=? " +
"AND billing_tx_history.date_of_service=? " +
"AND (billing_tx_history.data_entry_time=? OR billing_tx_history.data_entry_time=?)";
#endregion
try
{
using (var connection = new OdbcConnection(connectionString))
{
connection.Open();
using (var dbcommand = new OdbcCommand(commandText, connection))
{
dbcommand.Parameters.Add(new OdbcParameter("PATID", Patid));
dbcommand.Parameters.Add(new OdbcParameter("EPISODE_NUMBER", EpisodeNumber));
dbcommand.Parameters.Add(new OdbcParameter("SERVICE_CODE", ServiceCode));
dbcommand.Parameters.Add(new OdbcParameter("PROVIDER_ID", StaffId));
dbcommand.Parameters.Add(new OdbcParameter("date_of_service", ServiceDate.ToString("yyyy-MM-dd")));
dbcommand.Parameters.Add(new OdbcParameter("data_entry_time", DateTime.Now.ToString("hh:mm tt")));
dbcommand.Parameters.Add(new OdbcParameter("data_entry_time", DateTime.Now.AddMinutes(-1).ToString("hh:mm tt")));
using (var reader = dbcommand.ExecuteReader())
{
if (reader.Read())
{
#region ReadInValues
service.ServiceCost = reader["cost_of_service"].ToString();
service.ServiceDate = DateTime.Parse(reader["date_of_service"].ToString());
service.Duration = reader["duration"].ToString();
service.StartTime = reader["start_time"].ToString();
service.EndTime = reader["end_time"].ToString();
service.EpisodeNumber = reader["EPISODE_NUMBER"].ToString();
service.Facility = reader["FACILITY"].ToString();
service.JoinToTxHistory = reader["JOIN_TO_TX_HISTORY"].ToString();
service.LocationCode = reader["location_code"].ToString();
service.LocationValue = reader["location_value"].ToString();
service.NotUniqueId = reader["NOT_uniqueid"].ToString();
service.OrigJoinToTxHistory = reader["ORIG_JOIN_TO_TX_HISTORY"].ToString();
service.Patid = reader["PATID"].ToString();
service.PatientName = reader["v_patient_name"].ToString();
service.GuarantorId = reader["GUARANTOR_ID"].ToString();
service.GuarantorName = reader["guarantor_name"].ToString();
service.ProgramCode = reader["program_code"].ToString();
service.ProgramValue = reader["program_value"].ToString();
service.ProgramRRGCode = reader["program_X_RRG_code"].ToString();
service.ProgramRRGValue = reader["program_X_RRG_value"].ToString();
service.StaffId = reader["PROVIDER_ID"].ToString();
service.StaffName = reader["v_PROVIDER_NAME"].ToString();
service.ServiceCode = reader["SERVICE_CODE"].ToString();
service.ServiceValue = reader["v_service_value"].ToString();
service.UnitsOfService = reader["units_of_service"].ToString();
#endregion
}
else
{
service = null;
}
}
}
connection.Close();
}
}
catch (Exception e)
{
}
return service;
}
private bool guarantorAndServiceNeedAuth(Service service)
{
List<String> List202 = new List<String>() { "203", "300", "3000", "301", "3001", "307", "313", "315", "316", "400", "4000", "4001" };
List<String> List207_208_210_215 = new List<String>() { "203", "3000", "3001", "300", "301", "307", "313", "315", "316", "400", "401", "402", "403", "404", "405", "4000", "4001" };
List<String> List212 = new List<String>() { "400", "401", "402", "403", "404", "405", "300", "3000", "301", "3001", "307", "313", "315", "316", "203" };
List<String> List213_406 = new List<String>() { "200", "201", "202", "203", "3000", "3001", "300", "301", "307", "313", "315", "316", "400", "401", "402", "4000", "4001" };
List<String> List57 = new List<String>() { "203" };
switch (service.GuarantorId)
{
case "57": return List57.Contains(service.ServiceCode);
case "202": return List202.Contains(service.ServiceCode);
case "205": return true;
case "207": return List207_208_210_215.Contains(service.ServiceCode);
case "208": return List207_208_210_215.Contains(service.ServiceCode);
case "210": return List207_208_210_215.Contains(service.ServiceCode);
case "212": return List212.Contains(service.ServiceCode);
case "213": return List213_406.Contains(service.ServiceCode);
case "215": return List207_208_210_215.Contains(service.ServiceCode);//Added this for Magellan complete care noAuths to send email alerts
case "211": return List207_208_210_215.Contains(service.ServiceCode);//Added this for Prestige (CAID) noAuths to send email alerts
case "302": return true;
case "303": return true;
case "401": return true;
case "403": return true;
case "406": return List213_406.Contains(service.ServiceCode);
case "701": return true;
default: return false;
}
}
private bool isAuthValid(Service service)
{
bool temp = true;
var connectionString = ConfigurationManager.ConnectionStrings["CacheODBC"].ConnectionString;
var commandText = "SELECT history_managed_care_auths.auth_start_date " +
"FROM SYSTEM.history_managed_care_auths " +
"WHERE history_managed_care_auths.PATID=? " +
"AND history_managed_care_auths.GUARANTOR_ID=? " +
"AND history_managed_care_auths.auth_start_date<=? " +
"AND history_managed_care_auths.auth_end_date>=? " +
"AND (history_managed_care_auths.rem_units IS NULL OR CAST(history_managed_care_auths.rem_units as DOUBLE)>0) " +
"AND (history_managed_care_auths.rem_visits IS NULL OR CAST(history_managed_care_auths.rem_visits as DOUBLE)>0) " +
"AND history_managed_care_auths.service_codes_all like ?";
try
{
using (var connection = new OdbcConnection(connectionString))
{
connection.Open();
using (var dbcommand = new OdbcCommand(commandText, connection))
{
dbcommand.Parameters.Add(new OdbcParameter("PATID", service.Patid));
dbcommand.Parameters.Add(new OdbcParameter("GUARANTOR_ID", service.GuarantorId));
dbcommand.Parameters.Add(new OdbcParameter("auth_start_date", service.ServiceDate.ToString("yyyy-MM-dd")));
dbcommand.Parameters.Add(new OdbcParameter("auth_end_date", service.ServiceDate.ToString("yyyy-MM-dd")));
dbcommand.Parameters.Add(new OdbcParameter("service_codes_all", "%" + service.ServiceCode + "%"));
using (var reader = dbcommand.ExecuteReader())
{
if (reader.Read())
temp = true;
else
temp = false;
}
}
connection.Close();
}
}
catch (Exception e)
{
}
return temp;
}
public OptionObject ToDraftAuthorizationNotification(OptionObject optionObject)
{
List<string> UpdateCommands = new List<string>();
OptionObject returnOptionObject = new OptionObject();
//string guarantorID;
var noteStatus = new FieldObject { FieldNumber = "50010" };
var serviceCode = new FieldObject { FieldNumber = "51001" };
var serviceDate = new FieldObject { FieldNumber = "51011" };
var serviceDuration = new FieldObject { FieldNumber = "51003" };
foreach (var form in optionObject.Forms)
{
foreach (var field in form.CurrentRow.Fields)
{
if (field.FieldNumber.Equals(noteStatus.FieldNumber))
noteStatus.FieldValue = field.FieldValue;
if (field.FieldNumber.Equals(serviceCode.FieldNumber))
serviceCode.FieldValue = field.FieldValue;
if (field.FieldNumber.Equals(serviceDate.FieldNumber))
serviceDate.FieldValue = field.FieldValue;
if (field.FieldNumber.Equals(serviceDuration.FieldNumber))
serviceDuration.FieldValue = field.FieldValue;
}
}
var service = new Service();
service = GetServiceJustEntered(optionObject.EntityID, optionObject.EpisodeNumber.ToString(),
DateTime.Parse(serviceDate.FieldValue), serviceCode.FieldValue,
optionObject.OptionStaffId);
try
{
if (service != null && guarantorAndServiceNeedAuth(service))
if (!isAuthValid(service))
{
//Set note to Draft and Disable
string SetToDraft = "7001|50010|D|1|0|0";
UpdateCommands.Add(SetToDraft);
OptionObjectHelper OOHelper = new OptionObjectHelper(optionObject, UpdateCommands);
returnOptionObject = OOHelper.returnOptionObject;
}
}
catch (Exception e)
{
}
// var svcCodeList = ConfigurationManager.AppSettings["ServiceCodesToExclude"].ToString().Split(',').ToList();
// if (Convert.ToInt32(serviceDuration.FieldValue) > 300 && svcCodeList.IndexOf(serviceCode.FieldValue) < 0)
// {
// sendEmail(ConfigurationManager.AppSettings["SMTPFromEmailAddress"].ToString(),
// "Service with a duration of " + serviceDuration.FieldValue + " entered.",
// "Client ID: " + optionObject.EntityID +
// "\nEpisode #: " + optionObject.EpisodeNumber +
// "\nGuarantor ID: " + service.GuarantorId +
// "\nService Code: " + serviceCode.FieldValue +
// "\nService Date: " + serviceDate.FieldValue +
// "\nStaff ID: " + optionObject.OptionStaffId,
// new List<string> { ConfigurationManager.AppSettings["SMTPCreateSWTicket"].ToString() },
// new List<string>(),
// ConfigurationManager.AppSettings["AssignToBilling"].ToString().Split(',').ToList());
// }
return returnOptionObject;
}
