public EB02(string code, string descript)
{
this.code = code;
this.descript = descript;
this.coverageLevel = BenefitCoverageLevel.Individual; //ignored
this.isSupported = false;
}
public EB02(string code, string descript, BenefitCoverageLevel coverageLevel)
{
this.code = code;
this.descript = descript;
this.coverageLevel = coverageLevel;
this.isSupported = true;
}
public static void CreateDeductibleGeneral(long planNum,BenefitCoverageLevel coverageLevel,double amt){
Benefit ben=new Benefit();
ben.PlanNum=planNum;
ben.BenefitType=InsBenefitType.Deductible;
ben.CovCatNum=0;
ben.CoverageLevel=coverageLevel;
ben.MonetaryAmt=amt;
ben.TimePeriod=BenefitTimePeriod.CalendarYear;
Benefits.Insert(ben);
}
public static void CreateDeductibleGeneral(long planNum, BenefitCoverageLevel coverageLevel, double amt)
{
Benefit ben = new Benefit();
ben.PlanNum = planNum;
ben.BenefitType = InsBenefitType.Deductible;
ben.CovCatNum = 0;
ben.CoverageLevel = coverageLevel;
ben.MonetaryAmt = amt;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
Benefits.Insert(ben);
}
public static Benefit CreateAnnualMax(long planNum, BenefitCoverageLevel coverageLevel, double amt)
{
Benefit ben = new Benefit();
ben.PlanNum = planNum;
ben.BenefitType = InsBenefitType.Limitations;
ben.CovCatNum = 0;
ben.CoverageLevel = coverageLevel;
ben.MonetaryAmt = amt;
ben.TimePeriod = BenefitTimePeriod.CalendarYear;
Benefits.Insert(ben);
return(ben);
}
public static void CreateFrequencyCategory(long planNum, EbenefitCategory category, BenefitQuantity quantityQualifier, Byte quantity,
BenefitCoverageLevel coverageLevel = BenefitCoverageLevel.None)
{
Benefit ben = new Benefit();
ben.PlanNum = planNum;
ben.BenefitType = InsBenefitType.Limitations;
ben.CovCatNum = CovCats.GetForEbenCat(category).CovCatNum;
ben.CoverageLevel = coverageLevel;
ben.TimePeriod = BenefitTimePeriod.None;
ben.Quantity = quantity;
ben.QuantityQualifier = quantityQualifier;
Benefits.Insert(ben);
}
///<summary>Only for display purposes rather than any calculations. Gets a general deductible from the supplied list of benefits. Ignores benefits that do not match either the planNum or the patPlanNum.</summary>
public static double GetDeductGeneralDisplay(List<Benefit> benList,long planNum,long patPlanNum,BenefitCoverageLevel level) {
//No need to check RemotingRole; no call to db.
for(int i=0;i<benList.Count;i++) {
if(benList[i].PlanNum==0 && benList[i].PatPlanNum!=patPlanNum) {
continue;
}
if(benList[i].PatPlanNum==0 && benList[i].PlanNum!=planNum) {
continue;
}
if(benList[i].BenefitType!=InsBenefitType.Deductible) {
continue;
}
if(benList[i].QuantityQualifier!=BenefitQuantity.None) {
continue;
}
if(benList[i].TimePeriod!=BenefitTimePeriod.CalendarYear && benList[i].TimePeriod!=BenefitTimePeriod.ServiceYear) {
continue;
}
if(benList[i].CoverageLevel != level) {
continue;
}
if(benList[i].CodeNum != 0) {
continue;
}
if(benList[i].CovCatNum != 0) {
EbenefitCategory eben=CovCats.GetEbenCat(benList[i].CovCatNum);
if(eben != EbenefitCategory.General && eben != EbenefitCategory.None) {
continue;
}
}
return benList[i].MonetaryAmt;
}
return -1;
}
public EB02(string code,string descript) {
this.code=code;
this.descript=descript;
this.coverageLevel=BenefitCoverageLevel.Individual;//ignored
this.isSupported=false;
}
public EB02(string code,string descript,BenefitCoverageLevel coverageLevel) {
this.code=code;
this.descript=descript;
this.coverageLevel=coverageLevel;
this.isSupported=true;
}
///<summary>Only for display purposes rather than for calculations. Get insurance deductible used for one benefit year. Must supply a history list for the patient/family. asofDate is used to determine which benefit year to calc. Usually date of service for a claim. The planNum is the plan to get value for. ExcludeClaim is the ClaimNum to exclude, or enter -1 to include all. It includes pending deductibles in the result.</summary>
public static double GetDedUsedDisplay(List<ClaimProcHist> histList,DateTime asofDate,long planNum,long patPlanNum,long excludeClaim,List<InsPlan> planList,BenefitCoverageLevel coverageLevel,long patNum) {
//No need to check RemotingRole; no call to db.
InsPlan curPlan=GetPlan(planNum,planList);
if(curPlan==null) {
return 0;
}
//get the most recent renew date, possibly including today. Date based on annual max.
DateTime renewDate=BenefitLogic.ComputeRenewDate(asofDate,curPlan.MonthRenew);
DateTime stopDate=renewDate.AddYears(1);
double retVal=0;
for(int i=0;i<histList.Count;i++) {
if(histList[i].PlanNum!=planNum
|| histList[i].ClaimNum == excludeClaim
|| histList[i].ProcDate >= stopDate
|| histList[i].ProcDate < renewDate
//no need to check status, because only the following statuses will be part of histlist:
//Adjustment,NotReceived,Received,Supplemental
)
{
continue;
}
if(coverageLevel!=BenefitCoverageLevel.Family && histList[i].PatNum != patNum) {
continue;//to exclude histList items from other family members
}
retVal+=histList[i].Deduct;
}
return retVal;
}
public static void CreateAgeLimitation(long planNum, EbenefitCategory category, int ageThrough,
BenefitCoverageLevel coverageLevel = BenefitCoverageLevel.None)
{
CreateFrequencyCategory(planNum, category, BenefitQuantity.AgeLimit, (byte)ageThrough, coverageLevel);
}
public static Benefit CreateAgeLimitation(long planNum, EbenefitCategory category, int ageThrough,
BenefitCoverageLevel coverageLevel = BenefitCoverageLevel.None, long codeNum = 0)
{
return(CreateFrequencyCategory(planNum, category, BenefitQuantity.AgeLimit, (byte)ageThrough, coverageLevel, codeNum));
}
