/// <summary>Returns true if ClaimProcAllowCreditsGreaterThanProcFee preference allows the user to add credits greater than the proc fee. Otherwise returns false </summary>
private bool isClaimProcGreaterThanProcFee()
{
ClaimProcCreditsGreaterThanProcFee creditsGreaterPref = (ClaimProcCreditsGreaterThanProcFee)PrefC.GetInt(PrefName.ClaimProcAllowCreditsGreaterThanProcFee);
if (creditsGreaterPref == ClaimProcCreditsGreaterThanProcFee.Allow)
{
return(true);
}
List <Procedure> listProcs = Procedures.GetManyProc(ClaimProcsToEdit.Select(x => x.ProcNum).ToList(), false);
List <ClaimProc> listClaimProcsForPat = ClaimProcs.Refresh(PatCur.PatNum);
List <PaySplit> listPaySplitForSelectedCP = PaySplits.GetPaySplitsFromProcs(ClaimProcsToEdit.Select(x => x.ProcNum).ToList());
List <Adjustment> listAdjForSelectedCP = Adjustments.GetForProcs(ClaimProcsToEdit.Select(x => x.ProcNum).ToList());
bool isCreditGreater = false;
List <string> listProcDescripts = new List <string>();
for (int i = 0; i < ClaimProcsToEdit.Length; i++)
{
ClaimProc claimProcCur = ClaimProcsToEdit[i];
int insPayIdx = gridMain.ListGridColumns.GetIndex(Lan.g("TableClaimProc", "Ins Pay"));
int writeoffIdx = gridMain.ListGridColumns.GetIndex(Lan.g("TableClaimProc", "Writeoff"));
int feeAcctIdx = gridMain.ListGridColumns.GetIndex(Lan.g("TableClaimProc", "Fee"));
decimal insPayAmt = (decimal)ClaimProcs.ProcInsPay(listClaimProcsForPat.FindAll(x => x.ClaimProcNum != claimProcCur.ClaimProcNum), claimProcCur.ProcNum)
+ PIn.Decimal(gridMain.ListGridRows[i].Cells[insPayIdx].Text);
decimal writeOff = (decimal)ClaimProcs.ProcWriteoff(listClaimProcsForPat.FindAll(x => x.ClaimProcNum != claimProcCur.ClaimProcNum), claimProcCur.ProcNum)
+ PIn.Decimal(gridMain.ListGridRows[i].Cells[writeoffIdx].Text);
decimal feeAcct = PIn.Decimal(gridMain.ListGridRows[i].Cells[feeAcctIdx].Text);
decimal adj = listAdjForSelectedCP.Where(x => x.ProcNum == claimProcCur.ProcNum).Select(x => (decimal)x.AdjAmt).Sum();
decimal patPayAmt = listPaySplitForSelectedCP.Where(x => x.ProcNum == claimProcCur.ProcNum).Select(x => (decimal)x.SplitAmt).Sum();
//Any changes to this calculation should also consider FormClaimProc.IsClaimProcGreaterThanProcFee().
decimal creditRem = feeAcct - patPayAmt - insPayAmt - writeOff + adj;
isCreditGreater |= (creditRem.IsLessThanZero());
if (creditRem.IsLessThanZero())
{
Procedure proc = listProcs.FirstOrDefault(x => x.ProcNum == claimProcCur.ProcNum);
listProcDescripts.Add((proc == null ? "" : ProcedureCodes.GetProcCode(proc.CodeNum).ProcCode)
+ "\t" + Lan.g(this, "Fee") + ": " + feeAcct.ToString("F")
+ "\t" + Lan.g(this, "Credits") + ": " + (Math.Abs(-patPayAmt - insPayAmt - writeOff + adj)).ToString("F")
+ "\t" + Lan.g(this, "Remaining") + ": (" + Math.Abs(creditRem).ToString("F") + ")");
}
}
if (!isCreditGreater)
{
return(true);
}
if (creditsGreaterPref == ClaimProcCreditsGreaterThanProcFee.Block)
{
MsgBoxCopyPaste msgBox = new MsgBoxCopyPaste(Lan.g(this, "Remaining amount is negative for the following procedures") + ":\r\n"
+ string.Join("\r\n", listProcDescripts) + "\r\n" + Lan.g(this, "Not allowed to continue."));
msgBox.Text = Lan.g(this, "Overpaid Procedure Warning");
msgBox.ShowDialog();
return(false);
}
if (creditsGreaterPref == ClaimProcCreditsGreaterThanProcFee.Warn)
{
return(MessageBox.Show(Lan.g(this, "Remaining amount is negative for the following procedures") + ":\r\n"
+ string.Join("\r\n", listProcDescripts.Take(10)) + "\r\n" + (listProcDescripts.Count > 10?"...\r\n":"") + Lan.g(this, "Continue?")
, Lan.g(this, "Overpaid Procedure Warning"), MessageBoxButtons.OKCancel) == DialogResult.OK);
}
return(true); //should never get to this line, only possible if another enum value is added to allow, warn, and block
}
///<summary>Sets given appt.AptStatus to broken.
///Provide procCode that should be charted, can be null but will not chart a broken procedure.
///Also considers various broken procedure based prefs.
///Makes its own securitylog entries.</summary>
public static void BreakApptHelper(Appointment appt, Patient pat, ProcedureCode procCode)
{
//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.In("D9986", "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);
}
#region HL7
//If there is an existing HL7 def enabled, send a SIU message if there is an outbound SIU message defined
if (HL7Defs.IsExistingHL7Enabled())
{
//S15 - Appt Cancellation event
MessageHL7 messageHL7 = MessageConstructor.GenerateSIU(pat, Patients.GetPat(pat.Guarantor), EventTypeHL7.S15, appt);
//Will be null if there is no outbound SIU message defined, so do nothing
if (messageHL7 != null)
{
HL7Msg hl7Msg = new HL7Msg();
hl7Msg.AptNum = appt.AptNum;
hl7Msg.HL7Status = HL7MessageStatus.OutPending; //it will be marked outSent by the HL7 service.
hl7Msg.MsgText = messageHL7.ToString();
hl7Msg.PatNum = pat.PatNum;
HL7Msgs.Insert(hl7Msg);
#if DEBUG
MessageBox.Show("Appointments", messageHL7.ToString());
#endif
}
}
#endregion
List <Procedure> listProcedures = new List <Procedure>();
//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;
Procedure brokenProcedure = new Procedure();
bool wasBrokenProcDeleted = false;
if (PrefC.GetYN(PrefName.PrePayAllowedForTpProcs))
{
listProcedures = Procedures.GetProcsForSingle(appt.AptNum, false);
if (listProcedures.Count > 0)
{
listSplitsForApptProcs = PaySplits.GetPaySplitsFromProcs(listProcedures.Select(x => x.ProcNum).ToList());
}
}
#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 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.
brokenProcedure.ProcFee = listSplitsForApptProcs.Sum(x => x.SplitAmt);
isNonRefundable = true;
}
else
{
brokenProcedure.ProcFee = procFee;
}
if (!PrefC.GetBool(PrefName.EasyHidePublicHealth))
{
brokenProcedure.SiteNum = pat.SiteNum;
}
Procedures.Insert(brokenProcedure);
//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);
FormProcBroken FormPB = new FormProcBroken(brokenProcedure, isNonRefundable);
FormPB.IsNew = true;
FormPB.ShowDialog();
brokenProcAmount = FormPB.AmountTotal;
wasBrokenProcDeleted = FormPB.IsProcDeleted;
}
#endregion
#region BrokenApptAdjustment
if (PrefC.GetBool(PrefName.BrokenApptAdjustment))
{
Adjustment AdjustmentCur = new Adjustment();
AdjustmentCur.DateEntry = DateTime.Today;
AdjustmentCur.AdjDate = DateTime.Today;
AdjustmentCur.ProcDate = DateTime.Today;
AdjustmentCur.ProvNum = appt.ProvNum;
AdjustmentCur.PatNum = pat.PatNum;
AdjustmentCur.AdjType = PrefC.GetLong(PrefName.BrokenAppointmentAdjustmentType);
AdjustmentCur.ClinicNum = appt.ClinicNum;
FormAdjust FormA = new FormAdjust(pat, AdjustmentCur);
FormA.IsNew = true;
FormA.ShowDialog();
}
#endregion
#region BrokenApptCommLog
if (PrefC.GetBool(PrefName.BrokenApptCommLog))
{
Commlog commlogCur = new Commlog();
commlogCur.PatNum = pat.PatNum;
commlogCur.CommDateTime = DateTime.Now;
commlogCur.CommType = Commlogs.GetTypeAuto(CommItemTypeAuto.APPT);
commlogCur.Note = Lan.g("Appointment", "Appt BROKEN for") + " " + appt.ProcDescript + " " + appt.AptDateTime.ToString();
commlogCur.Mode_ = CommItemMode.None;
commlogCur.UserNum = Security.CurUser.UserNum;
commlogCur.IsNew = true;
FormCommItem FormCI = new FormCommItem(commlogCur);
FormCI.ShowDialog();
}
#endregion
#region Transfer money from TP Procedures if necessary
//Note this MUST come after FormProcBroken since clicking cancel in that window will delete the procedure.
if (isNonRefundable && !wasBrokenProcDeleted && 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);
double amtPaidOnApt = listSplitsForApptProcs.Sum(x => x.SplitAmt);
if (amtPaidOnApt > amt)
{
//If the original prepayment amount is greater than the amt being specified for the appointment break, transfer
//the difference to an Unallocated Unearned Paysplit on the account.
double remainingAmt = amtPaidOnApt - amt;
//We have to create a new transfer payment here to correlate to the split.
Payment txfrPayment = new Payment();
txfrPayment.PayAmt = 0;
txfrPayment.PayDate = DateTime.Today;
txfrPayment.ClinicNum = split.ClinicNum;
txfrPayment.PayNote = "Automatic transfer from treatment planned procedure prepayment.";
txfrPayment.PatNum = split.PatNum; //ultimately where the payment ends up.
txfrPayment.PayType = 0;
Payments.Insert(txfrPayment);
PaymentEdit.IncomeTransferData transferData = PaymentEdit.IncomeTransferData.CreateTransfer(split, txfrPayment.PayNum, true, remainingAmt);
PaySplit offset = transferData.ListSplitsCur.FirstOrDefault(x => x.FSplitNum != 0);
long offsetSplitNum = PaySplits.Insert(offset); //Get the FSplitNum from the offset
PaySplit allocation = transferData.ListSplitsCur.FirstOrDefault(x => x.FSplitNum == 0);
allocation.FSplitNum = offsetSplitNum;
PaySplits.Insert(allocation); //Insert so the split is now up to date
SecurityLogs.MakeLogEntry(Permissions.PaymentCreate, txfrPayment.PatNum, "Automatic transfer of funds for treatment plan procedure pre-payments.");
}
brokenProcAmount -= amt;
}
}
}
//if broken appointment procedure was deleted (user cancelled out of the window) just keep money on the original procedure.
#endregion
AppointmentEvent.Fire(ODEventType.AppointmentEdited, appt);
AutomationL.Trigger(AutomationTrigger.BreakAppointment, null, pat.PatNum);
Recalls.SynchScheduledApptFull(appt.PatNum);
}
///<summary>Checks to see if the appointments provider has at least one mismatch provider on all the completed procedures attached to the appointment.
///If so, checks to see if the user has permission to edit a completed procedure. If the user does, then the user has the option to change the provider to match.</summary>
public static bool DoRemoveCompletedProcs(Appointment apt, List <Procedure> listProcsForAppt, bool checkForAllProcCompl = false)
{
if (listProcsForAppt.Count == 0)
{
return(false);
}
if (checkForAllProcCompl && (apt.AptStatus != ApptStatus.Complete || listProcsForAppt.All(x => x.ProcStatus == ProcStat.C)))
{
return(false);
}
List <Procedure> listCompletedProcWithDifferentProv = new List <Procedure>();
foreach (Procedure proc in listProcsForAppt)
{
if (proc.ProcStatus != ProcStat.C) //should all be complete already.
{
continue;
}
ProcedureCode procCode = ProcedureCodes.GetProcCode(proc.CodeNum);
long provNum = Procedures.GetProvNumFromAppointment(apt, proc, procCode);
if (provNum != proc.ProvNum)
{
listCompletedProcWithDifferentProv.Add(proc);
}
}
if (listCompletedProcWithDifferentProv.Count == 0)
{
return(false); //no completed procedures or prov changed.
}
List <PaySplit> listPaySplit = PaySplits.GetPaySplitsFromProcs(listCompletedProcWithDifferentProv.Select(x => x.ProcNum).ToList());
if (listPaySplit.Count > 0)
{
MsgBox.Show("Procedures", "The appointment provider does not match the provider on at least one completed procedure.\r\n"
+ "The procedure provider cannot be changed to match the appointment provider because the paysplit provider would no longer match. "
+ "Any change to the provider on the completed procedure(s) or paysplit(s) will have to be made manually.");
return(true); //paysplits exist on one of the completed procedures. Per Nathan, don't change the provider. User will need to change manually.
}
foreach (Procedure proc in listCompletedProcWithDifferentProv)
{
Permissions perm = Permissions.ProcComplEdit;
if (proc.ProcStatus.In(ProcStat.EC, ProcStat.EO))
{
perm = Permissions.ProcExistingEdit;
}
if (Security.IsGlobalDateLock(perm, proc.ProcDate))
{
return(true);
}
if (!Security.IsAuthorized(perm, proc.ProcDate, true, true))
{
MessageBox.Show(Lan.g("Procedures", "The appointment provider does not match the provider on at least one completed procedure.") + "\r\n"
+ Lans.g("Procedures", "Not authorized for") + ": " + GroupPermissions.GetDesc(perm) + "\r\n"
+ Lan.g("Procedures", "Any change to the provider on the completed procedure(s) will have to be made manually."));
return(true); //user does not have permission to change the provider. Don't change provider.
}
}
//The appointment is set complete, completed procedures exist, and provider does not match appointment.
//Ask if they would like to change the providers on the completed procedure to match the appointments provider
if (!MsgBox.Show("Procedures", MsgBoxButtons.YesNo, "The appointment provider does not match the provider on at least one completed procedure.\r\n"
+ "Change the provider on the completed procedure(s) to match the provider on the appointment?"))
{
return(true); //user does not want to change the providers
}
//user wants to change the provider on the completed procedure
return(false);
}
