Esempio n. 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);
        }
Esempio n. 2
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        public void Claims_CalculateAndUpdate_PreauthOrderWriteoff()
        {
            string suffix = MethodBase.GetCurrentMethod().Name;
            //create the patient and insurance information
            Patient pat = PatientT.CreatePatient(suffix);
            //proc - Crown
            Procedure proc         = ProcedureT.CreateProcedure(pat, "D2750", ProcStat.C, "8", 1000);
            long      feeSchedNum1 = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, suffix);

            FeeT.CreateFee(feeSchedNum1, proc.CodeNum, 900);
            Carrier carrier = CarrierT.CreateCarrier(suffix);
            InsPlan insPlan = InsPlanT.CreateInsPlanPPO(carrier.CarrierNum, feeSchedNum1);

            BenefitT.CreateAnnualMax(insPlan.PlanNum, 1000);
            BenefitT.CreateCategoryPercent(insPlan.PlanNum, EbenefitCategory.Crowns, 100);
            InsSub  sub = InsSubT.CreateInsSub(pat.PatNum, insPlan.PlanNum);
            PatPlan pp  = PatPlanT.CreatePatPlan(1, pat.PatNum, sub.InsSubNum);
            //create lists and variables required for ComputeEstimates()
            List <InsSub>    SubList         = InsSubs.RefreshForFam(Patients.GetFamily(pat.PatNum));
            List <InsPlan>   listInsPlan     = InsPlans.RefreshForSubList(SubList);
            List <PatPlan>   listPatPlan     = PatPlans.Refresh(pat.PatNum);
            List <Benefit>   listBenefits    = Benefits.Refresh(listPatPlan, SubList);
            List <Procedure> listProcsForPat = Procedures.Refresh(pat.PatNum);
            List <Procedure> procsForClaim   = new List <Procedure>();

            procsForClaim.Add(proc);
            //Create the claim and associated claimprocs
            //The order of these claimprocs is the whole point of the unit test.
            //Create Preauth
            ClaimProcs.CreateEst(new ClaimProc(), proc, insPlan, sub, 0, 500, true, true);
            //Create Estimate
            ClaimProcs.CreateEst(new ClaimProc(), proc, insPlan, sub, 1000, 1000, true, false);
            List <ClaimProc> listClaimProcs = ClaimProcs.Refresh(pat.PatNum);
            Claim            claimWaiting   = ClaimT.CreateClaim("W", listPatPlan, listInsPlan, listClaimProcs, listProcsForPat, pat, procsForClaim, listBenefits, SubList, false);

            Assert.AreEqual(100, claimWaiting.WriteOff, "WriteOff Amount");
        }