///<summary>Users using the OpenDentalService to create claim snapshots only get primary claim snap shots created.</summary>
private static void CreateClaimSnapShotService()
{
//No need to check RemotingRole; no call to db.
List <Procedure> listCompletedProcs = Procedures.GetCompletedByDateCompleteForDateRange(DateTime.Today, DateTime.Today);
List <ClaimProc> listClaimProcs = ClaimProcs.GetForProcsWithOrdinal(listCompletedProcs.Select(x => x.ProcNum).ToList(), 1).Where(x => !x.Status.In(ClaimProcStatus.Preauth, ClaimProcStatus.Adjustment)).ToList();
List <PatPlan> listPatPlans = PatPlans.GetListByInsSubNums(listClaimProcs.Select(x => x.InsSubNum).ToList());
listClaimProcs = listClaimProcs
.OrderByDescending(x => x.ClaimNum) //order by claim num
.ThenByDescending(x => x.SecDateEntry) //then by creation date
//group by procnum and ordinal
.GroupBy(x => new { ProcNum = x.ProcNum, Ordinal = PatPlans.GetOrdinal(x.InsSubNum, listPatPlans.Where(y => y.PatNum == x.PatNum).ToList()) })
.Select(x => x.First()) //get the first for each group
.ToList();
//Loop through all the claimprocs and create a claimsnapshot entry for each.
for (int i = 0; i < listClaimProcs.Count; i++)
{
ClaimProc cpCur = listClaimProcs[i];
if (cpCur.Status == ClaimProcStatus.CapClaim ||
cpCur.Status == ClaimProcStatus.CapComplete ||
cpCur.Status == ClaimProcStatus.CapEstimate ||
cpCur.Status == ClaimProcStatus.Preauth ||
cpCur.Status == ClaimProcStatus.Supplemental ||
cpCur.Status == ClaimProcStatus.InsHist)
{
continue;
}
//get the procfee
double procFee = 0;
Procedure procCur = listCompletedProcs.Find(x => x.ProcNum == cpCur.ProcNum);
if (procCur != null)
{
procFee = procCur.ProcFee;
}
//get the writeoff
double writeoffAmt = cpCur.WriteOff;
//For the Service, only use the WriteOff amount on the claimproc if the claimproc is associated to a claim,
//as this means that value has been set.
if (cpCur.Status != ClaimProcStatus.NotReceived && cpCur.Status != ClaimProcStatus.Received)
{
if (cpCur.WriteOffEstOverride != -1)
{
writeoffAmt = cpCur.WriteOffEstOverride;
}
else
{
writeoffAmt = cpCur.WriteOffEst;
}
}
//create the snapshot
ClaimSnapshot snapshot = new ClaimSnapshot();
snapshot.ProcNum = cpCur.ProcNum;
snapshot.Writeoff = writeoffAmt;
snapshot.InsPayEst = cpCur.InsEstTotal;
snapshot.Fee = procFee;
snapshot.ClaimProcNum = cpCur.ClaimProcNum;
snapshot.SnapshotTrigger = ClaimSnapshotTrigger.Service;
ClaimSnapshots.Insert(snapshot);
}
}
///<summary>Do not call this until after determining if the repeate charge might generate a claim. This function checks current insurance and
///may not add claims if no insurance is found.</summary>
private static List <Claim> AddClaimsHelper(RepeatCharge repeateCharge, Procedure proc)
{
//No remoting role check; no call to db
List <PatPlan> patPlanList = PatPlans.Refresh(repeateCharge.PatNum);
List <InsSub> subList = InsSubs.RefreshForFam(Patients.GetFamily(repeateCharge.PatNum));
List <InsPlan> insPlanList = InsPlans.RefreshForSubList(subList);
List <Benefit> benefitList = Benefits.Refresh(patPlanList, subList);
List <Claim> retVal = new List <Claim>();
Claim claimCur;
if (patPlanList.Count == 0) //no current insurance, do not create a claim
{
return(retVal);
}
//create the claimprocs
Procedures.ComputeEstimates(proc, proc.PatNum, new List <ClaimProc>(), true, insPlanList, patPlanList, benefitList,
Patients.GetPat(proc.PatNum).Age, subList);
//get claimprocs for this proc, may be more than one
List <ClaimProc> claimProcList = ClaimProcs.GetForProc(ClaimProcs.Refresh(proc.PatNum), proc.ProcNum);
string claimType = "P";
if (patPlanList.Count == 1 && PatPlans.GetOrdinal(PriSecMed.Medical, patPlanList, insPlanList, subList) > 0) //if there's exactly one medical plan
{
claimType = "Med";
}
claimCur = Claims.CreateClaimForRepeatCharge(claimType, patPlanList, insPlanList, claimProcList, proc, subList);
claimProcList = ClaimProcs.Refresh(proc.PatNum);
if (claimCur.ClaimNum == 0)
{
return(retVal);
}
retVal.Add(claimCur);
Claims.CalculateAndUpdate(new List <Procedure> {
proc
}, insPlanList, claimCur, patPlanList, benefitList, Patients.GetPat(proc.PatNum).Age, subList);
if (PatPlans.GetOrdinal(PriSecMed.Secondary, patPlanList, insPlanList, subList) > 0 && //if there exists a secondary plan
!CultureInfo.CurrentCulture.Name.EndsWith("CA")) //and not canada (don't create secondary claim for canada)
{
claimCur = Claims.CreateClaimForRepeatCharge("S", patPlanList, insPlanList, claimProcList, proc, subList);
if (claimCur.ClaimNum == 0)
{
return(retVal);
}
retVal.Add(claimCur);
ClaimProcs.Refresh(proc.PatNum);
claimCur.ClaimStatus = "H";
Claims.CalculateAndUpdate(new List <Procedure> {
proc
}, insPlanList, claimCur, patPlanList, benefitList, Patients.GetPat(proc.PatNum).Age, subList);
}
return(retVal);
}
