///<summary>Creates a general deductible of $50, a deductible of $50 on D0220, sets a $30 D0220 complete and creates a claim,
///creates a $100 D2750, that is TP'ed, and then creates a $30 D0220 that is TP'ed.</summary>
///<param name="actAssert">The first claimproc is for the D2750 and the second claimproc is for the second D0220.</param>
public void GetDeductibleByCodeDeductLessThanGeneral(string suffix, Action <ClaimProc, ClaimProc> actAssert)
{
Patient pat = PatientT.CreatePatient(suffix);
InsuranceT.AddInsurance(pat, suffix);
List <InsSub> listSubs = InsSubT.GetInsSubs(pat);
List <InsPlan> listPlans = InsPlans.RefreshForSubList(listSubs);
List <PatPlan> listPatPlans = PatPlans.Refresh(pat.PatNum);
InsPlan plan = InsPlanT.GetPlanForPriSecMed(PriSecMed.Primary, listPatPlans, listPlans, listSubs);
BenefitT.CreateDeductibleGeneral(plan.PlanNum, BenefitCoverageLevel.Individual, 50);
BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Diagnostic, 100);
BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Crowns, 50);
BenefitT.CreateDeductible(plan.PlanNum, EbenefitCategory.Diagnostic, 0);
BenefitT.CreateDeductible(plan.PlanNum, "D0220", 50);
List <Benefit> listBens = Benefits.Refresh(listPatPlans, listSubs);
Procedure proc1 = ProcedureT.CreateProcedure(pat, "D0220", ProcStat.C, "", 30);//proc1 - Intraoral - periapical first film
ClaimT.CreateClaim("P", listPatPlans, listPlans, new List <ClaimProc>(), new List <Procedure> {
proc1
}, pat, new List <Procedure> {
proc1
}, listBens,
listSubs);
Procedure proc2 = ProcedureT.CreateProcedure(pat, "D2750", ProcStat.TP, "", 100, priority: 0); //proc2 - Crown
Procedure proc3 = ProcedureT.CreateProcedure(pat, "D0220", ProcStat.TP, "", 30, priority: 1); //proc3 - Intraoral - periapical first film
List <ClaimProc> claimProcs = ProcedureT.ComputeEstimates(pat, listPatPlans, listPlans, listSubs, listBens);
ClaimProc claimProc2 = claimProcs.FirstOrDefault(x => x.ProcNum == proc2.ProcNum);
ClaimProc claimProc3 = claimProcs.FirstOrDefault(x => x.ProcNum == proc3.ProcNum);
actAssert(claimProc2, claimProc3);
}
public void InsPlan_GetInsUsedDisplay_OrthoProcsNotAffectInsUsed()
{
string suffix = "13";
Patient pat = PatientT.CreatePatient(suffix);
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, plan.PlanNum);
long subNum = sub.InsSubNum;
PatPlan patPlan = PatPlanT.CreatePatPlan(1, pat.PatNum, subNum);
BenefitT.CreateAnnualMax(plan.PlanNum, 100);
BenefitT.CreateOrthoMax(plan.PlanNum, 500);
BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Diagnostic, 100);
BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Orthodontics, 100);
Procedure proc1 = ProcedureT.CreateProcedure(pat, "D0140", ProcStat.C, "", 59); //limEx
Procedure proc2 = ProcedureT.CreateProcedure(pat, "D8090", ProcStat.C, "", 348); //Comprehensive ortho
ClaimProcT.AddInsPaid(pat.PatNum, plan.PlanNum, proc1.ProcNum, 59, subNum, 0, 0);
ClaimProcT.AddInsPaid(pat.PatNum, plan.PlanNum, proc2.ProcNum, 348, subNum, 0, 0);
//Lists
Family fam = Patients.GetFamily(pat.PatNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlans = PatPlans.Refresh(pat.PatNum);
List <Benefit> benefitList = Benefits.Refresh(patPlans, subList);
List <ClaimProcHist> histList = ClaimProcs.GetHistList(pat.PatNum, benefitList, patPlans, planList, DateTime.Today, subList);
//Validate
double insUsed = InsPlans.GetInsUsedDisplay(histList, DateTime.Today, plan.PlanNum, patPlan.PatPlanNum, -1, planList, benefitList, pat.PatNum, subNum);
Assert.AreEqual(59, insUsed);
}
public void InsPlan_GetPendingDisplay_LimitationsOverrideGeneralLimitations()
{
string suffix = "31";
Patient pat = PatientT.CreatePatient(suffix);
long patNum = pat.PatNum;
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
long planNum = plan.PlanNum;
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, planNum); //guarantor is subscriber
long subNum = sub.InsSubNum;
long patPlanNum = PatPlanT.CreatePatPlan(1, pat.PatNum, subNum).PatPlanNum;
BenefitT.CreateAnnualMax(planNum, 1000);
BenefitT.CreateCategoryPercent(planNum, EbenefitCategory.RoutinePreventive, 100);
BenefitT.CreateLimitation(planNum, EbenefitCategory.RoutinePreventive, 1000); //Changing this amount would affect patient portion vs ins portion. But regardless of the amount, this should prevent any pending from showing in the box, which is for general pending only.
Procedure proc = ProcedureT.CreateProcedure(pat, "D1110", ProcStat.C, "", 125); //Prophy
//Lists
List <ClaimProc> claimProcs = ClaimProcs.Refresh(pat.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(pat.PatNum);
Claim claim = ClaimT.CreateClaim("P", patPlans, planList, claimProcs, ProcList, pat, ProcList, benefitList, subList);//Creates the claim in the same manner as the account module, including estimates and status NotReceived.
List <ClaimProcHist> histList = ClaimProcs.GetHistList(patNum, benefitList, patPlans, planList, DateTime.Today, subList);
//Validate
Assert.AreEqual(0, InsPlans.GetPendingDisplay(histList, DateTime.Today, plan, patPlanNum, -1, patNum, subNum, benefitList));
}
public void InsPlan_GetInsUsedDisplay_LimitationsOverride()
{
string suffix = "6";
Patient pat = PatientT.CreatePatient(suffix);
long patNum = pat.PatNum;
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
long planNum = plan.PlanNum;
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, planNum); //guarantor is subscriber
long subNum = sub.InsSubNum;
long patPlanNum = PatPlanT.CreatePatPlan(1, pat.PatNum, subNum).PatPlanNum;
BenefitT.CreateAnnualMax(planNum, 1000);
BenefitT.CreateLimitation(planNum, EbenefitCategory.Diagnostic, 1000);
Procedure proc = ProcedureT.CreateProcedure(pat, "D0120", ProcStat.C, "", 50); //An exam
long procNum = proc.ProcNum;
Procedure proc2 = ProcedureT.CreateProcedure(pat, "D2750", ProcStat.C, "8", 830); //create a crown
ClaimProcT.AddInsPaid(patNum, planNum, procNum, 50, subNum, 0, 0);
ClaimProcT.AddInsPaid(patNum, planNum, proc2.ProcNum, 400, subNum, 0, 0);
//Lists
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 <ClaimProcHist> histList = ClaimProcs.GetHistList(patNum, benefitList, patPlans, planList, DateTime.Today, subList);
//Validate
double insUsed = InsPlans.GetInsUsedDisplay(histList, DateTime.Today, planNum, patPlanNum, -1, planList, benefitList, patNum, subNum);
Assert.AreEqual(400, insUsed);
}
///<summary>Creates a procedure and computes estimates for a patient where the secondary insurance has a COB rule of Medicaid.</summary>
private void ComputeEstimatesMedicaidCOB(string suffix, double procFee, double priAllowed, double secAllowed, int priPercentCovered,
int secPercentCovered, Action <ClaimProc /*Primary*/, ClaimProc /*Secondary*/, Procedure> assertAct)
{
Patient pat = PatientT.CreatePatient(suffix);
long ppoFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "PPO " + suffix);
InsuranceT.AddInsurance(pat, suffix, "p", ppoFeeSchedNum);
long medicaidFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "PPO " + suffix);
InsuranceT.AddInsurance(pat, suffix, "p", medicaidFeeSchedNum, 2, cobRule: EnumCobRule.SecondaryMedicaid);
List <InsSub> listSubs = InsSubT.GetInsSubs(pat);
List <InsPlan> listPlans = InsPlans.RefreshForSubList(listSubs);
List <PatPlan> listPatPlans = PatPlans.Refresh(pat.PatNum);
InsPlan priPlan = InsPlanT.GetPlanForPriSecMed(PriSecMed.Primary, listPatPlans, listPlans, listSubs);
BenefitT.CreateCategoryPercent(priPlan.PlanNum, EbenefitCategory.Diagnostic, priPercentCovered);
InsPlan secPlan = InsPlanT.GetPlanForPriSecMed(PriSecMed.Secondary, listPatPlans, listPlans, listSubs);
BenefitT.CreateCategoryPercent(secPlan.PlanNum, EbenefitCategory.Diagnostic, secPercentCovered);
List <Benefit> listBens = Benefits.Refresh(listPatPlans, listSubs);
string procStr = "D0150";
Procedure proc = ProcedureT.CreateProcedure(pat, procStr, ProcStat.TP, "", procFee);
ProcedureCode procCode = ProcedureCodes.GetProcCode(procStr);
FeeT.CreateFee(ppoFeeSchedNum, procCode.CodeNum, priAllowed);
FeeT.CreateFee(medicaidFeeSchedNum, procCode.CodeNum, secAllowed);
Procedures.ComputeEstimates(proc, pat.PatNum, new List <ClaimProc>(), false, listPlans, listPatPlans, listBens, pat.Age, listSubs);
List <ClaimProc> listClaimProcs = ClaimProcs.Refresh(pat.PatNum);
assertAct(listClaimProcs.FirstOrDefault(x => x.PlanNum == priPlan.PlanNum), listClaimProcs.FirstOrDefault(x => x.PlanNum == secPlan.PlanNum), proc);
}
///<summary>Creates a procedure and returns its procedure fee.</summary>
private double GetProcFee(string suffix, bool doUseMedicalCode)
{
Prefs.UpdateBool(PrefName.InsPpoAlwaysUseUcrFee, true);
Prefs.UpdateBool(PrefName.MedicalFeeUsedForNewProcs, doUseMedicalCode);
Patient pat = PatientT.CreatePatient(suffix);
long ucrFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "UCR " + suffix);
FeeSchedT.UpdateUCRFeeSched(pat, ucrFeeSchedNum);
long ppoFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "PPO " + suffix);
InsuranceT.AddInsurance(pat, suffix, "p", ppoFeeSchedNum, 1, true);
List <InsSub> listSubs = InsSubT.GetInsSubs(pat);
List <InsPlan> listPlans = InsPlans.RefreshForSubList(listSubs);
List <PatPlan> listPatPlans = PatPlans.Refresh(pat.PatNum);
string procStr = "D0150";
string procStrMed = "D0120";
ProcedureCode procCode = ProcedureCodes.GetProcCode(procStr);
ProcedureCode procCodeMed = ProcedureCodes.GetProcCode(procStrMed);
procCode.MedicalCode = procCodeMed.ProcCode;
FeeT.CreateFee(ucrFeeSchedNum, procCode.CodeNum, 300);
FeeT.CreateFee(ppoFeeSchedNum, procCode.CodeNum, 120);
FeeT.CreateFee(ucrFeeSchedNum, procCodeMed.CodeNum, 175);
FeeT.CreateFee(ppoFeeSchedNum, procCodeMed.CodeNum, 85);
Procedure proc = ProcedureT.CreateProcedure(pat, procStr, ProcStat.TP, "", 300);
return(Procedures.GetProcFee(pat, listPatPlans, listSubs, listPlans, procCode.CodeNum, proc.ProvNum, proc.ClinicNum, procCode.MedicalCode));
}
private static Claim CreatePredetermination(Patient pat, List <Procedure> procList, long provTreat)
{
Family fam = Patients.GetFamily(pat.PatNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlanList = PatPlans.Refresh(pat.PatNum);
List <Benefit> benefitList = Benefits.Refresh(patPlanList, subList);
List <ClaimProc> claimProcList = ClaimProcs.Refresh(pat.PatNum);
List <Procedure> procsForPat = Procedures.Refresh(pat.PatNum);
InsSub sub = InsSubs.GetSub(PatPlans.GetInsSubNum(patPlanList, 1), subList);
InsPlan insPlan = InsPlans.GetPlan(sub.PlanNum, planList);
Claim claim = new Claim();
Claims.Insert(claim); //to retreive a key for new Claim.ClaimNum
claim.PatNum = pat.PatNum;
claim.DateService = procList[0].ProcDate;
claim.DateSent = DateTime.Today;
claim.ClaimStatus = "W";
claim.InsSubNum = PatPlans.GetInsSubNum(patPlanList, 1);
claim.InsSubNum2 = PatPlans.GetInsSubNum(patPlanList, 2);
InsSub sub1 = InsSubs.GetSub(claim.InsSubNum, subList);
InsSub sub2 = InsSubs.GetSub(claim.InsSubNum, subList);
claim.PlanNum = sub1.PlanNum;
claim.PlanNum2 = sub2.PlanNum;
claim.PatRelat = PatPlans.GetRelat(patPlanList, 1);
claim.PatRelat2 = PatPlans.GetRelat(patPlanList, 2);
claim.ClaimType = "PreAuth";
claim.ProvTreat = provTreat;
claim.IsProsthesis = "N";
claim.ProvBill = Providers.GetBillingProvNum(claim.ProvTreat, 0);
claim.EmployRelated = YN.No;
ClaimProc cp;
List <Procedure> procListClaim = new List <Procedure>(); //this list will exclude lab fees
for (int i = 0; i < procList.Count; i++)
{
if (procList[i].ProcNumLab == 0)
{
procListClaim.Add(procList[i]);
}
}
for (int i = 0; i < procListClaim.Count; i++)
{
cp = new ClaimProc();
ClaimProcs.CreateEst(cp, procListClaim[i], insPlan, sub);
cp.ClaimNum = claim.ClaimNum;
cp.Status = ClaimProcStatus.NotReceived;
cp.CodeSent = ProcedureCodes.GetProcCode(procListClaim[i].CodeNum).ProcCode;
cp.LineNumber = (byte)(i + 1);
ClaimProcs.Update(cp);
}
claimProcList = ClaimProcs.Refresh(pat.PatNum);
ClaimL.CalculateAndUpdate(procsForPat, planList, claim, patPlanList, benefitList, pat.Age, subList);
return(claim);
}
public void InsPlan_GetDedRemainDisplay_IndividualAndFamilyDeductiblesInsRemaining()
{
string suffix = "20";
Patient pat = PatientT.CreatePatient(suffix); //guarantor
long patNum = pat.PatNum;
Patient pat2 = PatientT.CreatePatient(suffix);
PatientT.SetGuarantor(pat2, pat.PatNum);
Patient pat3 = PatientT.CreatePatient(suffix);
PatientT.SetGuarantor(pat3, pat.PatNum);
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
long planNum = plan.PlanNum;
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, planNum); //guarantor is subscriber
long subNum = sub.InsSubNum;
PatPlan patPlan = PatPlanT.CreatePatPlan(1, pat.PatNum, subNum); //all three patients have the same plan
PatPlan patPlan2 = PatPlanT.CreatePatPlan(1, pat2.PatNum, subNum); //all three patients have the same plan
PatPlan patPlan3 = PatPlanT.CreatePatPlan(1, pat3.PatNum, subNum); //all three patients have the same plan
BenefitT.CreateDeductibleGeneral(planNum, BenefitCoverageLevel.Individual, 75);
BenefitT.CreateDeductibleGeneral(planNum, BenefitCoverageLevel.Family, 150);
ClaimProcT.AddInsUsedAdjustment(pat3.PatNum, planNum, 0, subNum, 75); //Adjustment goes on the third patient
Procedure proc = ProcedureT.CreateProcedure(pat2, "D2750", ProcStat.C, "20", 1280); //proc for second patient with a deductible already applied.
ClaimProcT.AddInsPaid(pat2.PatNum, planNum, proc.ProcNum, 304, subNum, 50, 597);
proc = ProcedureT.CreateProcedure(pat, "D4355", ProcStat.TP, "", 135); //proc is for the first patient
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 <ClaimProcHist> histList = ClaimProcs.GetHistList(patNum, benefitList, patPlans, planList, DateTime.Today, subList);
List <ClaimProcHist> loopList = new List <ClaimProcHist>();
//Validate
List <ClaimProcHist> HistList = ClaimProcs.GetHistList(pat.PatNum, benefitList, patPlans, planList, DateTime.Today, subList);
double dedFam = Benefits.GetDeductGeneralDisplay(benefitList, planNum, patPlan.PatPlanNum, BenefitCoverageLevel.Family);
double ded = Benefits.GetDeductGeneralDisplay(benefitList, planNum, patPlan.PatPlanNum, BenefitCoverageLevel.Individual);
double dedRem = InsPlans.GetDedRemainDisplay(HistList, DateTime.Today, planNum, patPlan.PatPlanNum, -1, planList, pat.PatNum, ded, dedFam); //test family and individual deductible together
Assert.AreEqual(25, dedRem);
dedRem = InsPlans.GetDedRemainDisplay(HistList, DateTime.Today, planNum, patPlan.PatPlanNum, -1, planList, pat.PatNum, ded, -1); //test individual deductible by itself
Assert.AreEqual(75, dedRem);
}
public void Claims_CalculateAndUpdate_ProcedureCodeDowngradeHigherFee()
{
string suffix = "61";
Patient pat = PatientT.CreatePatient(suffix);
long ucrFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "UCR Fees" + suffix);
long ppoFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "PPO Downgrades" + suffix);
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan plan = InsPlanT.CreateInsPlan(carrier.CarrierNum);
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, plan.PlanNum);
long subNum = sub.InsSubNum;
BenefitT.CreateCategoryPercent(plan.PlanNum, EbenefitCategory.Restorative, 100);
PatPlanT.CreatePatPlan(1, pat.PatNum, subNum);
ProcedureCode originalProcCode = ProcedureCodes.GetProcCode("D2391");
ProcedureCode downgradeProcCode = ProcedureCodes.GetProcCode("D2140");
originalProcCode.SubstitutionCode = "D2140";
originalProcCode.SubstOnlyIf = SubstitutionCondition.Always;
ProcedureCodes.Update(originalProcCode);
FeeT.CreateFee(ucrFeeSchedNum, originalProcCode.CodeNum, 140);
FeeT.CreateFee(ucrFeeSchedNum, downgradeProcCode.CodeNum, 120);
FeeT.CreateFee(ppoFeeSchedNum, originalProcCode.CodeNum, 80);
FeeT.CreateFee(ppoFeeSchedNum, downgradeProcCode.CodeNum, 100);
Procedure proc = ProcedureT.CreateProcedure(pat, "D2391", ProcStat.C, "1", 140);//Tooth 1
List <ClaimProc> claimProcs = ClaimProcs.Refresh(pat.PatNum);
List <ClaimProc> claimProcListOld = new List <ClaimProc>();
Family fam = Patients.GetFamily(pat.PatNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
List <PatPlan> patPlans = PatPlans.Refresh(pat.PatNum);
List <Benefit> benefitList = Benefits.Refresh(patPlans, subList);
List <Procedure> ProcList = Procedures.Refresh(pat.PatNum);
InsPlan insPlan = planList[0];//Should only be one
InsPlan planOld = insPlan.Copy();
insPlan.PlanType = "p";
insPlan.FeeSched = ppoFeeSchedNum;
InsPlans.Update(insPlan, planOld);
//Creates the claim in the same manner as the account module, including estimates.
Claim claim = ClaimT.CreateClaim("P", patPlans, planList, claimProcs, ProcList, pat, ProcList, benefitList, subList);
ClaimProc clProc = ClaimProcs.Refresh(pat.PatNum)[0]; //Should only be one
Assert.AreEqual(80, clProc.InsEstTotal);
Assert.AreEqual(60, clProc.WriteOff);
}
public void Claims_CalculateAndUpdate_PreauthOrderWriteoff()
{
string suffix = MethodBase.GetCurrentMethod().Name;
//create the patient and insurance information
Patient pat = PatientT.CreatePatient(suffix);
//proc - Crown
Procedure proc = ProcedureT.CreateProcedure(pat, "D2750", ProcStat.C, "8", 1000);
long feeSchedNum1 = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, suffix);
FeeT.CreateFee(feeSchedNum1, proc.CodeNum, 900);
Carrier carrier = CarrierT.CreateCarrier(suffix);
InsPlan insPlan = InsPlanT.CreateInsPlanPPO(carrier.CarrierNum, feeSchedNum1);
BenefitT.CreateAnnualMax(insPlan.PlanNum, 1000);
BenefitT.CreateCategoryPercent(insPlan.PlanNum, EbenefitCategory.Crowns, 100);
InsSub sub = InsSubT.CreateInsSub(pat.PatNum, insPlan.PlanNum);
PatPlan pp = PatPlanT.CreatePatPlan(1, pat.PatNum, sub.InsSubNum);
//create lists and variables required for ComputeEstimates()
List <InsSub> SubList = InsSubs.RefreshForFam(Patients.GetFamily(pat.PatNum));
List <InsPlan> listInsPlan = InsPlans.RefreshForSubList(SubList);
List <PatPlan> listPatPlan = PatPlans.Refresh(pat.PatNum);
List <Benefit> listBenefits = Benefits.Refresh(listPatPlan, SubList);
List <Procedure> listProcsForPat = Procedures.Refresh(pat.PatNum);
List <Procedure> procsForClaim = new List <Procedure>();
procsForClaim.Add(proc);
//Create the claim and associated claimprocs
//The order of these claimprocs is the whole point of the unit test.
//Create Preauth
ClaimProcs.CreateEst(new ClaimProc(), proc, insPlan, sub, 0, 500, true, true);
//Create Estimate
ClaimProcs.CreateEst(new ClaimProc(), proc, insPlan, sub, 1000, 1000, true, false);
List <ClaimProc> listClaimProcs = ClaimProcs.Refresh(pat.PatNum);
Claim claimWaiting = ClaimT.CreateClaim("W", listPatPlan, listInsPlan, listClaimProcs, listProcsForPat, pat, procsForClaim, listBenefits, SubList, false);
Assert.AreEqual(100, claimWaiting.WriteOff, "WriteOff Amount");
}
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);
}
///<summary>Creates a procedure and computes estimates for a patient where the secondary insurance has a COB rule of Medicaid.</summary>
private void ComputeEstimatesFixedBenefits(string suffix, double procFee, double ppoFee, double fixedBenefitFee
, int priPercentCoveredOverride, bool hasSecondary, double secFee, Action <FixedBenefitAssertItem> assertAct)
{
Patient pat = PatientT.CreatePatient(suffix);
string procStr = "D0150";
Procedure proc = ProcedureT.CreateProcedure(pat, procStr, ProcStat.TP, "", procFee);
ProcedureCode procCode = ProcedureCodes.GetProcCode(procStr);
long ppoFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "PPO " + suffix);
long catPercFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.Normal, "Category % " + suffix);
long fixedBenefitFeeSchedNum = FeeSchedT.CreateFeeSched(FeeScheduleType.FixedBenefit, "Fixed Benefit " + suffix);
if (ppoFee > -1)
{
FeeT.CreateFee(ppoFeeSchedNum, procCode.CodeNum, ppoFee);
}
FeeT.CreateFee(fixedBenefitFeeSchedNum, procCode.CodeNum, fixedBenefitFee);
InsuranceT.AddInsurance(pat, suffix, "p", ppoFeeSchedNum, copayFeeSchedNum: fixedBenefitFeeSchedNum);
if (hasSecondary)
{
FeeT.CreateFee(catPercFeeSchedNum, procCode.CodeNum, secFee);
InsuranceT.AddInsurance(pat, suffix, "", catPercFeeSchedNum, 2, false, EnumCobRule.Standard);
}
List <InsSub> listSubs = InsSubT.GetInsSubs(pat);
List <InsPlan> listPlans = InsPlans.RefreshForSubList(listSubs);
List <PatPlan> listPatPlans = PatPlans.Refresh(pat.PatNum);
InsPlan priPlan = InsPlanT.GetPlanForPriSecMed(PriSecMed.Primary, listPatPlans, listPlans, listSubs);
InsPlan secPlan = null;
if (hasSecondary)
{
secPlan = InsPlanT.GetPlanForPriSecMed(PriSecMed.Secondary, listPatPlans, listPlans, listSubs);
//TODO: Add diagnostic code benefit for 100%
BenefitT.CreateCategoryPercent(secPlan.PlanNum, EbenefitCategory.Diagnostic, 100);
}
List <Benefit> listBens = Benefits.Refresh(listPatPlans, listSubs);
Procedures.ComputeEstimates(proc, pat.PatNum, new List <ClaimProc>(), false, listPlans, listPatPlans, listBens, pat.Age, listSubs);
List <ClaimProc> listClaimProcs = ClaimProcs.Refresh(pat.PatNum);
if (priPercentCoveredOverride > 0)
{
foreach (ClaimProc cpCur in listClaimProcs)
{
cpCur.PercentOverride = priPercentCoveredOverride;
ClaimProcs.Update(cpCur);
}
Procedures.ComputeEstimates(proc, pat.PatNum, new List <ClaimProc>(), false, listPlans, listPatPlans, listBens, pat.Age, listSubs);
listClaimProcs = ClaimProcs.Refresh(pat.PatNum);
}
foreach (ClaimProc cpCur in listClaimProcs)
{
cpCur.PercentOverride = priPercentCoveredOverride;
ClaimProcs.Update(cpCur);
}
Procedures.ComputeEstimates(proc, pat.PatNum, listClaimProcs, false, listPlans, listPatPlans, listBens, pat.Age, listSubs);
listClaimProcs = ClaimProcs.Refresh(pat.PatNum);
assertAct(new FixedBenefitAssertItem()
{
Procedure = proc,
PrimaryClaimProc = listClaimProcs.FirstOrDefault(x => x.PlanNum == priPlan.PlanNum),
SecondaryClaimProc = secPlan == null ? null : listClaimProcs.FirstOrDefault(x => x.PlanNum == secPlan.PlanNum),
});
}
///<summary>Called from Eclaims and includes multiple claims.</summary>
public static string SendBatch(Clearinghouse clearinghouseClin, List <ClaimSendQueueItem> queueItems, int batchNum)
{
//STEP 1 - Build XML output.
List <DP_RACINDP> listDps = new List <DP_RACINDP>();
List <ProcedureCode> listProcCodes = ProcedureCodes.GetAllCodes();
List <Etrans> listEtrans = new List <Etrans>();
foreach (ClaimSendQueueItem queueItem in queueItems)
{
Etrans etrans = Etranss.SetClaimSentOrPrinted(queueItem.ClaimNum, queueItem.PatNum, clearinghouseClin.HqClearinghouseNum, EtransType.Claim_Ramq, batchNum, Security.CurUser.UserNum);
listEtrans.Add(etrans);
//Now we need to update our cache of claims to reflect the change that took place in the database above in Etranss.SetClaimSentOrPrinted()
queueItem.ClaimStatus = "S";
Claim claim = Claims.GetClaim(queueItem.ClaimNum);
Provider provClaimTreat = Providers.GetProv(claim.ProvTreat);
DP_RACINDP dp = new DP_RACINDP();
#region Header
dp.CHN = DP_RACINDPCHN.Item06;
dp.CHNSpecified = true;
dp.ENRG = DP_RACINDPENRG.Item1;
dp.ENRGSpecified = true;
//We hijack the TaxID number for the TRNSM field. The TRNSM is a office identifying number. Test range for developers is 18000 to 18999.
dp.TRNSM = clearinghouseClin.SenderTIN;
dp.DISP = provClaimTreat.NationalProvID;
//dp.CPTE_ADMN=;//Administrative account number. Not currently used.
JulianCalendar calendar = new JulianCalendar();
dp.ATTES = (DateTime.Now.Year % 10).ToString() //One digit for year
+ calendar.GetDayOfYear(DateTime.Now).ToString().PadLeft(3, '0') //3 digits for Julian day of year.
+ (etrans.CarrierTransCounter % 1000).ToString().PadLeft(3, '0'); //3 digits for sequence number.
dp.NCE = (etrans.CarrierTransCounter % 10000).ToString().PadLeft(4, '0');
dp.DISP_REFNT = claim.CanadianReferralProviderNum.Trim();
//dp.DIAGN=;//Diagnostic code. Not currently used.
dp.ETAB = provClaimTreat.CanadianOfficeNum; //Usually empty.
//dp.ADMIS=;//Date of patient admission. Not currently used. This would be the same as the date of service for dental claims anyway.
//dp.SORTI=;//Date patient discharged. Not currently used. This would be the same as the date of service for dental claims anyway.
dp.TOT_DEM = claim.ClaimFee.ToString().Replace(".", "").PadLeft(6, '0');
dp.COMPL = TidyStr(claim.ClaimNote, 200);
//dp.CS=;//Not sure what this is. Not currently used.
//dp.AUTOR=claim.PreAuthString;//Authorization number when invoicing acrylic prostheses. Required if DAT_AUTOR is present. Not currently used.
//dp.DAT_AUTOR=claim.CanadianDateInitialLower;//Date of authorization when invoicing acrylic prostheses. Format YYMMDD. Not currently used.
dp.SERV = claim.DateService.ToString("yyMMdd");
#endregion Header
#region Insurance
//Most fields in the insuranace section are optional.
InsSub insSub = InsSubs.GetOne(claim.InsSubNum);
dp.PERS_ASSU = new DP_RACINDPPERS_ASSU();
dp.PERS_ASSU.NAM = insSub.SubscriberID;
Patient pat = Patients.GetPat(claim.PatNum);
dp.PERS_ASSU.PRE = TidyStr(pat.FName, 20);
dp.PERS_ASSU.NOM = TidyStr(pat.LName, 30);
if (pat.Birthdate.Year > 1880)
{
dp.PERS_ASSU.NAISS = pat.Birthdate.ToString("yyyyMMdd");
}
if (pat.Gender == PatientGender.Male)
{
dp.PERS_ASSU.SEXE = DP_RACINDPPERS_ASSUSEXE.M;
}
else if (pat.Gender == PatientGender.Female)
{
dp.PERS_ASSU.SEXE = DP_RACINDPPERS_ASSUSEXE.F;
}
else
{
//There is no value for UNKNOWN. This field is optional if the subscriber ID is present anyway.
}
List <PatPlan> listPatPlans = PatPlans.Refresh(claim.PatNum);
PatPlan patPlan = PatPlans.GetByInsSubNum(listPatPlans, insSub.InsSubNum);
dp.PERS_ASSU.CAM = patPlan.PatID;
if (insSub.DateTerm.Year > 1880)
{
dp.PERS_ASSU.EXPIR_CAM = insSub.DateTerm.ToString("yyMM");
}
InsPlan insPlan = InsPlans.RefreshOne(claim.PlanNum);
InsPlan insPlan2 = InsPlans.RefreshOne(claim.PlanNum2);
Carrier carrier = null;
if (claim.ClaimType == "S")
{
carrier = Carriers.GetCarrier(insPlan2.CarrierNum);
}
else
{
carrier = Carriers.GetCarrier(insPlan.CarrierNum);
}
if (carrier.Address.Trim() != "")
{
dp.PERS_ASSU.ADR_1 = carrier.Address;
dp.PERS_ASSU.ADR_2 = carrier.Address2;
dp.PERS_ASSU.CP = carrier.Zip;
}
#endregion Insurance
#region Procedures
List <ClaimProc> listClaimProcsForPat = ClaimProcs.Refresh(claim.PatNum);
List <ClaimProc> listClaimProcsForClaim = ClaimProcs.GetForSendClaim(listClaimProcsForPat, claim.ClaimNum); //Excludes labs.
List <Procedure> listProcsForPat = Procedures.Refresh(claim.PatNum);
List <DP_RACINDPACTE> listProcs = new List <DP_RACINDPACTE>();
foreach (ClaimProc claimProc in listClaimProcsForClaim)
{
Procedure proc = Procedures.GetProcFromList(listProcsForPat, claimProc.ProcNum);
if (proc.ProcFee == 0)
{
continue;
}
ProcedureCode procCode = ProcedureCodes.GetProcCode(proc.CodeNum, listProcCodes);
if (procCode.NoBillIns)
{
continue;
}
DP_RACINDPACTE acteProc = new DP_RACINDPACTE();
acteProc.ACTE = procCode.ProcCode;
if (procCode.ProcCode.Length > 5)
{
acteProc.ACTE = procCode.ProcCode.Substring(0, 5);
}
acteProc.ROLE = "1"; //1 for principal role and 2 for assistant role.
//acte.MODIF=;//Optional. Not sure what to put here, so leaving blank for now.
acteProc.UNIT = proc.UnitQty.ToString().PadLeft(3, '0');
acteProc.MNT = proc.ProcFee.ToString("F").Replace(".", "").PadLeft(6, '0');
acteProc.DENT = proc.ToothNum.ToString().PadLeft(2, '0');
acteProc.SURF = proc.Surf.ToString().PadLeft(2, '0');
listProcs.Add(acteProc);
List <Procedure> listLabProcs = Procedures.GetCanadianLabFees(proc.ProcNum, listProcsForPat);
foreach (Procedure labProc in listLabProcs)
{
if (labProc.ProcFee == 0)
{
continue;
}
ProcedureCode labProcCode = ProcedureCodes.GetProcCode(labProc.CodeNum, listProcCodes);
DP_RACINDPACTE acteLab = new DP_RACINDPACTE();
acteLab.ACTE = labProcCode.ProcCode;
if (labProcCode.ProcCode.Length > 5)
{
acteLab.ACTE = labProcCode.ProcCode.Substring(0, 5);
}
acteLab.ROLE = "1"; //1 for principal role and 2 for assistant role.
acteLab.MNT = labProc.ProcFee.ToString("F").Replace(".", "").PadLeft(6, '0');
listProcs.Add(acteLab);
}
}
dp.ACTE = listProcs.ToArray();
#endregion Procedures
listDps.Add(dp);
}
DP_RACIN batch = new DP_RACIN();
batch.DP = listDps.ToArray();
StringWriter sw = new StringWriter();
XmlSerializer serializer = new XmlSerializer(typeof(DP_RACIN));
serializer.Serialize(sw, batch);
string xml = sw.ToString();
//Save a copy of the batch xml to each etrans entry (one per claim).
EtransMessageText etransMsgText = new EtransMessageText();
etransMsgText.MessageText = xml;
EtransMessageTexts.Insert(etransMsgText);
foreach (Etrans etrans in listEtrans)
{
etrans.EtransMessageTextNum = etransMsgText.EtransMessageTextNum;
Etranss.Update(etrans);
}
//Step 2 - ZIP XML and save to report path. The zip file name and file name within the zip file do not matter.
string zipFilePath = CodeBase.ODFileUtils.CreateRandomFile(clearinghouseClin.ExportPath, ".zip", "claims");
ZipFile zip = null;
try {
zip = new ZipFile();
zip.UseZip64WhenSaving = Zip64Option.Always;
zip.AddEntry("claims" + DateTime.Now.ToString("yyyyMMddHHmmss") + ".xml", xml);
zip.Save(zipFilePath);
zip.Dispose();
}
catch (Exception ex) {
ex.ToString();
if (zip != null)
{
zip.Dispose();
}
if (File.Exists(zipFilePath))
{
try {
File.Delete(zipFilePath);
}
catch (Exception ex2) {
ex2.ToString();
}
}
}
return(xml);
}
public void FillInsInfo()
{
//Broken during overhaul of 6.7, fixed in 6.8 by DrTech
textPriMax.Text = "";
textPriDed.Text = "";
textPriDedFam.Text = "";
textPriDedRem.Text = "";
textPriUsed.Text = "";
textPriPend.Text = "";
textPriRem.Text = "";
textSecMax.Text = "";
textSecDed.Text = "";
textSecDedFam.Text = "";
textSecDedRem.Text = "";
textSecUsed.Text = "";
textSecPend.Text = "";
textSecRem.Text = "";
if (PatCur == null) //redundant
{
return;
}
List <InsSub> SubList = InsSubs.RefreshForFam(FamCur);
List <InsPlan> InsPlanList = InsPlans.RefreshForSubList(SubList);
List <PatPlan> PatPlanList = PatPlans.Refresh(PatCur.PatNum);
List <Benefit> BenefitList = Benefits.Refresh(PatPlanList, SubList);
List <ClaimProc> ClaimProcList = ClaimProcs.Refresh(PatCur.PatNum);
List <ClaimProcHist> HistList = ClaimProcs.GetHistList(PatCur.PatNum, BenefitList, PatPlanList, InsPlanList, DateTime.Today, SubList);
double max = 0;
double ded = 0;
double dedFam = 0;
double dedUsed = 0;
double remain = 0;
double pend = 0;
double used = 0;
InsPlan PlanCur; //=new InsPlan();
if (PatPlanList.Count > 0)
{
PlanCur = InsPlans.GetPlan(InsSubs.GetOne(PatPlanList[0].InsSubNum).PlanNum, InsPlanList);
pend = InsPlans.GetPendingDisplay(HistList, DateTime.Today, PlanCur, PatPlanList[0].PatPlanNum, -1, PatCur.PatNum, PatPlanList[0].InsSubNum, BenefitList);
used = InsPlans.GetInsUsedDisplay(HistList, DateTime.Today, PlanCur.PlanNum, PatPlanList[0].PatPlanNum,
-1, InsPlanList, BenefitList, PatCur.PatNum, PatPlanList[0].InsSubNum);
textPriPend.Text = pend.ToString("F");
textPriUsed.Text = used.ToString("F");
max = Benefits.GetAnnualMaxDisplay(BenefitList, PlanCur.PlanNum, PatPlanList[0].PatPlanNum, false);
if (max == -1) //if annual max is blank
{
textPriMax.Text = "";
textPriRem.Text = "";
}
else
{
remain = max - used - pend;
if (remain < 0)
{
remain = 0;
}
textPriMax.Text = max.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");
dedUsed = InsPlans.GetDedUsedDisplay(HistList, DateTime.Today, PlanCur.PlanNum, PatPlanList[0].PatPlanNum, -1, InsPlanList,
BenefitCoverageLevel.Individual, PatCur.PatNum);
textPriDedRem.Text = (ded - dedUsed).ToString("F");
}
if (dedFam != -1)
{
textPriDedFam.Text = dedFam.ToString("F");
}
}
if (PatPlanList.Count > 1)
{
PlanCur = InsPlans.GetPlan(InsSubs.GetOne(PatPlanList[0].InsSubNum).PlanNum, InsPlanList);
pend = InsPlans.GetPendingDisplay(HistList, DateTime.Today, PlanCur, PatPlanList[1].PatPlanNum, -1, PatCur.PatNum, PatPlanList[1].InsSubNum, BenefitList);
textSecPend.Text = pend.ToString("F");
used = InsPlans.GetInsUsedDisplay(HistList, DateTime.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, false);
if (max == -1)
{
textSecMax.Text = "";
textSecRem.Text = "";
}
else
{
remain = max - used - pend;
if (remain < 0)
{
remain = 0;
}
textSecMax.Text = max.ToString("F");
textSecRem.Text = remain.ToString("F");
}
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");
dedUsed = InsPlans.GetDedUsedDisplay(HistList, DateTime.Today, PlanCur.PlanNum, PatPlanList[1].PatPlanNum, -1, InsPlanList,
BenefitCoverageLevel.Individual, PatCur.PatNum);
textSecDedRem.Text = (ded - dedUsed).ToString("F");
}
if (dedFam != -1)
{
textSecDedFam.Text = dedFam.ToString("F");
}
}
/*
* //**only different line from tx pl routine fillsummary
* if(PatPlanList.Count == 0) {
* labelInsLeft.Text = Lan.g(this,"No Ins.");
* labelInsLeftAmt.Text = "";
* }
* else {
* labelInsLeft.Text = Lan.g(this,"Ins. Left");
* labelInsLeftAmt.Text = textPriRem.Text;
* }*/
}
public static void FillPtInfo(OpenDental.ContrChart sender, Patient PatCur)
{
//first, get all the objects we need. Because they are by ref, the original gets altered.
ODGrid gridPtInfo = (ODGrid)sender.Controls.Find("gridPtInfo", true)[0];
TabControl tabControlImages = (TabControl)sender.Controls.Find("tabControlImages", true)[0];
TextBox textTreatmentNotes = (TextBox)sender.Controls.Find("textTreatmentNotes", true)[0];
//bool TreatmentNoteChanged=sender.TreatmentNoteChanged;//might have to do a by ref here?
//Then get some data that we need
Family fam = null;
PatientNote PatientNoteCur = null;
List <PatPlan> PatPlanList = null;
List <InsSub> SubList = null;
List <InsPlan> PlanList = null;
if (PatCur != null)
{
fam = Patients.GetFamily(PatCur.PatNum);
PatientNoteCur = PatientNotes.Refresh(PatCur.PatNum, PatCur.Guarantor);
PatPlanList = PatPlans.Refresh(PatCur.PatNum);
SubList = InsSubs.RefreshForFam(fam);
PlanList = InsPlans.RefreshForSubList(SubList);
}
//Then, continue with the slightly altered original method.
gridPtInfo.Height = tabControlImages.Top - gridPtInfo.Top;
textTreatmentNotes.Text = "";
if (PatCur != null)
{
textTreatmentNotes.Text = PatientNoteCur.Treatment;
textTreatmentNotes.Enabled = true;
textTreatmentNotes.Select(textTreatmentNotes.Text.Length + 2, 1);
textTreatmentNotes.ScrollToCaret();
sender.TreatmentNoteChanged = false;
}
gridPtInfo.BeginUpdate();
gridPtInfo.Columns.Clear();
ODGridColumn col = new ODGridColumn("", 100); //Lan.g("TableChartPtInfo",""),);
gridPtInfo.Columns.Add(col);
col = new ODGridColumn("", 300);
gridPtInfo.Columns.Add(col);
gridPtInfo.Rows.Clear();
if (PatCur == null)
{
gridPtInfo.EndUpdate();
return;
}
ODGridRow row;
//Age
row = new ODGridRow();
row.Cells.Add("Age");
row.Cells.Add(PatientLogic.DateToAgeString(PatCur.Birthdate));
row.Tag = null;
gridPtInfo.Rows.Add(row);
//Credit type
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "ABC0"));
row.Cells.Add(PatCur.CreditType);
row.Tag = null;
gridPtInfo.Rows.Add(row);
//Billing type
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Billing Type"));
row.Cells.Add(DefC.GetName(DefCat.BillingTypes, PatCur.BillingType));
row.Tag = null;
gridPtInfo.Rows.Add(row);
//Referrals
RefAttach[] RefAttachList = RefAttaches.Refresh(PatCur.PatNum);
for (int i = 0; i < RefAttachList.Length; i++)
{
row = new ODGridRow();
row.ColorBackG = Color.Aquamarine;
if (RefAttachList[i].IsFrom)
{
row.Cells.Add("Referred From");
}
else
{
row.Cells.Add("Referred To");
}
row.Cells.Add(Referrals.GetNameLF(RefAttachList[i].ReferralNum));
row.Tag = null;
gridPtInfo.Rows.Add(row);
}
//Date First Visit
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Date First Visit"));
if (PatCur.DateFirstVisit.Year < 1880)
{
row.Cells.Add("??");
}
else if (PatCur.DateFirstVisit == DateTime.Today)
{
row.Cells.Add(Lan.g("TableChartPtInfo", "NEW PAT"));
}
else
{
row.Cells.Add(PatCur.DateFirstVisit.ToShortDateString());
}
row.Tag = null;
gridPtInfo.Rows.Add(row);
//Prov - Pri & Sec
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Prov. (Pri, Sec)"));
if (PatCur.SecProv != 0)
{
row.Cells.Add(Providers.GetAbbr(PatCur.PriProv) + ", " + Providers.GetAbbr(PatCur.SecProv));
}
else
{
row.Cells.Add(Providers.GetAbbr(PatCur.PriProv) + ", " + "None");
}
row.Tag = null;
gridPtInfo.Rows.Add(row);
//PriIns
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Pri Ins"));
string name;
if (PatPlanList.Count > 0)
{
name = InsPlans.GetCarrierName(PatPlans.GetPlanNum(PatPlanList, 1), PlanList);
if (PatPlanList[0].IsPending)
{
name += Lan.g("TableChartPtInfo", " (pending)");
}
row.Cells.Add(name);
}
else
{
row.Cells.Add("");
}
row.Tag = null;
gridPtInfo.Rows.Add(row);
//SecIns
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Sec Ins"));
if (PatPlanList.Count > 1)
{
name = InsPlans.GetCarrierName(PatPlans.GetPlanNum(PatPlanList, 2), PlanList);
if (PatPlanList[1].IsPending)
{
name += Lan.g("TableChartPtInfo", " (pending)");
}
row.Cells.Add(name);
}
else
{
row.Cells.Add("");
}
row.Tag = null;
gridPtInfo.Rows.Add(row);
//Registration keys-------------------------------------------------------------------------------------------
if (PrefC.GetBool(PrefName.DistributorKey))
{
RegistrationKey[] keys = RegistrationKeys.GetForPatient(PatCur.PatNum);
for (int i = 0; i < keys.Length; i++)
{
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Registration Key"));
string str = keys[i].RegKey.Substring(0, 4) + "-" + keys[i].RegKey.Substring(4, 4) + "-" +
keys[i].RegKey.Substring(8, 4) + "-" + keys[i].RegKey.Substring(12, 4);
if (keys[i].IsForeign)
{
str += "\r\nForeign";
}
else
{
str += "\r\nUSA";
}
str += "\r\nStarted: " + keys[i].DateStarted.ToShortDateString();
if (keys[i].DateDisabled.Year > 1880)
{
str += "\r\nDisabled: " + keys[i].DateDisabled.ToShortDateString();
}
if (keys[i].DateEnded.Year > 1880)
{
str += "\r\nEnded: " + keys[i].DateEnded.ToShortDateString();
}
if (keys[i].Note != "")
{
str += keys[i].Note;
}
row.Cells.Add(str);
row.Tag = keys[i].Copy();
gridPtInfo.Rows.Add(row);
}
}
ODGridCell cell;
//medical fields-----------------------------------------------------------------
bool showMed = true;
if (Programs.IsEnabled(ProgramName.eClinicalWorks) && ProgramProperties.GetPropVal(ProgramName.eClinicalWorks, "IsStandalone") == "0")
{
showMed = false;
}
if (showMed)
{
//premed flag.
if (PatCur.Premed)
{
row = new ODGridRow();
row.Cells.Add("");
cell = new ODGridCell();
cell.Text = Lan.g("TableChartPtInfo", "Premedicate");
cell.ColorText = Color.Red;
cell.Bold = YN.Yes;
row.Cells.Add(cell);
row.ColorBackG = DefC.Long[(int)DefCat.MiscColors][3].ItemColor;
row.Tag = "med";
gridPtInfo.Rows.Add(row);
}
//diseases
Disease[] DiseaseList = Diseases.Refresh(PatCur.PatNum);
row = new ODGridRow();
cell = new ODGridCell(Lan.g("TableChartPtInfo", "Diseases"));
cell.Bold = YN.Yes;
row.Cells.Add(cell);
if (DiseaseList.Length > 0)
{
row.Cells.Add("");
}
else
{
row.Cells.Add(Lan.g("TableChartPtInfo", "none"));
}
row.ColorBackG = DefC.Long[(int)DefCat.MiscColors][3].ItemColor;
row.Tag = "med";
gridPtInfo.Rows.Add(row);
for (int i = 0; i < DiseaseList.Length; i++)
{
row = new ODGridRow();
cell = new ODGridCell(DiseaseDefs.GetName(DiseaseList[i].DiseaseDefNum));
cell.ColorText = Color.Red;
cell.Bold = YN.Yes;
row.Cells.Add(cell);
row.Cells.Add(DiseaseList[i].PatNote);
row.ColorBackG = DefC.Long[(int)DefCat.MiscColors][3].ItemColor;
row.Tag = "med";
gridPtInfo.Rows.Add(row);
}
//MedUrgNote
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Med Urgent"));
cell = new ODGridCell();
cell.Text = PatCur.MedUrgNote;
cell.ColorText = Color.Red;
cell.Bold = YN.Yes;
row.Cells.Add(cell);
row.ColorBackG = DefC.Long[(int)DefCat.MiscColors][3].ItemColor;
row.Tag = "med";
gridPtInfo.Rows.Add(row);
//Medical
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Medical Summary"));
row.Cells.Add(PatientNoteCur.Medical);
row.ColorBackG = DefC.Long[(int)DefCat.MiscColors][3].ItemColor;
row.Tag = "med";
gridPtInfo.Rows.Add(row);
//Service
row = new ODGridRow();
row.Cells.Add(Lan.g("TableChartPtInfo", "Service Notes"));
row.Cells.Add(PatientNoteCur.Service);
row.ColorBackG = DefC.Long[(int)DefCat.MiscColors][3].ItemColor;
row.Tag = "med";
gridPtInfo.Rows.Add(row);
//medications
Medications.Refresh();
MedicationPats.Refresh(PatCur.PatNum);
row = new ODGridRow();
cell = new ODGridCell(Lan.g("TableChartPtInfo", "Medications"));
cell.Bold = YN.Yes;
row.Cells.Add(cell);
if (MedicationPats.List.Length > 0)
{
row.Cells.Add("");
}
else
{
row.Cells.Add(Lan.g("TableChartPtInfo", "none"));
}
row.ColorBackG = DefC.Long[(int)DefCat.MiscColors][3].ItemColor;
row.Tag = "med";
gridPtInfo.Rows.Add(row);
string text;
Medication med;
for (int i = 0; i < MedicationPats.List.Length; i++)
{
row = new ODGridRow();
med = Medications.GetMedication(MedicationPats.List[i].MedicationNum);
text = med.MedName;
if (med.MedicationNum != med.GenericNum)
{
text += "(" + Medications.GetMedication(med.GenericNum).MedName + ")";
}
row.Cells.Add(text);
text = MedicationPats.List[i].PatNote
+ "(" + Medications.GetGeneric(MedicationPats.List[i].MedicationNum).Notes + ")";
row.Cells.Add(text);
row.ColorBackG = DefC.Long[(int)DefCat.MiscColors][3].ItemColor;
row.Tag = "med";
gridPtInfo.Rows.Add(row);
}
} //if !eCW.enabled
gridPtInfo.EndUpdate();
}
///<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);
}
///<summary>Returns null if there is no HL7Def enabled or if there is no outbound DFT defined for the enabled HL7Def.</summary>
public static MessageHL7 GenerateDFT(List <Procedure> listProcs, EventTypeHL7 eventType, Patient pat, Patient guar, long aptNum, string pdfDescription, string pdfDataString)
{
//In \\SERVERFILES\storage\OPEN DENTAL\Programmers Documents\Standards (X12, ADA, etc)\HL7\Version2.6\V26_CH02_Control_M4_JAN2007.doc
//On page 28, there is a Message Construction Pseudocode as well as a flowchart which might help.
MessageHL7 msgHl7 = new MessageHL7(MessageTypeHL7.DFT);
HL7Def hl7Def = HL7Defs.GetOneDeepEnabled();
if (hl7Def == null)
{
return(null);
}
//find a DFT message in the def
HL7DefMessage hl7DefMessage = null;
for (int i = 0; i < hl7Def.hl7DefMessages.Count; i++)
{
if (hl7Def.hl7DefMessages[i].MessageType == MessageTypeHL7.DFT && hl7Def.hl7DefMessages[i].InOrOut == InOutHL7.Outgoing)
{
hl7DefMessage = hl7Def.hl7DefMessages[i];
//continue;
break;
}
}
if (hl7DefMessage == null) //DFT message type is not defined so do nothing and return
{
return(null);
}
if (PrefC.GetBool(PrefName.ShowFeaturePatientClone))
{
pat = Patients.GetOriginalPatientForClone(pat);
}
Provider prov = Providers.GetProv(Patients.GetProvNum(pat));
Appointment apt = Appointments.GetOneApt(aptNum);
List <PatPlan> listPatPlans = PatPlans.Refresh(pat.PatNum);
for (int i = 0; i < hl7DefMessage.hl7DefSegments.Count; i++)
{
int repeatCount = 1;
if (hl7DefMessage.hl7DefSegments[i].SegmentName == SegmentNameHL7.FT1)
{
repeatCount = listProcs.Count;
}
else if (hl7DefMessage.hl7DefSegments[i].SegmentName == SegmentNameHL7.IN1)
{
repeatCount = listPatPlans.Count;
}
//for example, countRepeat can be zero in the case where we are only sending a PDF of the TP to eCW, and no procs.
//or the patient does not have any current insplans for IN1 segments
for (int j = 0; j < repeatCount; j++) //FT1 is optional and can repeat so add as many FT1's as procs in procList, IN1 is optional and can repeat as well, repeat for the number of patplans in patplanList
{
if (hl7DefMessage.hl7DefSegments[i].SegmentName == SegmentNameHL7.FT1 && listProcs.Count > j)
{
prov = Providers.GetProv(listProcs[j].ProvNum);
}
Procedure proc = null;
if (listProcs.Count > j) //procList could be an empty list
{
proc = listProcs[j];
}
PatPlan patPlanCur = null;
InsPlan insPlanCur = null;
InsSub insSubCur = null;
Carrier carrierCur = null;
Patient subscriber = null;
if (hl7DefMessage.hl7DefSegments[i].SegmentName == SegmentNameHL7.IN1)
{
patPlanCur = listPatPlans[j];
insSubCur = InsSubs.GetOne(patPlanCur.InsSubNum);
insPlanCur = InsPlans.RefreshOne(insSubCur.PlanNum);
carrierCur = Carriers.GetCarrier(insPlanCur.CarrierNum);
subscriber = Patients.GetPat(insSubCur.Subscriber);
}
SegmentHL7 seg = new SegmentHL7(hl7DefMessage.hl7DefSegments[i].SegmentName);
seg.SetField(0, hl7DefMessage.hl7DefSegments[i].SegmentName.ToString());
for (int f = 0; f < hl7DefMessage.hl7DefSegments[i].hl7DefFields.Count; f++)
{
string fieldName = hl7DefMessage.hl7DefSegments[i].hl7DefFields[f].FieldName;
if (fieldName == "") //If fixed text instead of field name just add text to segment
{
seg.SetField(hl7DefMessage.hl7DefSegments[i].hl7DefFields[f].OrdinalPos, hl7DefMessage.hl7DefSegments[i].hl7DefFields[f].FixedText);
}
else
{
string fieldValue = "";
if (hl7DefMessage.hl7DefSegments[i].SegmentName == SegmentNameHL7.IN1)
{
fieldValue = FieldConstructor.GenerateFieldIN1(hl7Def, fieldName, j + 1, patPlanCur, insSubCur, insPlanCur, carrierCur, listPatPlans.Count, subscriber);
}
else
{
fieldValue = FieldConstructor.GenerateField(hl7Def, fieldName, MessageTypeHL7.DFT, pat, prov, proc, guar, apt, j + 1, eventType,
pdfDescription, pdfDataString, MessageStructureHL7.DFT_P03, seg.Name);
}
seg.SetField(hl7DefMessage.hl7DefSegments[i].hl7DefFields[f].OrdinalPos, fieldValue);
}
}
msgHl7.Segments.Add(seg);
}
}
return(msgHl7);
}
///<summary>Sends data for Patient.Cur to an export file and then launches an exe to notify PT. If patient exists, this simply opens the patient. If patient does not exist, then this triggers creation of the patient in PT Dental. If isUpdate is true, then the export file and exe will have different names. In PT, update is a separate programlink with a separate button.</summary>
public static void SendData(Program ProgramCur, Patient pat, bool isUpdate)
{
//ArrayList ForProgram=ProgramProperties.GetForProgram(ProgramCur.ProgramNum);
//ProgramProperty PPCur=ProgramProperties.GetCur(ForProgram, "InfoFile path");
//string infoFile=PPCur.PropertyValue;
if (!Directory.Exists(dir))
{
MessageBox.Show(dir + " does not exist. PT Dental doesn't seem to be properly installed on this computer.");
return;
}
if (pat == null)
{
MessageBox.Show("No patient is selected.");
return;
}
if (!File.Exists(dir + "\\" + exportAddExe))
{
MessageBox.Show(dir + "\\" + exportAddExe + " does not exist. PT Dental doesn't seem to be properly installed on this computer.");
return;
}
if (!File.Exists(dir + "\\" + exportUpdateExe))
{
MessageBox.Show(dir + "\\" + exportUpdateExe + " does not exist. PT Dental doesn't seem to be properly installed on this computer.");
return;
}
string filename = dir + "\\" + exportAddCsv;
if (isUpdate)
{
filename = dir + "\\" + exportUpdateCsv;
}
using (StreamWriter sw = new StreamWriter(filename, false)){ //overwrites if it already exists.
sw.WriteLine("PAT_PK,PAT_LOGFK,PAT_LANFK,PAT_TITLE,PAT_FNAME,PAT_MI,PAT_LNAME,PAT_CALLED,PAT_ADDR1,PAT_ADDR2,PAT_CITY,PAT_ST,PAT_ZIP,PAT_HPHN,PAT_WPHN,PAT_EXT,PAT_FAX,PAT_PAGER,PAT_CELL,PAT_EMAIL,PAT_SEX,PAT_EDOCS,PAT_STATUS,PAT_TYPE,PAT_BIRTH,PAT_SSN,PAT_NOCALL,PAT_NOCORR,PAT_DISRES,PAT_LSTUPD,PAT_INSNM,PAT_INSGPL,PAT_INSAD1,PAT_INSAD2,PAT_INSCIT,PAT_INSST,PAT_INSZIP,PAT_INSPHN,PAT_INSEXT,PAT_INSCON,PAT_INSGNO,PAT_EMPNM,PAT_EMPAD1,PAT_EMPAD2,PAT_EMPCIT,PAT_EMPST,PAT_EMPZIP,PAT_EMPPHN,PAT_REFLNM,PAT_REFFNM,PAT_REFMI,PAT_REFPHN,PAT_REFEML,PAT_REFSPE,PAT_NOTES,PAT_FPSCAN,PAT_PREMED,PAT_MEDS,PAT_FTSTUD,PAT_PTSTUD,PAT_COLLEG,PAT_CHRTNO,PAT_OTHID,PAT_RESPRT,PAT_POLHLD,PAT_CUSCD,PAT_PMPID");
sw.Write(","); //PAT_PK Primary key. Long alphanumeric. We do not use.
sw.Write(","); //PAT_LOGFK Internal PT logical, it can be ignored.
sw.Write(","); //PAT_LANFK Internal PT logical, it can be ignored.
sw.Write(","); //PAT_TITLE We do not have this field yet
sw.Write(Tidy(pat.FName) + ","); //PAT_FNAME
sw.Write(Tidy(pat.MiddleI) + ","); //PAT_MI
sw.Write(Tidy(pat.LName) + ","); //PAT_LNAME
sw.Write(Tidy(pat.Preferred) + ","); //PAT_CALLED Nickname
sw.Write(Tidy(pat.Address) + ","); //PAT_ADDR1
sw.Write(Tidy(pat.Address2) + ","); //PAT_ADDR2
sw.Write(Tidy(pat.City) + ","); //PAT_CITY
sw.Write(Tidy(pat.State) + ","); //PAT_ST
sw.Write(Tidy(pat.Zip) + ","); //PAT_ZIP
sw.Write(TelephoneNumbers.FormatNumbersOnly(pat.HmPhone) + ","); //PAT_HPHN No punct
sw.Write(TelephoneNumbers.FormatNumbersOnly(pat.WkPhone) + ","); //PAT_WPHN
sw.Write(","); //PAT_EXT
sw.Write(","); //PAT_FAX
sw.Write(","); //PAT_PAGER
sw.Write(TelephoneNumbers.FormatNumbersOnly(pat.WirelessPhone) + ","); //PAT_CELL
sw.Write(Tidy(pat.Email) + ","); //PAT_EMAIL
if (pat.Gender == PatientGender.Female)
{
sw.Write("Female");
}
else if (pat.Gender == PatientGender.Male)
{
sw.Write("Male");
}
sw.Write(","); //PAT_SEX might be blank if unknown
sw.Write(","); //PAT_EDOCS Internal PT logical, it can be ignored.
sw.Write(pat.PatStatus.ToString() + ","); //PAT_STATUS Any text allowed
sw.Write(pat.Position.ToString() + ","); //PAT_TYPE Any text allowed
if (pat.Birthdate.Year > 1880)
{
sw.Write(pat.Birthdate.ToString("MM/dd/yyyy")); //PAT_BIRTH MM/dd/yyyy
}
sw.Write(",");
sw.Write(Tidy(pat.SSN) + ","); //PAT_SSN No punct
if (pat.PreferContactMethod == ContactMethod.DoNotCall ||
pat.PreferConfirmMethod == ContactMethod.DoNotCall ||
pat.PreferRecallMethod == ContactMethod.DoNotCall)
{
sw.Write("1");
}
sw.Write(","); //PAT_NOCALL T if no call
sw.Write(","); //PAT_NOCORR No correspondence HIPAA
sw.Write(","); //PAT_DISRES Internal PT logical, it can be ignored.
sw.Write(","); //PAT_LSTUPD Internal PT logical, it can be ignored.
List <PatPlan> patPlanList = PatPlans.Refresh(pat.PatNum);
Family fam = Patients.GetFamily(pat.PatNum);
List <InsSub> subList = InsSubs.RefreshForFam(fam);
List <InsPlan> planList = InsPlans.RefreshForSubList(subList);
PatPlan patplan = null;
InsSub sub = null;
InsPlan plan = null;
Carrier carrier = null;
Employer emp = null;
if (patPlanList.Count > 0)
{
patplan = patPlanList[0];
sub = InsSubs.GetSub(patplan.InsSubNum, subList);
plan = InsPlans.GetPlan(sub.PlanNum, planList);
carrier = Carriers.GetCarrier(plan.CarrierNum);
if (plan.EmployerNum != 0)
{
emp = Employers.GetEmployer(plan.EmployerNum);
}
}
if (plan == null)
{
sw.Write(","); //PAT_INSNM
sw.Write(","); //PAT_INSGPL Ins group plan name
sw.Write(","); //PAT_INSAD1
sw.Write(","); //PAT_INSAD2
sw.Write(","); //PAT_INSCIT
sw.Write(","); //PAT_INSST
sw.Write(","); //PAT_INSZIP
sw.Write(","); //PAT_INSPHN
}
else
{
sw.Write(Tidy(carrier.CarrierName) + ","); //PAT_INSNM
sw.Write(Tidy(plan.GroupName) + ","); //PAT_INSGPL Ins group plan name
sw.Write(Tidy(carrier.Address) + ","); //PAT_INSAD1
sw.Write(Tidy(carrier.Address2) + ","); //PAT_INSAD2
sw.Write(Tidy(carrier.City) + ","); //PAT_INSCIT
sw.Write(Tidy(carrier.State) + ","); //PAT_INSST
sw.Write(Tidy(carrier.Zip) + ","); //PAT_INSZIP
sw.Write(TelephoneNumbers.FormatNumbersOnly(carrier.Phone) + ","); //PAT_INSPHN
}
sw.Write(","); //PAT_INSEXT
sw.Write(","); //PAT_INSCON Ins contact person
if (plan == null)
{
sw.Write(",");
}
else
{
sw.Write(Tidy(plan.GroupNum) + ","); //PAT_INSGNO Ins group number
}
if (emp == null)
{
sw.Write(","); //PAT_EMPNM
}
else
{
sw.Write(Tidy(emp.EmpName) + ","); //PAT_EMPNM
}
sw.Write(","); //PAT_EMPAD1
sw.Write(","); //PAT_EMPAD2
sw.Write(","); //PAT_EMPCIT
sw.Write(","); //PAT_EMPST
sw.Write(","); //PAT_EMPZIP
sw.Write(","); //PAT_EMPPHN
/*we don't support employer info yet.
* sw.Write(Tidy(emp.Address)+",");//PAT_EMPAD1
* sw.Write(Tidy(emp.Address2)+",");//PAT_EMPAD2
* sw.Write(Tidy(emp.City)+",");//PAT_EMPCIT
* sw.Write(Tidy(emp.State)+",");//PAT_EMPST
* sw.Write(Tidy(emp.State)+",");//PAT_EMPZIP
* sw.Write(TelephoneNumbers.FormatNumbersOnly(emp.Phone)+",");//PAT_EMPPHN*/
Referral referral = Referrals.GetReferralForPat(pat.PatNum); //could be null
if (referral == null)
{
sw.Write(","); //PAT_REFLNM
sw.Write(","); //PAT_REFFNM
sw.Write(","); //PAT_REFMI
sw.Write(","); //PAT_REFPHN
sw.Write(","); //PAT_REFEML Referral source email
sw.Write(","); //PAT_REFSPE Referral specialty. Customizable, so any allowed
}
else
{
sw.Write(Tidy(referral.LName) + ","); //PAT_REFLNM
sw.Write(Tidy(referral.FName) + ","); //PAT_REFFNM
sw.Write(Tidy(referral.MName) + ","); //PAT_REFMI
sw.Write(referral.Telephone + ","); //PAT_REFPHN
sw.Write(Tidy(referral.EMail) + ","); //PAT_REFEML Referral source email
if (referral.PatNum == 0 && !referral.NotPerson) //not a patient, and is a person
{
sw.Write(Defs.GetName(DefCat.ProviderSpecialties, referral.Specialty));
}
sw.Write(","); //PAT_REFSPE Referral specialty. Customizable, so any allowed
}
sw.Write(","); //PAT_NOTES No limits. We won't use this right now for exports.
//sw.Write(",");//PAT_NOTE1-PAT_NOTE10 skipped
sw.Write(","); //PAT_FPSCAN Internal PT logical, it can be ignored.
if (pat.Premed)
{
sw.Write("1");
}
else
{
sw.Write("0");
}
sw.Write(","); //PAT_PREMED F or T
sw.Write(Tidy(pat.MedUrgNote) + ","); //PAT_MEDS The meds that they must premedicate with.
if (pat.StudentStatus == "F") //fulltime
{
sw.Write("1");
}
else
{
sw.Write("0");
}
sw.Write(","); //PAT_FTSTUD T/F
if (pat.StudentStatus == "P") //parttime
{
sw.Write("1");
}
else
{
sw.Write("0");
}
sw.Write(","); //PAT_PTSTUD
sw.Write(Tidy(pat.SchoolName) + ","); //PAT_COLLEG Name of college
sw.Write(Tidy(pat.ChartNumber) + ","); //PAT_CHRTNO
sw.Write(pat.PatNum.ToString() + ","); //PAT_OTHID The primary key in Open Dental ************IMPORTANT***************
if (pat.PatNum == pat.Guarantor)
{
sw.Write("1");
}
else
{
sw.Write("0");
}
sw.Write(","); //PAT_RESPRT Responsible party checkbox T/F
if (plan != null && pat.PatNum == sub.Subscriber) //if current patient is the subscriber on their primary plan
{
sw.Write("1");
}
else
{
sw.Write("0");
}
sw.Write(","); //PAT_POLHLD Policy holder checkbox T/F
sw.Write(","); //PAT_CUSCD Web sync folder, used internally this can be ignored.
sw.Write(""); //PAT_PMPID Practice Management Program ID. Can be ignored
sw.WriteLine();
}
try{
if (isUpdate)
{
ODFileUtils.ProcessStart(dir + "\\" + exportUpdateExe); //already validated to exist
}
else
{
ODFileUtils.ProcessStart(dir + "\\" + exportAddExe); //already validated to exist
}
//MessageBox.Show("done");
}
catch (Exception ex) {
MessageBox.Show(ex.Message);
}
}
///<summary>Returns null if there is no HL7Def enabled or if there is no outbound ADT defined for the enabled HL7Def.</summary>
public static MessageHL7 GenerateADT(Patient pat, Patient guar, EventTypeHL7 eventType)
{
HL7Def hl7Def = HL7Defs.GetOneDeepEnabled();
if (hl7Def == null)
{
return(null);
}
//find an outbound ADT message in the def
HL7DefMessage hl7DefMessage = null;
for (int i = 0; i < hl7Def.hl7DefMessages.Count; i++)
{
if (hl7Def.hl7DefMessages[i].MessageType == MessageTypeHL7.ADT && hl7Def.hl7DefMessages[i].InOrOut == InOutHL7.Outgoing)
{
hl7DefMessage = hl7Def.hl7DefMessages[i];
//continue;
break;
}
}
if (hl7DefMessage == null) //ADT message type is not defined so do nothing and return
{
return(null);
}
if (PrefC.GetBool(PrefName.ShowFeaturePatientClone))
{
pat = Patients.GetOriginalPatientForClone(pat);
}
MessageHL7 messageHL7 = new MessageHL7(MessageTypeHL7.ADT);
Provider prov = Providers.GetProv(Patients.GetProvNum(pat));
List <PatPlan> listPatPlans = PatPlans.Refresh(pat.PatNum);
for (int i = 0; i < hl7DefMessage.hl7DefSegments.Count; i++)
{
int countRepeat = 1;
//IN1 segment can repeat, get the number of current insurance plans attached to the patient
if (hl7DefMessage.hl7DefSegments[i].SegmentName == SegmentNameHL7.IN1)
{
countRepeat = listPatPlans.Count;
}
//countRepeat is usually 1, but for repeatable/optional fields, it may be 0 or greater than 1
//for example, countRepeat can be zero if the patient does not have any current insplans, in which case no IN1 segments will be included
for (int j = 0; j < countRepeat; j++) //IN1 is optional and can repeat so add as many as listPatplans
{
PatPlan patplanCur = null;
InsPlan insplanCur = null;
InsSub inssubCur = null;
Carrier carrierCur = null;
Patient patSub = null;
if (hl7DefMessage.hl7DefSegments[i].SegmentName == SegmentNameHL7.IN1) //index repeat is guaranteed to be less than listPatplans.Count
{
patplanCur = listPatPlans[j];
inssubCur = InsSubs.GetOne(patplanCur.InsSubNum);
insplanCur = InsPlans.RefreshOne(inssubCur.PlanNum);
carrierCur = Carriers.GetCarrier(insplanCur.CarrierNum);
if (pat.PatNum == inssubCur.Subscriber)
{
patSub = pat.Copy();
}
else
{
patSub = Patients.GetPat(inssubCur.Subscriber);
}
}
SegmentHL7 seg = new SegmentHL7(hl7DefMessage.hl7DefSegments[i].SegmentName);
seg.SetField(0, hl7DefMessage.hl7DefSegments[i].SegmentName.ToString());
for (int k = 0; k < hl7DefMessage.hl7DefSegments[i].hl7DefFields.Count; k++)
{
string fieldName = hl7DefMessage.hl7DefSegments[i].hl7DefFields[k].FieldName;
if (fieldName == "") //If fixed text instead of field name just add text to segment
{
seg.SetField(hl7DefMessage.hl7DefSegments[i].hl7DefFields[k].OrdinalPos, hl7DefMessage.hl7DefSegments[i].hl7DefFields[k].FixedText);
}
else
{
string fieldValue = "";
if (hl7DefMessage.hl7DefSegments[i].SegmentName == SegmentNameHL7.IN1)
{
fieldValue = FieldConstructor.GenerateFieldIN1(hl7Def, fieldName, j + 1, patplanCur, inssubCur, insplanCur, carrierCur, listPatPlans.Count, patSub);
}
else
{
fieldValue = FieldConstructor.GenerateFieldADT(hl7Def, fieldName, pat, prov, guar, j + 1, eventType, seg.Name);
}
seg.SetField(hl7DefMessage.hl7DefSegments[i].hl7DefFields[k].OrdinalPos, fieldValue);
}
}
messageHL7.Segments.Add(seg);
}
}
return(messageHL7);
}