///<summary>Gets all claims for the patient selected. Fills gridClaims and tags each row with its corrisponding claim object.</summary>
private void FillGridClaims()
{
int sortByColIdx = gridClaims.SortedByColumnIdx; //Keep previous sorting
bool isSortAsc = gridClaims.SortedIsAscending;
if (sortByColIdx == -1)
{
sortByColIdx = 0;
isSortAsc = false;
}
gridClaims.BeginUpdate();
gridClaims.Rows.Clear();
gridClaims.Columns.Clear();
gridClaims.Columns.Add(new UI.ODGridColumn("Date Service", 100, HorizontalAlignment.Center)
{
SortingStrategy = UI.GridSortingStrategy.DateParse
});
gridClaims.Columns.Add(new UI.ODGridColumn("Carrier", 240, HorizontalAlignment.Center)
{
SortingStrategy = UI.GridSortingStrategy.StringCompare
});
gridClaims.Columns.Add(new UI.ODGridColumn("Status", 120, HorizontalAlignment.Center)
{
SortingStrategy = UI.GridSortingStrategy.StringCompare
});
if (!PrefC.GetBool(PrefName.EasyNoClinics)) //Using clinics
{
gridClaims.Columns.Add(new UI.ODGridColumn("Clinic", 190, HorizontalAlignment.Left)
{
SortingStrategy = UI.GridSortingStrategy.StringCompare
});
}
gridClaims.Columns.Add(new UI.ODGridColumn("ClaimFee", 70, HorizontalAlignment.Right)
{
SortingStrategy = UI.GridSortingStrategy.AmountParse
});
List <Claim> listClaims = Claims.Refresh(_patNum);
for (int i = 0; i < listClaims.Count; i++)
{
UI.ODGridRow row = new UI.ODGridRow();
row.Tag = listClaims[i];
row.Cells.Add(listClaims[i].DateService.ToShortDateString()); //DOS
row.Cells.Add(Carriers.GetName(InsPlans.RefreshOne(listClaims[i].PlanNum).CarrierNum)); //Carrier
row.Cells.Add(Claims.GetClaimStatusString(listClaims[i].ClaimStatus)); //Status
if (!PrefC.GetBool(PrefName.EasyNoClinics)) //Using clinics
{
Clinic clinic = Clinics.GetClinic(listClaims[i].ClinicNum);
if (clinic == null)
{
row.Cells.Add(""); //Clinic
}
else
{
row.Cells.Add(clinic.Description); //Clinic
}
}
row.Cells.Add(listClaims[i].ClaimFee.ToString("f")); //Claimfee
gridClaims.Rows.Add(row);
}
gridClaims.EndUpdate();
gridClaims.SortForced(sortByColIdx, isSortAsc);
}
private void butNewClaims_Click(object sender, EventArgs e)
{
if (gridMain.SelectedIndices.Length == 0) //No selections made.
{
MsgBox.Show(this, "Please select at least one procedure.");
return;
}
if (!ContrAccount.CheckClearinghouseDefaults())
{
return;
}
//Generate List and Table----------------------------------------------------------------------------------------------------------------------
//List of all procedures being shown.
//Pulls procedures based off of the PatNum, if the row was selected in gridMain and if it has been attached to a claim.
List <ProcNotBilled> listNotBilledProcs = new List <ProcNotBilled>();
List <long> listPatNums = new List <long>();
Patient patOld = new Patient();
List <Claim> listPatClaims = new List <Claim>();
List <ClaimProc> listPatClaimProcs = new List <ClaimProc>();
List <ClaimProc> listCurClaimProcs = new List <ClaimProc>();
//Table rows need to be 1:1 with gridMain rows due to logic in ContrAccount.toolBarButIns_Click(...).
DataTable table = new DataTable();
//Required columns as mentioned by ContrAccount.toolBarButIns_Click().
table.Columns.Add("ProcNum");
table.Columns.Add("chargesDouble");
table.Columns.Add("ProcNumLab");
for (int i = 0; i < gridMain.Rows.Count; i++) //Loop through gridMain to construct listNotBilledProcs.
{
long procNumCur = PIn.Long(gridMain.Rows[i].Tag.ToString()); //Tag is set to procNum in fillGrid().
Procedure procCur = Procedures.GetOneProc(procNumCur, false);
long patNumCur = procCur.PatNum;
if (patOld.PatNum != patNumCur) //Procedures in gridMain are ordered by patient, so when the patient changes, we know previous patient is complete.
{
listPatClaims = Claims.Refresh(patNumCur);
listPatClaimProcs = ClaimProcs.Refresh(patNumCur);
patOld = Patients.GetPat(procCur.PatNum);
}
listCurClaimProcs = ClaimProcs.GetForProc(listPatClaimProcs, procNumCur);
bool hasPriClaim = false;
bool hasSecClaim = false;
for (int j = 0; j < listCurClaimProcs.Count; j++)
{
ClaimProc claimProcCur = listCurClaimProcs[j];
if (claimProcCur.ClaimNum > 0 && claimProcCur.Status != ClaimProcStatus.Preauth && claimProcCur.Status != ClaimProcStatus.Estimate)
{
Claim claimCur = Claims.GetFromList(listPatClaims, claimProcCur.ClaimNum);
switch (claimCur.ClaimType)
{
case "P":
hasPriClaim = true;
break;
case "S":
hasSecClaim = true;
break;
}
}
}
bool isSelected = gridMain.SelectedIndices.Contains(i);
listNotBilledProcs.Add(new ProcNotBilled(patOld, procNumCur, i, isSelected, hasPriClaim, hasSecClaim, procCur.ClinicNum, procCur.PlaceService));
DataRow row = table.NewRow();
row["ProcNum"] = procNumCur;
#region Calculate chargesDouble
//Logic copied from AccountModules.GetAccount(...) line 857.
double qty = (procCur.UnitQty + procCur.BaseUnits);
if (qty == 0)
{
qty = 1;
}
double writeOffCapSum = listPatClaimProcs.Where(x => x.Status == ClaimProcStatus.CapComplete).Select(y => y.WriteOff).ToList().Sum();
row["chargesDouble"] = (procCur.ProcFee * qty) - writeOffCapSum;
row["ProcNumLab"] = procCur.ProcNumLab;
#endregion Calculate chargesDouble
table.Rows.Add(row);
if (listPatNums.Contains(patNumCur))
{
continue;
}
listPatNums.Add(patNumCur);
}
List <List <ProcNotBilled> > listGroupedProcs = new List <List <ProcNotBilled> >();
Patient patCur = null;
List <PatPlan> listPatPlans = null;
List <InsSub> listInsSubs = null;
List <InsPlan> listInsPlans = null;
List <Procedure> listPatientProcs = null;
ProcNotBilled procNotBilled = new ProcNotBilled(); //When automatically grouping, this is used as the procedure to group by.
long patNumOld = 0;
int claimCreatedCount = 0;
int patIndex = 0;
//The procedures show in the grid ordered by patient. Also listPatNums contains unique patnums which are in the same order as the grid.
while (patIndex < listPatNums.Count)
{
List <ProcNotBilled> listProcs = listNotBilledProcs.Where(x => x.Patient.PatNum == listPatNums[patIndex] && x.IsRowSelected && !x.IsAttached).ToList();
if (listProcs.Count == 0)
{
patNumOld = listPatNums[patIndex];
patIndex++; //No procedures were selected for this patient.
continue;
}
else
{
//Maintain the same patient, in order to create one or more additional claims for the remaining procedures.
//Currently will only happen for specific instances;
//--Canadian customers who are attempting to create a claim with over 7 procedures.
//--When checkAutoGroupProcs is checked and when there are multiple procedure groupings by GroupKey status, ClinicNum, and placeService.
}
if (patNumOld != listPatNums[patIndex]) //The patient could repeat if we had to group the procedures for the patinet into multiple claims.
{
patCur = Patients.GetPat(listPatNums[patIndex]);
listPatPlans = PatPlans.Refresh(patCur.PatNum);
listInsSubs = InsSubs.RefreshForFam(Patients.GetFamily(patCur.PatNum));
listInsPlans = InsPlans.RefreshForSubList(listInsSubs);
listPatientProcs = Procedures.Refresh(patCur.PatNum);
}
if (checkAutoGroupProcs.Checked) //Automatically Group Procedures.
{
procNotBilled = listProcs[0];
//Update listProcs to reflect those that match the procNotBilled values.
listProcs = listProcs.FindAll(x => x.HasPriClaim == procNotBilled.HasPriClaim && x.HasSecClaim == procNotBilled.HasSecClaim);
if (PrefC.HasClinicsEnabled) //Group by clinic only if clinics enabled.
{
listProcs = listProcs.FindAll(x => x.ClinicNum == procNotBilled.ClinicNum);
}
else if (!PrefC.GetBool(PrefName.EasyHidePublicHealth)) //Group by Place of Service only if Public Health feature is enabled.
{
listProcs = listProcs.FindAll(x => x.PlaceService == procNotBilled.PlaceService);
}
}
GetUniqueDiagnosticCodes(listProcs, listPatientProcs, listPatPlans, listInsSubs, listInsPlans);
if (listProcs.Count > 7 && CultureInfo.CurrentCulture.Name.EndsWith("CA")) //Canadian. en-CA or fr-CA
{
listProcs = listProcs.Take(7).ToList(); //Returns first 7 items of the list.
}
listProcs.ForEach(x => x.IsAttached = true); //This way we can not attach procedures to multiple claims thanks to the logic above.
if (listProcs.Any(x => listProcs[0].PlaceService != x.PlaceService) || listProcs.Any(x => listProcs[0].ClinicNum != x.ClinicNum))
{
//Regardless if we are automatically grouping or not,
//if all procs in our list at this point do not share the same PlaceService or ClinicNum then claims will not be made.
}
else //Basic validation passed.
{
if (!listProcs[0].HasPriClaim && //Medical claim.
PatPlans.GetOrdinal(PriSecMed.Medical, listPatPlans, listInsPlans, listInsSubs) > 0 && //Has medical ins.
PatPlans.GetOrdinal(PriSecMed.Primary, listPatPlans, listInsPlans, listInsSubs) == 0 && //Does not have primary dental ins.
PatPlans.GetOrdinal(PriSecMed.Secondary, listPatPlans, listInsPlans, listInsSubs) == 0) //Does not have secondary dental ins.
{
claimCreatedCount++;
}
else //Not a medical claim.
{
if (!listProcs[0].HasPriClaim && PatPlans.GetOrdinal(PriSecMed.Primary, listPatPlans, listInsPlans, listInsSubs) > 0) //Primary claim.
{
claimCreatedCount++;
}
if (!listProcs[0].HasSecClaim && PatPlans.GetOrdinal(PriSecMed.Secondary, listPatPlans, listInsPlans, listInsSubs) > 0) //Secondary claim.
{
claimCreatedCount++;
}
}
}
listGroupedProcs.Add(listProcs);
}
if (!MsgBox.Show(this, true, "Clicking continue will create up to " + POut.Int(claimCreatedCount) + " claims and cannot be undone, except by manually going to each account. "
+ "Some claims may not be created if there are validation issues. Would you like to proceed?"))
{
return;
}
//Create Claims--------------------------------------------------------------------------------------------------------------------------------
claimCreatedCount = 0;
string claimErrors = "";
foreach (List <ProcNotBilled> listProcs in listGroupedProcs)
{
patCur = listProcs[0].Patient;
gridMain.SetSelected(false); //Need to deslect all rows each time so that ContrAccount.toolBarButIns_Click(...) only uses pertinent rows.
for (int j = 0; j < listProcs.Count; j++)
{
gridMain.SetSelected(listProcs[j].RowIndex, true); //Select the pertinent rows so that they will be attached to the claim below.
}
ContrAccount.toolBarButIns_Click(false, patCur, Patients.GetFamily(patCur.PatNum), gridMain, table,
procNotBilled.HasPriClaim, procNotBilled.HasSecClaim);
string errorTitle = patCur.PatNum + " " + patCur.GetNameLFnoPref() + " - ";
if (patNumOld == patCur.PatNum && !string.IsNullOrEmpty(ContrAccount.ClaimErrorsCur))
{
claimErrors += "\t\t" + ContrAccount.ClaimErrorsCur + "\r\n";
}
else if (!string.IsNullOrEmpty(ContrAccount.ClaimErrorsCur))
{
claimErrors += errorTitle + ContrAccount.ClaimErrorsCur + "\r\n";
}
claimCreatedCount += ContrAccount.ClaimCreatedCount;
patNumOld = patCur.PatNum;
}
FillGrid();
if (!string.IsNullOrEmpty(claimErrors))
{
MsgBoxCopyPaste form = new MsgBoxCopyPaste(claimErrors);
form.ShowDialog();
}
MessageBox.Show(Lan.g(this, "Number of claims created") + ": " + claimCreatedCount);
}
///<summary>All of the code from this method is copied directly from the account module, ContrAccount.FillSummary().</summary>
private void FillSummary()
{
textFamPriMax.Text = "";
textFamPriDed.Text = "";
textFamSecMax.Text = "";
textFamSecDed.Text = "";
textPriMax.Text = "";
textPriDed.Text = "";
textPriDedRem.Text = "";
textPriUsed.Text = "";
textPriPend.Text = "";
textPriRem.Text = "";
textSecMax.Text = "";
textSecDed.Text = "";
textSecDedRem.Text = "";
textSecUsed.Text = "";
textSecPend.Text = "";
textSecRem.Text = "";
if (_patCur == null)
{
return;
}
double maxFam = 0;
double maxInd = 0;
double ded = 0;
double dedFam = 0;
double dedRem = 0;
double remain = 0;
double pend = 0;
double used = 0;
InsPlan PlanCur;
InsSub SubCur;
List <PatPlan> PatPlanList = PatPlans.Refresh(_patCur.PatNum);
if (!PatPlans.IsPatPlanListValid(PatPlanList))
{
//PatPlans had invalid references and need to be refreshed.
PatPlanList = PatPlans.Refresh(_patCur.PatNum);
}
List <InsSub> subList = InsSubs.RefreshForFam(_famCur);
List <InsPlan> InsPlanList = InsPlans.RefreshForSubList(subList);
List <Benefit> BenefitList = Benefits.Refresh(PatPlanList, subList);
List <Claim> ClaimList = Claims.Refresh(_patCur.PatNum);
List <ClaimProcHist> HistList = ClaimProcs.GetHistList(_patCur.PatNum, BenefitList, PatPlanList, InsPlanList, DateTimeOD.Today, subList);
if (PatPlanList.Count > 0)
{
SubCur = InsSubs.GetSub(PatPlanList[0].InsSubNum, subList);
PlanCur = InsPlans.GetPlan(SubCur.PlanNum, InsPlanList);
pend = InsPlans.GetPendingDisplay(HistList, DateTimeOD.Today, PlanCur, PatPlanList[0].PatPlanNum,
-1, _patCur.PatNum, PatPlanList[0].InsSubNum, BenefitList);
used = InsPlans.GetInsUsedDisplay(HistList, DateTimeOD.Today, PlanCur.PlanNum, PatPlanList[0].PatPlanNum,
-1, InsPlanList, BenefitList, _patCur.PatNum, PatPlanList[0].InsSubNum);
textPriPend.Text = pend.ToString("F");
textPriUsed.Text = used.ToString("F");
maxFam = Benefits.GetAnnualMaxDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[0].PatPlanNum, true);
maxInd = Benefits.GetAnnualMaxDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[0].PatPlanNum, false);
if (maxFam == -1)
{
textFamPriMax.Text = "";
}
else
{
textFamPriMax.Text = maxFam.ToString("F");
}
if (maxInd == -1) //if annual max is blank
{
textPriMax.Text = "";
textPriRem.Text = "";
}
else
{
remain = maxInd - used - pend;
if (remain < 0)
{
remain = 0;
}
//textFamPriMax.Text=max.ToString("F");
textPriMax.Text = maxInd.ToString("F");
textPriRem.Text = remain.ToString("F");
}
//deductible:
ded = Benefits.GetDeductGeneralDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[0].PatPlanNum, BenefitCoverageLevel.Individual);
dedFam = Benefits.GetDeductGeneralDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[0].PatPlanNum, BenefitCoverageLevel.Family);
if (ded != -1)
{
textPriDed.Text = ded.ToString("F");
dedRem = InsPlans.GetDedRemainDisplay(HistList, DateTimeOD.Today, PlanCur.PlanNum, PatPlanList[0].PatPlanNum,
-1, InsPlanList, _patCur.PatNum, ded, dedFam);
textPriDedRem.Text = dedRem.ToString("F");
}
if (dedFam != -1)
{
textFamPriDed.Text = dedFam.ToString("F");
}
}
if (PatPlanList.Count > 1)
{
SubCur = InsSubs.GetSub(PatPlanList[1].InsSubNum, subList);
PlanCur = InsPlans.GetPlan(SubCur.PlanNum, InsPlanList);
pend = InsPlans.GetPendingDisplay(HistList, DateTimeOD.Today, PlanCur, PatPlanList[1].PatPlanNum,
-1, _patCur.PatNum, PatPlanList[1].InsSubNum, BenefitList);
textSecPend.Text = pend.ToString("F");
used = InsPlans.GetInsUsedDisplay(HistList, DateTimeOD.Today, PlanCur.PlanNum, PatPlanList[1].PatPlanNum,
-1, InsPlanList, BenefitList, _patCur.PatNum, PatPlanList[1].InsSubNum);
textSecUsed.Text = used.ToString("F");
//max=Benefits.GetAnnualMaxDisplay(BenefitList,PlanCur.PlanNum,PatPlanList[1].PatPlanNum);
maxFam = Benefits.GetAnnualMaxDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[1].PatPlanNum, true);
maxInd = Benefits.GetAnnualMaxDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[1].PatPlanNum, false);
if (maxFam == -1)
{
textFamSecMax.Text = "";
}
else
{
textFamSecMax.Text = maxFam.ToString("F");
}
if (maxInd == -1) //if annual max is blank
{
textSecMax.Text = "";
textSecRem.Text = "";
}
else
{
remain = maxInd - used - pend;
if (remain < 0)
{
remain = 0;
}
//textFamSecMax.Text=max.ToString("F");
textSecMax.Text = maxInd.ToString("F");
textSecRem.Text = remain.ToString("F");
}
//deductible:
ded = Benefits.GetDeductGeneralDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[1].PatPlanNum, BenefitCoverageLevel.Individual);
dedFam = Benefits.GetDeductGeneralDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[1].PatPlanNum, BenefitCoverageLevel.Family);
if (ded != -1)
{
textSecDed.Text = ded.ToString("F");
dedRem = InsPlans.GetDedRemainDisplay(HistList, DateTimeOD.Today, PlanCur.PlanNum, PatPlanList[1].PatPlanNum,
-1, InsPlanList, _patCur.PatNum, ded, dedFam);
textSecDedRem.Text = dedRem.ToString("F");
}
if (dedFam != -1)
{
textFamSecDed.Text = dedFam.ToString("F");
}
}
}
