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hirensoni913hirensoni913
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OP-1066: modular IMIS: time correlations don't work (#158)
* SubmitSingleClaim SP is now includes historical timestamp for ProductItems/ProductServices * SubmitSingleClaim SP is now taking historical data for items/services * Historical Price lists are taken care while processing claims
1 parent ed11a55 commit 2f59166

2 files changed

Lines changed: 79 additions & 45 deletions

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‎sql/stored_procedures/uspProcessSingleClaimStep1.sql‎

89.7 KB
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‎sql/stored_procedures/uspSubmitSingleClaim.sql‎

Lines changed: 79 additions & 45 deletions
Original file line numberDiff line numberDiff line change
@@ -268,21 +268,22 @@ BEGIN
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UPDATE tblClaimItems SET tblClaimItems.RejectionReason = 2
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FROM dbo.tblClaimItems
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LEFT OUTER JOIN
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(SELECT tblPLItemsDetail.ItemID
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FROM tblHF INNER JOIN
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tblPLItems ON tblHF.PLItemID = tblPLItems.PLItemID INNER JOIN
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tblPLItemsDetail ON tblPLItems.PLItemID = tblPLItemsDetail.PLItemID
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WHERE (tblHF.HfID = @HFID) AND (tblPLItems.ValidityTo IS NULL) AND (tblPLItemsDetail.ValidityTo IS NULL)) PLItems
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(SELECT tblPLItemsDetail.ItemID
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FROM tblHF
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INNER JOIN tblPLItemsDetail ON tblHF.PLItemID = tblPLItemsDetail.PLItemID
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AND @TargetDate BETWEEN tblPLItemsDetail.ValidityFrom AND ISNULL(tblPLItemsDetail.ValidityTo, GETDATE())
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WHERE tblHF.HFID = @HFID) PLItems
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ON tblClaimItems.ItemID = PLItems.ItemID
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WHERE tblClaimItems.ClaimID = @ClaimID AND tblClaimItems.ValidityTo IS NULL AND PLItems.ItemID IS NULL
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UPDATE tblClaimServices SET tblClaimServices.RejectionReason = 2
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FROM dbo.tblClaimServices
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LEFT OUTER JOIN
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(SELECT tblPLServicesDetail.ServiceID
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FROM tblHF INNER JOIN
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tblPLServicesDetail ON tblHF.PLServiceID = tblPLServicesDetail.PLServiceID
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WHERE (tblHF.HfID = @HFID) AND (tblPLServicesDetail.ValidityTo IS NULL) AND (tblPLServicesDetail.ValidityTo IS NULL)) PLServices
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(SELECT tblPLServicesDetail.ServiceID
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FROM tblHF
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INNER JOIN tblPLServicesDetail ON tblHF.PLServiceID = tblPLServicesDetail.PLServiceID
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AND @TargetDate BETWEEN tblPLServicesDetail.ValidityFrom AND ISNULL(tblPLServicesDetail.ValidityTo, GETDATE())
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WHERE tblHF.HfID = @HFID) PLServices
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ON tblClaimServices.ServiceID = PLServices.ServiceID
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WHERE tblClaimServices.ClaimID = @ClaimID AND tblClaimServices.ValidityTo IS NULL AND PLServices.ServiceID IS NULL
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@@ -333,28 +334,44 @@ BEGIN
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IF @Adult = 1
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DECLARE PRODSERVICELOOP CURSOR LOCAL FORWARD_ONLY FOR
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SELECT TblProduct.ProdID , tblProductServices.ProdServiceID , tblInsureePolicy.EffectiveDate, tblPolicy.EffectiveDate, tblInsureePolicy.ExpiryDate , tblPolicy.PolicyStage
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FROM tblFamilies INNER JOIN
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tblPolicy ON tblFamilies.FamilyID = tblPolicy.FamilyID INNER JOIN
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tblProduct ON tblPolicy.ProdID = tblProduct.ProdID INNER JOIN
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tblProductServices ON tblProduct.ProdID = tblProductServices.ProdID INNER JOIN
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tblInsureePolicy ON tblPolicy.PolicyID = tblInsureePolicy.PolicyId
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WHERE (tblPolicy.EffectiveDate <= @TargetDate) AND (tblPolicy.ExpiryDate >= @TargetDate) AND (tblPolicy.ValidityTo IS NULL) AND (tblProductServices.ValidityTo IS NULL) AND
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(tblPolicy.PolicyStatus = 2 OR tblPolicy.PolicyStatus = 8) AND (tblProductServices.ServiceID = @ServiceID) AND (tblFamilies.FamilyID = @FamilyID) AND (tblProduct.ValidityTo IS NULL) AND
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(tblInsureePolicy.EffectiveDate <= @TargetDate) AND (tblInsureePolicy.ExpiryDate >= @TargetDate) AND (tblInsureePolicy.InsureeId = @InsureeID) AND
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(tblInsureePolicy.ValidityTo IS NULL)
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FROM tblFamilies
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INNER JOIN tblPolicy ON tblFamilies.FamilyID = tblPolicy.FamilyID
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INNER JOIN tblProduct ON tblPolicy.ProdID = tblProduct.ProdID
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INNER JOIN tblProductServices ON tblProduct.ProdID = tblProductServices.ProdID
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AND @TargetDate BETWEEN tblProductServices.ValidityFrom AND ISNULL(tblProductServices.ValidityTo, GETDATE())
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INNER JOIN tblInsureePolicy ON tblPolicy.PolicyID = tblInsureePolicy.PolicyId
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WHERE tblPolicy.EffectiveDate <= @TargetDate
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AND tblPolicy.ExpiryDate >= @TargetDate
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AND tblPolicy.ValidityTo IS NULL
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AND (tblPolicy.PolicyStatus = 2 OR tblPolicy.PolicyStatus = 8)
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AND tblProductServices.ServiceID = @ServiceID
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AND tblFamilies.FamilyID = @FamilyID
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AND tblProduct.ValidityTo IS NULL
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AND tblInsureePolicy.EffectiveDate <= @TargetDate
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AND tblInsureePolicy.ExpiryDate >= @TargetDate
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AND tblInsureePolicy.InsureeId = @InsureeID
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AND tblInsureePolicy.ValidityTo IS NULL
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ORDER BY DATEADD(m,ISNULL(tblProductServices.WaitingPeriodAdult, 0), tblInsureePolicy.EffectiveDate)
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ELSE
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DECLARE PRODSERVICELOOP CURSOR LOCAL FORWARD_ONLY FOR
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SELECT TblProduct.ProdID , tblProductServices.ProdServiceID , tblInsureePolicy.EffectiveDate, tblPolicy.EffectiveDate, tblInsureePolicy.ExpiryDate , tblPolicy.PolicyStage
349-
FROM tblFamilies INNER JOIN
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tblPolicy ON tblFamilies.FamilyID = tblPolicy.FamilyID INNER JOIN
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tblProduct ON tblPolicy.ProdID = tblProduct.ProdID INNER JOIN
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tblProductServices ON tblProduct.ProdID = tblProductServices.ProdID INNER JOIN
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tblInsureePolicy ON tblPolicy.PolicyID = tblInsureePolicy.PolicyId
354-
WHERE (tblPolicy.EffectiveDate <= @TargetDate) AND (tblPolicy.ExpiryDate >= @TargetDate) AND (tblPolicy.ValidityTo IS NULL) AND (tblProductServices.ValidityTo IS NULL) AND
355-
(tblPolicy.PolicyStatus = 2 OR tblPolicy.PolicyStatus = 8) AND (tblProductServices.ServiceID = @ServiceID) AND (tblFamilies.FamilyID = @FamilyID) AND (tblProduct.ValidityTo IS NULL) AND
356-
(tblInsureePolicy.EffectiveDate <= @TargetDate) AND (tblInsureePolicy.ExpiryDate >= @TargetDate) AND (tblInsureePolicy.InsureeId = @InsureeID) AND
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(tblInsureePolicy.ValidityTo IS NULL)
358+
FROM tblFamilies
359+
INNER JOIN tblPolicy ON tblFamilies.FamilyID = tblPolicy.FamilyID
360+
INNER JOIN tblProduct ON tblPolicy.ProdID = tblProduct.ProdID
361+
INNER JOIN tblProductServices ON tblProduct.ProdID = tblProductServices.ProdID
362+
AND @TargetDate BETWEEN tblProductServices.ValidityFrom AND ISNULL(tblProductServices.ValidityTo, GETDATE())
363+
INNER JOIN tblInsureePolicy ON tblPolicy.PolicyID = tblInsureePolicy.PolicyId
364+
WHERE tblPolicy.EffectiveDate <= @TargetDate
365+
AND tblPolicy.ExpiryDate >= @TargetDate
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AND tblPolicy.ValidityTo IS NULL
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AND (tblPolicy.PolicyStatus = 2 OR tblPolicy.PolicyStatus = 8)
368+
AND tblProductServices.ServiceID = @ServiceID
369+
AND tblFamilies.FamilyID = @FamilyID
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AND tblProduct.ValidityTo IS NULL
371+
AND tblInsureePolicy.EffectiveDate <= @TargetDate
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AND tblInsureePolicy.ExpiryDate >= @TargetDate
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AND tblInsureePolicy.InsureeId = @InsureeID
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AND tblInsureePolicy.ValidityTo IS NULL
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ORDER BY DATEADD(m,ISNULL(tblProductServices.WaitingPeriodChild, 0), tblInsureePolicy.EffectiveDate)
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@@ -703,28 +720,45 @@ BEGIN
703720
IF @Adult = 1
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DECLARE PRODITEMLOOP CURSOR LOCAL FORWARD_ONLY FOR
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SELECT TblProduct.ProdID , tblProductItems.ProdItemID , tblInsureePolicy.EffectiveDate, tblPolicy.EffectiveDate, tblInsureePolicy.ExpiryDate , tblPolicy.PolicyStage
706-
FROM tblFamilies INNER JOIN
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tblPolicy ON tblFamilies.FamilyID = tblPolicy.FamilyID INNER JOIN
708-
tblProduct ON tblPolicy.ProdID = tblProduct.ProdID INNER JOIN
709-
tblProductItems ON tblProduct.ProdID = tblProductItems.ProdID INNER JOIN
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tblInsureePolicy ON tblPolicy.PolicyID = tblInsureePolicy.PolicyId
711-
WHERE (tblPolicy.EffectiveDate <= @TargetDate) AND (tblPolicy.ExpiryDate >= @TargetDate) AND (tblPolicy.ValidityTo IS NULL) AND (tblProductItems.ValidityTo IS NULL) AND
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(tblPolicy.PolicyStatus = 2 OR tblPolicy.PolicyStatus = 8) AND (tblProductItems.ItemID = @ItemID) AND (tblFamilies.FamilyID = @FamilyID) AND (tblProduct.ValidityTo IS NULL) AND
713-
(tblInsureePolicy.EffectiveDate <= @TargetDate) AND (tblInsureePolicy.ExpiryDate >= @TargetDate) AND (tblInsureePolicy.InsureeId = @InsureeID) AND
714-
(tblInsureePolicy.ValidityTo IS NULL)
723+
FROM tblFamilies
724+
INNER JOIN tblPolicy ON tblFamilies.FamilyID = tblPolicy.FamilyID
725+
INNER JOIN tblProduct ON tblPolicy.ProdID = tblProduct.ProdID
726+
INNER JOIN tblProductItems ON tblProduct.ProdID = tblProductItems.ProdID
727+
AND @TargetDate BETWEEN tblProductItems.ValidityFrom AND ISNULL(tblProductItems.ValidityTo, GETDATE())
728+
INNER JOIN tblInsureePolicy ON tblPolicy.PolicyID = tblInsureePolicy.PolicyId
729+
WHERE tblPolicy.EffectiveDate <= @TargetDate
730+
AND tblPolicy.ExpiryDate >= @TargetDate
731+
AND tblPolicy.ValidityTo IS NULL
732+
--AND tblProductItems.ValidityTo IS NULL
733+
AND (tblPolicy.PolicyStatus = 2 OR tblPolicy.PolicyStatus = 8)
734+
AND tblProductItems.ItemID = @ItemID
735+
AND tblFamilies.FamilyID = @FamilyID
736+
AND tblProduct.ValidityTo IS NULL
737+
AND tblInsureePolicy.EffectiveDate <= @TargetDate
738+
AND tblInsureePolicy.ExpiryDate >= @TargetDate
739+
AND tblInsureePolicy.InsureeId = @InsureeID
740+
AND tblInsureePolicy.ValidityTo IS NULL
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ORDER BY DATEADD(m,ISNULL(tblProductItems.WaitingPeriodAdult, 0), tblInsureePolicy.EffectiveDate)
716742
ELSE
717743
DECLARE PRODITEMLOOP CURSOR LOCAL FORWARD_ONLY FOR
718744
SELECT TblProduct.ProdID , tblProductItems.ProdItemID , tblInsureePolicy.EffectiveDate, tblPolicy.EffectiveDate, tblInsureePolicy.ExpiryDate , tblPolicy.PolicyStage
719-
FROM tblFamilies INNER JOIN
720-
tblPolicy ON tblFamilies.FamilyID = tblPolicy.FamilyID INNER JOIN
721-
tblProduct ON tblPolicy.ProdID = tblProduct.ProdID INNER JOIN
722-
tblProductItems ON tblProduct.ProdID = tblProductItems.ProdID INNER JOIN
723-
tblInsureePolicy ON tblPolicy.PolicyID = tblInsureePolicy.PolicyId
724-
WHERE (tblPolicy.EffectiveDate <= @TargetDate) AND (tblPolicy.ExpiryDate >= @TargetDate) AND (tblPolicy.ValidityTo IS NULL) AND (tblProductItems.ValidityTo IS NULL) AND
725-
(tblPolicy.PolicyStatus = 2 OR tblPolicy.PolicyStatus = 8) AND (tblProductItems.ItemID = @ItemID) AND (tblFamilies.FamilyID = @FamilyID) AND (tblProduct.ValidityTo IS NULL) AND
726-
(tblInsureePolicy.EffectiveDate <= @TargetDate) AND (tblInsureePolicy.ExpiryDate >= @TargetDate) AND (tblInsureePolicy.InsureeId = @InsureeID) AND
727-
(tblInsureePolicy.ValidityTo IS NULL)
745+
FROM tblFamilies
746+
INNER JOIN tblPolicy ON tblFamilies.FamilyID = tblPolicy.FamilyID
747+
INNER JOIN tblProduct ON tblPolicy.ProdID = tblProduct.ProdID
748+
INNER JOIN tblProductItems ON tblProduct.ProdID = tblProductItems.ProdID
749+
AND @TargetDate BETWEEN tblProductItems.ValidityFrom AND ISNULL(tblProductItems.ValidityTo, GETDATE())
750+
INNER JOIN tblInsureePolicy ON tblPolicy.PolicyID = tblInsureePolicy.PolicyId
751+
WHERE tblPolicy.EffectiveDate <= @TargetDate
752+
AND tblPolicy.ExpiryDate >= @TargetDate
753+
AND tblPolicy.ValidityTo IS NULL
754+
AND (tblPolicy.PolicyStatus = 2 OR tblPolicy.PolicyStatus = 8)
755+
AND tblProductItems.ItemID = @ItemID
756+
AND tblFamilies.FamilyID = @FamilyID
757+
AND (tblProduct.ValidityTo IS NULL)
758+
AND tblInsureePolicy.EffectiveDate <= @TargetDate
759+
AND tblInsureePolicy.ExpiryDate >= @TargetDate
760+
AND tblInsureePolicy.InsureeId = @InsureeID
761+
AND tblInsureePolicy.ValidityTo IS NULL
728762
ORDER BY DATEADD(m,ISNULL(tblProductItems.WaitingPeriodChild, 0), tblInsureePolicy.EffectiveDate)
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