public void PollForInsuranceClaim()
{
_logger.Info("\n");
_logger.Info(string.Format("Creating Claims. Date: {0:MM/dd/yyyy}", DateTime.Now));
_logger.Info("\n");
try
{
var billingAccounts = _billingAccountRepository.GetAll();
if (billingAccounts == null || !billingAccounts.Any())
{
_logger.Info("No billing account has been setup");
}
foreach (var billingAccount in billingAccounts)
{
var eventCustomers = _eventCustomerRepository.GetEventCustomersForInsuranceClaim(_settings.DaysAfterGetClaim, billingAccount.Id);
if (eventCustomers == null || !eventCustomers.Any())
{
_logger.Info("No Records Found!");
continue;
}
var eventCustomerEncounters = _encounterRepository.GetEventCustomerEncounterByEventCustomerIds(eventCustomers.Select(ec => ec.Id).ToArray());
var eventIds = eventCustomers.Select(ec => ec.EventId).Distinct().ToArray();
var events = _eventRepository.GetByIds(eventIds);
foreach (var eventId in eventIds)
{
var eventData = events.First(e => e.Id == eventId);
var claimResponse = _kareoApi.GetClaim(billingAccount, 32090, eventData.EventDate);//eventId
if (claimResponse == null || claimResponse.Charges == null || !claimResponse.Charges.Any())
{
_logger.Info(string.Format("No Claims for Event (Id:{0})", eventId));
continue;
}
var eventCustomersData = eventCustomers.Where(ec => ec.EventId == eventId).Select(ec => ec).ToArray();
foreach (var eventCustomer in eventCustomersData)
{
var eventCustomerEncounter = eventCustomerEncounters.First(ece => ece.EventCustomerId == eventCustomer.Id);
var chargeData = claimResponse.Charges.Where(c => c.EncounterID == eventCustomerEncounter.EncounterId.ToString()).Select(c => c).ToArray();
if (chargeData == null || !chargeData.Any())
{
_logger.Info(string.Format("No Claims for Event (Id:{0}) and Customer (Id:{1}) ", eventId, eventCustomer.CustomerId));
continue;
}
var orderId = _orderRepository.GetOrderIdByEventCustomerId(eventCustomer.Id);
var paymentsApplied = _paymentInstrumentRepository.GetByOrderId(orderId);
var insurancePayment = paymentsApplied.Where(pi => pi.PaymentType == PaymentType.Insurance).Select(pi => pi).SingleOrDefault();
if (insurancePayment == null)
{
_logger.Info(string.Format("No Insurance payment for Event (Id:{0}) and Customer (Id:{1}) ", eventId, eventCustomer.CustomerId));
continue;
}
decimal amount = 0m;
foreach (var charge in chargeData)
{
var claim = new Claim
{
Id = Convert.ToInt64(charge.ID),
EncounterId = Convert.ToInt64(charge.EncounterID),
BillingPatientId = Convert.ToInt64(charge.PatientID),
InsurancePaymentId = insurancePayment.Id,
ProcedureCode = charge.ProcedureCode,
ProcedureName = charge.ProcedureName,
Units = Convert.ToInt32(Convert.ToDecimal(charge.Units)),
TotalCharges = Convert.ToDecimal(charge.TotalCharges),
AdjustedCharges = Convert.ToDecimal(charge.AdjustedCharges),
Receipts = Convert.ToDecimal(charge.Receipts),
PatientBalance = Convert.ToDecimal(charge.PatientBalance),
InsuranceBalance = Convert.ToDecimal(charge.InsuranceBalance),
TotalBalance = Convert.ToDecimal(charge.TotalBalance),
Status = charge.Status,
DateCreated = DateTime.Now,
//FirstBillDate = Convert.ToDateTime(charge.PatientFirstBillDate),
//LastBillDate = Convert.ToDateTime(charge.PatientLastBillDate)
};
//TODO:Save Claim
_claimRepository.Save(claim);
amount += claim.TotalCharges - claim.TotalBalance;
}
//TODO:Update Insurance payment
insurancePayment.Amount = amount;
_paymentInstrumentRepository.SavePaymentInstrument(insurancePayment);
}
}
}
}
catch (Exception ex)
{
_logger.Error(string.Format("Error while fetching event customers Message:{0} \nStackTrace: {1}", ex.Message, ex.StackTrace));
_logger.Info("\n");
}
}