clsBillAuditor

clsBillAuditor supports orchestrator — performs audit rule application in SAIF.Business.Claim.Bill.AutomatedAudit.*

Purpose

• Orchestrator — performs audit rule application

Context

• Namespace: SAIF.Business.Claim.Bill.AutomatedAudit
• Assembly/package: SAIF.Business.Claim.Bill.AutomatedAudit

Public members

Member	Signature	Purpose
AuditBill	Function AuditBill(ByVal inBill As clsBillAudit) As Boolean	Executes the AuditBill operation and returns the requested result.*
ComputeFeeScheduleAllowance	Sub ComputeFeeScheduleAllowance(ByVal inSvc As clsBillAuditService)	Performs the ComputeFeeScheduleAllowance operation for the current instance.*
AlterFeeSchedule	Sub AlterFeeSchedule(ByVal inSvc As clsBillAuditService)	Performs the AlterFeeSchedule operation for the current instance.*
ComputeServiceLinePharmacyAllowance	Sub ComputeServiceLinePharmacyAllowance(ByVal service As clsBillAuditService, ByVal dispensingFeeOverride As Decimal)	Performs the ComputeServiceLinePharmacyAllowance operation for the current instance.*
ComputeMileageAllowance	Sub ComputeMileageAllowance(ByVal inSvc As clsBillAuditService)	Performs the ComputeMileageAllowance operation for the current instance.*
ComputeCostChargeAllowance	Sub ComputeCostChargeAllowance(ByVal inSvc As clsBillAuditService)	Performs the ComputeCostChargeAllowance operation for the current instance.*
DisplayHistory	Sub DisplayHistory()	Performs the DisplayHistory operation for the current instance.*
CheckForProviderContractPackagePrice	Sub CheckForProviderContractPackagePrice()	Performs the CheckForProviderContractPackagePrice operation for the current instance.*
GetEligiblePackagePricingAmount	Function GetEligiblePackagePricingAmount() As Decimal	Executes the GetEligiblePackagePricingAmount operation and returns the requested result.*
RemovePriorPackagePricingAdjustments	Sub RemovePriorPackagePricingAdjustments()	Performs the RemovePriorPackagePricingAdjustments operation for the current instance.*
FindProviderServiceContract	Function FindProviderServiceContract(ByVal inSvc As clsBillAuditService) As clsProviderServiceContractInfo	Executes the FindProviderServiceContract operation and returns the requested result.*
ContractQualifies	Function ContractQualifies(ByVal inSvc As clsBillAuditService, ByVal inContract As clsProviderServiceContractInfo, ByVal UseMCOQualification As Boolean) As Boolean	Executes the ContractQualifies operation and returns the requested result.*
CheckGlobal	Sub CheckGlobal(ByVal inSvc As clsBillAuditService)	Performs the CheckGlobal operation for the current instance.*
CheckHistoricalEMServices	Sub CheckHistoricalEMServices(ByVal inSvc As clsBillAuditService)	Performs the CheckHistoricalEMServices operation for the current instance.*
CheckCurrentEMServices	Sub CheckCurrentEMServices(ByVal inSvc As clsBillAuditService)	Performs the CheckCurrentEMServices operation for the current instance.*
CheckHistoricalSurgicalServices	Sub CheckHistoricalSurgicalServices(ByVal inSvc As clsBillAuditService)	Performs the CheckHistoricalSurgicalServices operation for the current instance.*
CheckThreePTRule	Sub CheckThreePTRule(ByVal inSvc As clsBillAuditService)	Performs the CheckThreePTRule operation for the current instance.*
CheckBundling	Sub CheckBundling(ByVal inSvc As clsBillAuditService)	Performs the CheckBundling operation for the current instance.*
ProcessBundle	Sub ProcessBundle(ByVal inSvc As clsBillAuditService, ByVal inBundledItem As clsCPTBundledItem)	Performs the ProcessBundle operation for the current instance.*
ProcessComponent	Sub ProcessComponent(ByVal insvc As clsBillAuditService, ByVal inBundledItem As clsCPTBundledItem)	Performs the ProcessComponent operation for the current instance.*
CheckDeniedClaim	Sub CheckDeniedClaim()	Performs the CheckDeniedClaim operation for the current instance.*
CheckForInelligbleProviders	Sub CheckForInelligbleProviders()	Performs the CheckForInelligbleProviders operation for the current instance.*
CheckForInelligbleServices	Sub CheckForInelligbleServices()	Performs the CheckForInelligbleServices operation for the current instance.*
CheckForDuplicates	Sub CheckForDuplicates()	Performs the CheckForDuplicates operation for the current instance.*
CheckForLateFiling	Sub CheckForLateFiling()	Performs the CheckForLateFiling operation for the current instance.*
CheckForNonMCOProvider	Sub CheckForNonMCOProvider()	Performs the CheckForNonMCOProvider operation for the current instance.*

Behavioral notes

• clsBillAuditor is part of the documented SAIF.Business.Claim.Bill.AutomatedAudit public contract.
• Public members are declared in Business\SAIF.Business.Claim.Bill.AutomatedAudit\AuditUtilities\clsBillAuditor.vb.

Constraints and usage notes

• Consumers should treat this type as a stable library entry point.

Note: Statements marked with * were inferred from code structure, naming conventions, or contextual evidence where direct confirmation was not available in source artifacts. Statements marked with ** could not be confirmed; treat as unknown until verified.

Sources

• Business\SAIF.Business.Claim.Bill.AutomatedAudit\AuditUtilities\clsBillAuditor.vb