Exemple #1
0
        ///<summary>Creates a general deductible of $50, a deductible of $50 on D0220, sets a $30 D0220 complete and creates a claim,
        ///creates a $100 D2750, that is TP'ed, and then creates a $30 D0220 that is TP'ed.</summary>
        ///<param name="actAssert">The first claimproc is for the D2750 and the second claimproc is for the second D0220.</param>
        public void GetDeductibleByCodeDeductLessThanGeneral(string suffix, Action <ClaimProc, ClaimProc> actAssert)
        {
            Patient pat = PatientT.CreatePatient(suffix);

            InsuranceT.AddInsurance(pat, suffix);
            List <InsSub>  listSubs     = InsSubT.GetInsSubs(pat);
            List <InsPlan> listPlans    = InsPlans.RefreshForSubList(listSubs);
            List <PatPlan> listPatPlans = PatPlans.Refresh(pat.PatNum);
            InsPlan        plan         = InsPlanT.GetPlanForPriSecMed(PriSecMed.Primary, listPatPlans, listPlans, listSubs);

            BenefitT.CreateDeductibleGeneral(plan.PlanNum, BenefitCoverageLevel.Individual, 50);
            BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Diagnostic, 100);
            BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Crowns, 50);
            BenefitT.CreateDeductible(plan.PlanNum, EbenefitCategory.Diagnostic, 0);
            BenefitT.CreateDeductible(plan.PlanNum, "D0220", 50);
            List <Benefit> listBens = Benefits.Refresh(listPatPlans, listSubs);
            Procedure      proc1    = ProcedureT.CreateProcedure(pat, "D0220", ProcStat.C, "", 30);//proc1 - Intraoral - periapical first film

            ClaimT.CreateClaim("P", listPatPlans, listPlans, new List <ClaimProc>(), new List <Procedure> {
                proc1
            }, pat, new List <Procedure> {
                proc1
            }, listBens,
                               listSubs);
            Procedure        proc2      = ProcedureT.CreateProcedure(pat, "D2750", ProcStat.TP, "", 100, priority: 0); //proc2 - Crown
            Procedure        proc3      = ProcedureT.CreateProcedure(pat, "D0220", ProcStat.TP, "", 30, priority: 1);  //proc3 - Intraoral - periapical first film
            List <ClaimProc> claimProcs = ProcedureT.ComputeEstimates(pat, listPatPlans, listPlans, listSubs, listBens);
            ClaimProc        claimProc2 = claimProcs.FirstOrDefault(x => x.ProcNum == proc2.ProcNum);
            ClaimProc        claimProc3 = claimProcs.FirstOrDefault(x => x.ProcNum == proc3.ProcNum);

            actAssert(claimProc2, claimProc3);
        }
Exemple #2
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        public void Benefits_OverAgeWithLifetimeMax()
        {
            string        suffix = MethodBase.GetCurrentMethod().Name;
            Patient       pat    = PatientT.CreatePatient(suffix, birthDate: DateTime.Now.AddYears(-20));
            InsuranceInfo ins    = InsuranceT.AddInsurance(pat, suffix);

            BenefitT.CreateCategoryPercent(ins.PrimaryInsPlan.PlanNum, EbenefitCategory.Orthodontics, 50);
            BenefitT.CreateAgeLimitation(ins.PrimaryInsPlan.PlanNum, EbenefitCategory.Orthodontics, 18);
            BenefitT.CreateOrthoMax(ins.PrimaryInsPlan.PlanNum, 1000);
            ins.RefreshBenefits();
            Procedure        proc           = ProcedureT.CreateProcedure(pat, "D8090", ProcStat.TP, "", 3000);//comprehensive orthodontic treatment
            List <ClaimProc> listClaimProcs = ProcedureT.ComputeEstimates(pat, ins);

            Assert.AreEqual(0, listClaimProcs.First().InsEstTotal);
        }