IClaimReportDataRetriever¶

Defines the contract for retrieving claim-level data needed to report on broken provider relationships (worker representation, attending physician, and benefit payment scenarios), implemented by ClaimReportDataRetriever and consumed by ClaimReportingService to drive the broken-provider-relationship report.

Purpose¶

Declares lookups for claims linked to a provider relationship by relationship category (legal representative, attending physician, benefit payment).
Declares a lookup for provider relationships that have expired on or after a given effective date.
Declares a method to build a per-claim ReportItem summarizing a claim's status, provider names, and adjuster contact for reporting.

Context¶

Namespace: SAIF.Services.Claims.Reports
Assembly/package: SAIF.Services (packaged inside the SAIF.SAIFCode.Core NuGet package)

Public members¶

Member	Signature	Purpose
GetLegalRepClaimsWithProviderRelationship(providerLocationId, parentProviderLocationId)	`IEnumerable<long> GetLegalRepClaimsWithProviderRelationship(long providerLocationId, long parentProviderLocationId)`	Returns the claim IDs where the given provider/parent-provider location pair serves as legal representative.
GetAttendingPhysicianClaimsWithProviderRelationship(providerLocationId, parentProviderLocationId)	`IEnumerable<long> GetAttendingPhysicianClaimsWithProviderRelationship(long providerLocationId, long parentProviderLocationId)`	Returns the claim IDs where the given provider/parent-provider location pair serves as attending physician.
GetBenefitPaymentClaimsWithProviderRelationship(providerLocationId, parentProviderLocationId)	`IEnumerable<long> GetBenefitPaymentClaimsWithProviderRelationship(long providerLocationId, long parentProviderLocationId)`	Returns the claim IDs linked to the provider/parent-provider location pair through benefit payments.
GetExpiredRelationships(effectiveDate)	`IEnumerable<ProviderRelationship> GetExpiredRelationships(DateTime effectiveDate)`	Returns provider relationships that expired on or after the given date and have no currently active replacement relationship.
GetReportDetails(claimId, relationship)	`ReportItem GetReportDetails(long claimId, ProviderRelationship relationship)`	Builds a `ReportItem` describing the claim's status, provider identities, and responsible adjuster for the given expired provider relationship.

Behavioral notes¶

This interface is the sole abstraction ClaimReportingService uses to source report data, keeping report orchestration decoupled from the underlying query providers.*

Constraints and usage notes¶

Implementations are expected to return empty (not exceptional) results when no matching claims/relationships exist, based on ClaimReportDataRetriever's behavior.*

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¶

Services/SAIF.Services/Claims/Reports/ClaimReportDataRetriever.cs