//
// GET: /Scheduling/Insurance/
public ActionResult Edit(long chargeCardId = 0)
{
if (chargeCardId > 0)
{
var chargeCard = _chargeCardRepository.GetById(chargeCardId);
var model = new EligibilityEditModel
{
CardDetail = chargeCard,
HideCardDetails = true
};
return(View(model));
}
return(View(new EligibilityEditModel()));
}
public ActionResult CheckEligibility(EligibilityEditModel model)
{
if (!ModelState.IsValid)
{
return(PartialView(model));
}
long?createdByOrgRoleUserId = null;
if (_sessionContext != null && _sessionContext.UserSession != null)
{
createdByOrgRoleUserId = _sessionContext.UserSession.CurrentOrganizationRole.OrganizationRoleUserId;
}
model = _eligibilityService.CheckEligibility(model, createdByOrgRoleUserId);
ModelState.Clear();
return(PartialView(model));
}
public EligibilityEditModel CheckEligibility(EligibilityEditModel model, long?orgRoleUserId)
{
var insuranceCompany = _insuranceCompanyRepository.GetById(model.Request.InsuranceCompanyId);
var insuranceServiceType = _insuranceServiceTypeRepository.GetById((long)EligibilityServiceType.HBPC);
var eligibilityRespose = _eligibilityApi.GetCoverage(model.Request, insuranceCompany, insuranceServiceType);
var creditCardResponse = CheckCreditCard(model.CardDetail);
if (eligibilityRespose.Plan != null && (eligibilityRespose.Plan.CoverageStatus == EligibleCoverageStatus.ActiveCoverage || eligibilityRespose.Plan.CoverageStatus == EligibleCoverageStatus.ActiveFullRiskCapitation ||
eligibilityRespose.Plan.CoverageStatus == EligibleCoverageStatus.ActiveServicesCapitated || eligibilityRespose.Plan.CoverageStatus == EligibleCoverageStatus.ActiveServicesCapitatedToPrimaryCarePhysician) &&
creditCardResponse.ProcessorResult == ProcessorResponseResult.Accepted)
{
decimal coPay = 0;
decimal coInsurance = 0;
if (eligibilityRespose.Plan.FinancialData != null)
{
if (eligibilityRespose.Plan.FinancialData.CoPayment != null && eligibilityRespose.Plan.FinancialData.CoPayment.Amounts != null)
{
if (insuranceCompany.InNetwork)
{
if (eligibilityRespose.Plan.FinancialData.CoPayment.Amounts.InNetWork != null && eligibilityRespose.Plan.FinancialData.CoPayment.Amounts.InNetWork.Any())
{
coPay = eligibilityRespose.Plan.FinancialData.CoPayment.Amounts.InNetWork.First().Amount;
}
}
else
{
if (eligibilityRespose.Plan.FinancialData.CoPayment.Amounts.OutNetWork != null && eligibilityRespose.Plan.FinancialData.CoPayment.Amounts.OutNetWork.Any())
{
coPay = eligibilityRespose.Plan.FinancialData.CoPayment.Amounts.OutNetWork.First().Amount;
}
}
}
if (eligibilityRespose.Plan.FinancialData.CoInsurance != null && eligibilityRespose.Plan.FinancialData.CoInsurance.Percents != null)
{
if (insuranceCompany.InNetwork)
{
if (eligibilityRespose.Plan.FinancialData.CoInsurance.Percents.InNetWork != null && eligibilityRespose.Plan.FinancialData.CoInsurance.Percents.InNetWork.Any())
{
coInsurance = eligibilityRespose.Plan.FinancialData.CoInsurance.Percents.InNetWork.First().Amount;
}
}
else
{
if (eligibilityRespose.Plan.FinancialData.CoInsurance.Percents.OutNetWork != null && eligibilityRespose.Plan.FinancialData.CoInsurance.Percents.OutNetWork.Any())
{
coPay = eligibilityRespose.Plan.FinancialData.CoInsurance.Percents.OutNetWork.First().Amount;
}
}
}
}
var eligibility = new Eligibility
{
Id = model.EligibilityId,
Guid = eligibilityRespose.Guid,
InsuranceCompanyId = model.Request.InsuranceCompanyId,
PlanName = eligibilityRespose.Plan.PlanName,
GroupName = eligibilityRespose.Demographics.Subscriber.GroupName,
CoPayment = coPay,
CoInsurance = coInsurance,
Request = JsonConvert.SerializeObject(model.Request),
Response = eligibilityRespose.RawResponse,
DateCreated = DateTime.Now,
CreatedByOrgRoleUserId = orgRoleUserId
};
eligibility = _eligibilityRepository.Save(eligibility);
model.EligibilityId = eligibility.Id;
var chargeCard = model.CardDetail;
chargeCard.DataRecorderMetaData = new DataRecorderMetaData
{
DataRecorderCreator = new OrganizationRoleUser(orgRoleUserId.HasValue && orgRoleUserId.Value > 0 ? orgRoleUserId.Value : 1),
DateCreated = DateTime.Now
};
chargeCard = _chargeCardRepository.Save(chargeCard);
model.CardDetail = chargeCard;
}
model.Response = eligibilityRespose;
if (creditCardResponse.ProcessorResult != ProcessorResponseResult.Accepted)
{
model.ChargeCardResponse = creditCardResponse.Message;
model.HideCardDetails = false;
}
return(model);
}
