Exemplo n.º 1
0
        public void Fees_GetAmount0()
        {
            double amt = _defaultFeeAmt * _rand.NextDouble();
            Fee    fee = CreateSingleFee(MethodBase.GetCurrentMethod().Name, amt, true, true);

            Assert.AreEqual(0, Fees.GetAmount0(_listProcCodes.Last().CodeNum, fee.FeeSched, fee.ClinicNum, fee.ProvNum));
            Assert.AreEqual(fee.Amount, Fees.GetAmount0(fee.CodeNum, fee.FeeSched, fee.ClinicNum, fee.ProvNum), _precision);
        }
Exemplo n.º 2
0
        public void Claims_CalculateAndUpdate_Allowed1Allowed2CompletedProcedures()
        {
            string  suffix       = "8";
            Patient pat          = PatientT.CreatePatient(suffix);
            long    patNum       = pat.PatNum;
            long    feeSchedNum1 = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, suffix);
            long    feeSchedNum2 = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, suffix + "b");
            //Standard Fee
            long codeNum = ProcedureCodes.GetCodeNum("D2750");
            Fee  fee     = Fees.GetFee(codeNum, 53, 0, 0);

            if (fee == null)
            {
                fee          = new Fee();
                fee.CodeNum  = codeNum;
                fee.FeeSched = 53;
                fee.Amount   = 1200;
                Fees.Insert(fee);
            }
            else
            {
                fee.Amount = 1200;
                Fees.Update(fee);
            }
            //PPO fees
            fee          = new Fee();
            fee.CodeNum  = codeNum;
            fee.FeeSched = feeSchedNum1;
            fee.Amount   = 600;
            Fees.Insert(fee);
            fee          = new Fee();
            fee.CodeNum  = codeNum;
            fee.FeeSched = feeSchedNum2;
            fee.Amount   = 800;
            Fees.Insert(fee);
            //Carrier
            Carrier carrier  = CarrierT.CreateCarrier(suffix);
            long    planNum1 = InsPlanT.CreateInsPlanPPO(carrier.CarrierNum, feeSchedNum1).PlanNum;
            long    planNum2 = InsPlanT.CreateInsPlanPPO(carrier.CarrierNum, feeSchedNum2).PlanNum;
            InsSub  sub1     = InsSubT.CreateInsSub(pat.PatNum, planNum1);
            long    subNum1  = sub1.InsSubNum;
            InsSub  sub2     = InsSubT.CreateInsSub(pat.PatNum, planNum2);
            long    subNum2  = sub2.InsSubNum;

            BenefitT.CreateCategoryPercent(planNum1, EbenefitCategory.Crowns, 50);
            BenefitT.CreateCategoryPercent(planNum2, EbenefitCategory.Crowns, 50);
            BenefitT.CreateAnnualMax(planNum1, 1000);
            BenefitT.CreateAnnualMax(planNum2, 1000);
            PatPlanT.CreatePatPlan(1, patNum, subNum1);
            PatPlanT.CreatePatPlan(2, patNum, subNum2);
            Procedure proc    = ProcedureT.CreateProcedure(pat, "D2750", ProcStat.TP, "8", Fees.GetAmount0(codeNum, 53));  //crown on 8
            long      procNum = proc.ProcNum;
            //Lists
            List <ClaimProc> claimProcs  = ClaimProcs.Refresh(patNum);
            Family           fam         = Patients.GetFamily(patNum);
            List <InsSub>    subList     = InsSubs.RefreshForFam(fam);
            List <InsPlan>   planList    = InsPlans.RefreshForSubList(subList);
            List <PatPlan>   patPlans    = PatPlans.Refresh(patNum);
            List <Benefit>   benefitList = Benefits.Refresh(patPlans, subList);
            List <Procedure> procList    = Procedures.Refresh(patNum);

            //Set complete and attach to claim
            ProcedureT.SetComplete(proc, pat, planList, patPlans, claimProcs, benefitList, subList);
            claimProcs = ClaimProcs.Refresh(patNum);
            List <Procedure> procsForClaim = new List <Procedure>();

            procsForClaim.Add(proc);
            Claim claim = ClaimT.CreateClaim("P", patPlans, planList, claimProcs, procList, pat, procsForClaim, benefitList, subList);

            //Validate
            Assert.AreEqual(500, claim.WriteOff);
        }
Exemplo n.º 3
0
        ///<summary>Most of the logic for breaking an appointment. Pass in the brokenFee (the number the user enters in the brokenAppointment window),
        ///Optionally pass in if the brokenappointment procedure is being deleted. Returns the broken procedure that was created.</summary>
        public static Procedure BreakAppointment(Appointment appt, Patient pat, ProcedureCode procCode, double feeOverride, bool isDeleteBrokenProc = false)
        {
            //suppressHistory is true due to below logic creating a log with a specific HistAppointmentAction instead of the generic changed.
            DateTime datePrevious    = appt.DateTStamp;
            bool     suppressHistory = false;

            if (procCode != null)
            {
                suppressHistory = procCode.ProcCode == "D9986" || procCode.ProcCode == "D9987";
            }
            Appointments.SetAptStatus(appt, ApptStatus.Broken, suppressHistory); //Appointments S-Class handles Signalods
            if (appt.AptStatus != ApptStatus.Complete)                           //seperate log entry for completed appointments.
            {
                SecurityLogs.MakeLogEntry(Permissions.AppointmentEdit, pat.PatNum,
                                          appt.ProcDescript + ", " + appt.AptDateTime.ToString()
                                          + ", Broken from the Appts module.", appt.AptNum, datePrevious);
            }
            else
            {
                SecurityLogs.MakeLogEntry(Permissions.AppointmentCompleteEdit, pat.PatNum,
                                          appt.ProcDescript + ", " + appt.AptDateTime.ToString()
                                          + ", Broken from the Appts module.", appt.AptNum, datePrevious);
            }
            List <Procedure> listProcedures = Procedures.GetProcsForSingle(appt.AptNum, false);
            //splits should only exist on procs if they are using tp pre-payments
            List <PaySplit> listSplitsForApptProcs = new List <PaySplit>();
            bool            isNonRefundable        = false;
            double          brokenProcAmount       = 0;

            if (listProcedures.Count > 0)
            {
                listSplitsForApptProcs = PaySplits.GetPaySplitsFromProcs(listProcedures.Select(x => x.ProcNum).ToList());
            }
            Procedure brokenProcedure = new Procedure();

            #region Charting the proc
            if (procCode != null)
            {
                switch (procCode.ProcCode)
                {
                case "D9986":                        //Missed
                    HistAppointments.CreateHistoryEntry(appt.AptNum, HistAppointmentAction.Missed);
                    break;

                case "D9987":                        //Cancelled
                    HistAppointments.CreateHistoryEntry(appt.AptNum, HistAppointmentAction.Cancelled);
                    break;
                }
                brokenProcedure.PatNum       = pat.PatNum;
                brokenProcedure.ProvNum      = (procCode.ProvNumDefault > 0 ? procCode.ProvNumDefault : appt.ProvNum);
                brokenProcedure.CodeNum      = procCode.CodeNum;
                brokenProcedure.ProcDate     = DateTime.Today;
                brokenProcedure.DateEntryC   = DateTime.Now;
                brokenProcedure.ProcStatus   = ProcStat.C;
                brokenProcedure.ClinicNum    = appt.ClinicNum;
                brokenProcedure.UserNum      = Security.CurUser.UserNum;
                brokenProcedure.Note         = Lans.g("AppointmentEdit", "Appt BROKEN for") + " " + appt.ProcDescript + "  " + appt.AptDateTime.ToString();
                brokenProcedure.PlaceService = (PlaceOfService)PrefC.GetInt(PrefName.DefaultProcedurePlaceService);              //Default proc place of service for the Practice is used.
                List <InsSub>  listInsSubs    = InsSubs.RefreshForFam(Patients.GetFamily(pat.PatNum));
                List <InsPlan> listInsPlans   = InsPlans.RefreshForSubList(listInsSubs);
                List <PatPlan> listPatPlans   = PatPlans.Refresh(pat.PatNum);
                InsPlan        insPlanPrimary = null;
                InsSub         insSubPrimary  = null;
                if (listPatPlans.Count > 0)
                {
                    insSubPrimary  = InsSubs.GetSub(listPatPlans[0].InsSubNum, listInsSubs);
                    insPlanPrimary = InsPlans.GetPlan(insSubPrimary.PlanNum, listInsPlans);
                }
                double procFee;
                long   feeSch;
                if (insPlanPrimary == null || procCode.NoBillIns)
                {
                    feeSch = FeeScheds.GetFeeSched(0, pat.FeeSched, brokenProcedure.ProvNum);
                }
                else                  //Only take into account the patient's insurance fee schedule if the D9986 procedure is not marked as NoBillIns
                {
                    feeSch = FeeScheds.GetFeeSched(insPlanPrimary.FeeSched, pat.FeeSched, brokenProcedure.ProvNum);
                }
                procFee = Fees.GetAmount0(brokenProcedure.CodeNum, feeSch, brokenProcedure.ClinicNum, brokenProcedure.ProvNum);
                if (insPlanPrimary != null && insPlanPrimary.PlanType == "p" && !insPlanPrimary.IsMedical)         //PPO
                {
                    double provFee = Fees.GetAmount0(brokenProcedure.CodeNum, Providers.GetProv(brokenProcedure.ProvNum).FeeSched, brokenProcedure.ClinicNum,
                                                     brokenProcedure.ProvNum);
                    brokenProcedure.ProcFee = Math.Max(provFee, procFee);
                }
                else
                {
                    brokenProcedure.ProcFee = procFee;
                }
                if (!PrefC.GetBool(PrefName.EasyHidePublicHealth))
                {
                    brokenProcedure.SiteNum = pat.SiteNum;
                }
                Procedures.Insert(brokenProcedure);
                Procedure procOld = brokenProcedure.Copy();
                //Now make a claimproc if the patient has insurance.  We do this now for consistency because a claimproc could get created in the future.
                List <Benefit>   listBenefits          = Benefits.Refresh(listPatPlans, listInsSubs);
                List <ClaimProc> listClaimProcsForProc = ClaimProcs.RefreshForProc(brokenProcedure.ProcNum);
                Procedures.ComputeEstimates(brokenProcedure, pat.PatNum, listClaimProcsForProc, false, listInsPlans, listPatPlans, listBenefits, pat.Age, listInsSubs);
                if (listSplitsForApptProcs.Count > 0 && PrefC.GetBool(PrefName.TpPrePayIsNonRefundable) && procCode.ProcCode == "D9986")
                {
                    //if there are pre-payments, non-refundable pre-payments is turned on, and the broken appointment is a missed code then auto-fill
                    //the window with the sum of the procs for the appointment. Transfer money below after broken procedure is confirmed by the user.
                    //normally goes to the form to let the user speficy, this is the auto filled amount for the form.
                    brokenProcedure.ProcFee = feeOverride;                  //listSplitsForApptProcs.Sum(x => x.SplitAmt);
                    isNonRefundable         = true;
                }
                if (isDeleteBrokenProc)
                {
                    brokenProcedure.ProcStatus = ProcStat.D;
                }
                brokenProcedure.ProcFee = feeOverride;
                brokenProcAmount        = feeOverride;
                Procedures.Update(brokenProcedure, procOld);
            }
            #endregion
            //Note this MUST come after FormProcBroken since clicking cancel in that window will delete the procedure.
            if (isNonRefundable && !isDeleteBrokenProc && listSplitsForApptProcs.Count > 0)
            {
                //transfer what the user specified in the broken appointment window.
                //transfer up to the amount specified by the user
                foreach (Procedure proc in listProcedures)
                {
                    if (brokenProcAmount == 0)
                    {
                        break;
                    }
                    List <PaySplit> listSplitsForAppointmentProcedure = listSplitsForApptProcs.FindAll(x => x.ProcNum == proc.ProcNum);
                    foreach (PaySplit split in listSplitsForAppointmentProcedure)
                    {
                        if (brokenProcAmount == 0)
                        {
                            break;
                        }
                        double amt = Math.Min(brokenProcAmount, split.SplitAmt);
                        Payments.CreateTransferForTpProcs(proc, new List <PaySplit> {
                            split
                        }, brokenProcedure, amt);
                        brokenProcAmount -= amt;
                    }
                }
            }
            return(brokenProcedure);
        }