SAIF.Business.View.Provider business rules¶

This page captures business rules enforced by this library.

BR-PRV-001 Primary tax ID must be a 9-digit number¶

Field	Value
Statement	A provider's primary tax ID must convert to a numeric value exactly 9 digits long.
Trigger	Rule-engine validation of `PrimaryTaxID` after `clsProvider` construction/load.
Enforcement	`clsProvider.Rule_ValidPrimaryTaxId` (`<RuleData("clsProvider01", "Invalid provider primary tax ID")>`).
Outcome	Broken rule "Invalid provider primary tax ID"; `IsValid` becomes false.
Tables	PROVIDER
SQL	SQL-PRV-01, SQL-PRV-01b
Source	`SAIF.Business.View.Provider/clsProvider.vb`

BR-PRV-002 Payee address resolution order¶

Field	Value
Statement	The payee address for a provider is the address of the tax-ID record that is effective today, not yet expired, and whose tax ID equals the primary location's provider primary tax ID; if none is found the primary location's active payment address is used.
Trigger	Read of `clsProvider.PayeeAddress`.
Enforcement	`clsProvider.vb:153–166`.
Outcome	Returns the tax-ID address or falls back to the payment address.
Tables	PROVIDER_TAX_ID
SQL	SQL-PTAX-01
Source	`SAIF.Business.View.Provider/clsProvider.vb`

BR-PRV-003 Provider-set retrieval uses unparameterized SQL¶

Field	Value
Statement	Provider-set retrieval accepts either a tax-ID array or a raw WHERE clause and injects both into SQL by string concatenation.*
Trigger	`GetProviderCollection` / `GetProvidersUsingWhere`.
Enforcement	`clsProviderCollection.Criteria.BuildSQLWhere`, `clsProviderCollection.vb:277–294`.
Outcome	Query is built without bind variables — untrusted input would be executed as SQL.*
Tables	PROVIDER, PROVIDER_TAX_ID
SQL	SQL-PRV-02, SQL-PRV-02b
Source	`SAIF.Business.View.Provider/clsProviderCollection.vb`

BR-PRV-004 Providers retrieved via factory methods are read-only¶

Field	Value
Statement	A provider retrieved through the public factory methods is returned in read-only state.
Trigger	`clsProvider.GetProvider` (both overloads).
Enforcement	`clsProvider.vb:317–339`.
Outcome	`ReadOnly = True` on the returned object.
Tables	PROVIDER
SQL	SQL-PRV-01, SQL-PRV-01b
Source	`SAIF.Business.View.Provider/clsProvider.vb`

BR-PRV-005 Payee type is always Provider¶

Field	Value
Statement	The payee type of a provider or provider location is always `Provider` with code `"PROV"`.
Trigger	Read of `PayeeType` / `PayeeTypeCode`.
Enforcement	`clsProvider.vb:182–192`; `clsProviderLocation.vb:412–422`.
Outcome	Constant payee classification.
Source	`SAIF.Business.View.Provider/clsProvider.vb`, `SAIF.Business.View.Provider/clsProviderLocation.vb`

BR-PRV-006 Primary location selection¶

Field	Value
Statement	The primary location of a provider is the location flagged primary; if none is flagged, the first location; if there are no locations, nothing.
Trigger	Read of `clsProvider.PrimaryLocation`.
Enforcement	`clsProvider.vb:104–117`.
Outcome	Deterministic primary-location selection.
Tables	PROVIDER_LOCATION
SQL	SQL-PLOC-02
Source	`SAIF.Business.View.Provider/clsProvider.vb`

BR-PLOC-001 Provider location ID must be positive¶

Field	Value
Statement	A loaded provider location must have a `ProviderLocationID` greater than zero.
Trigger	Level I rule check on `ProviderLocationID`.
Enforcement	`clsProviderLocation.Rule_ValidProviderLocation`, `clsProviderLocation.vb:605, 615–618` (`clsProviderLocation01`).
Outcome	Broken rule "Error: Invalid provider ID".
Tables	PROVIDER_LOCATION
SQL	SQL-PLOC-01
Source	`SAIF.Business.View.Provider/clsProviderLocation.vb`

BR-PLOC-002 Provider ID must be positive¶

Field	Value
Statement	The provider owning a location must resolve to a `ProviderID` greater than zero.
Trigger	Level III rule check on `ProviderID`.
Enforcement	`clsProviderLocation.Rule_ValidProvider`, `clsProviderLocation.vb:608, 623–626` (`clsProviderLocation02`).
Outcome	Broken rule "Error: Verify provider is valid".
Tables	PROVIDER_LOCATION
SQL	SQL-PLOC-01
Source	`SAIF.Business.View.Provider/clsProviderLocation.vb`

BR-PLOC-003 Provider type code must be non-empty¶

Field	Value
Statement	The provider type of a location must resolve to a non-empty code.
Trigger	Level III rule check on `ProviderTypeCode`.
Enforcement	`clsProviderLocation.Rule_ValidProviderTypeCode`, `clsProviderLocation.vb:609, 631–634` (`clsProviderLocation03`).
Outcome	Broken rule "Error: Verify provider type is valid".
Tables	PROVIDER_TYPE_CODE
SQL	SQL-PTYP-01
Source	`SAIF.Business.View.Provider/clsProviderLocation.vb`

BR-PLOC-004 Ineligible locations are excluded from filtered lists¶

Field	Value
Statement	A provider location is treated as ineligible on a date when that date falls within any of its ineligibility periods; filtered location lists exclude such locations.
Trigger	`IsDuringIneligibilityPeriod(date)`; `FilterBy_ProviderTypeCode[AndEffectiveDate]`.
Enforcement	`clsProviderLocation.vb:125–130`; `clsProviderLocationCollection.vb:51–60`.
Outcome	Ineligible locations are excluded from the filtered collection.
Tables	PROVIDER_INELIG_PERIOD
SQL	SQL-PINE-02
Source	`SAIF.Business.View.Provider/clsProviderLocation.vb`, `SAIF.Business.View.Provider/clsProviderLocationCollection.vb`

BR-PLOC-005 Provider location dirty state is composite¶

Field	Value
Statement	A provider location is dirty when its own state is dirty or its name object is dirty.
Trigger	Read of `clsProviderLocation.IsDirty`.
Enforcement	`clsProviderLocation.vb:461–472`.
Outcome	Composite dirty determination.
Source	`SAIF.Business.View.Provider/clsProviderLocation.vb`

BR-PADR-001 Addresses without expiration default to Date MaxValue¶

Field	Value
Statement	An address with no expiration date is treated as expiring at `Date.MaxValue`.
Trigger	`clsProviderAddress.Fill` during load.
Enforcement	`clsProviderAddress.vb:372–377`.
Outcome	Open-ended addresses remain active indefinitely.
Tables	PROVIDER_ADDRESS
SQL	SQL-PADR-01
Source	`SAIF.Business.View.Provider/clsProviderAddress.vb`

BR-PADR-002 Address active-on-date determination¶

Field	Value
Statement	An address is active on a date when that date lies between its start and termination dates.
Trigger	`ActiveAddresses()` / `ActiveAddresses(date)`.
Enforcement	`clsProviderAddressCollection.vb:85–101`.
Outcome	Inactive addresses are filtered out.
Tables	PROVIDER_ADDRESS
SQL	SQL-PADR-01
Source	`SAIF.Business.View.Provider/clsProviderAddressCollection.vb`

BR-PADR-003 Primary address fallback chain¶

Field	Value
Statement	Primary-address selection falls back by type: Correspondence → Physical; Payment → Physical → Correspondence; Physical → Correspondence.
Trigger	Read of `CorrespondenceAddress`, `PaymentAddress`, `PhysicalAddress`, `PrimaryAddress(type)`.
Enforcement	`clsProviderAddressCollection.CalculatePrimaryAddress`, `clsProviderAddressCollection.vb:161–189`.
Outcome	A best-available address of the requested kind.
Source	`SAIF.Business.View.Provider/clsProviderAddressCollection.vb`

BR-PADR-004 Empty address returned when none match¶

Field	Value
Statement	When no address of any fallback type exists, an empty address object is returned rather than nothing.
Trigger	End of `CalculatePrimaryAddress`.
Enforcement	`clsProviderAddressCollection.vb:186`.
Outcome	Callers never receive `Nothing`.
Source	`SAIF.Business.View.Provider/clsProviderAddressCollection.vb`

BR-PADR-005 Parent address preferred with child identity retained¶

Field	Value
Statement	When resolving a child/parent provider address, the parent's address wins if it is non-empty; it is cloned, flagged `IsParent`, annotated with the parent name and ID, but re-stamped with the child's business name and location ID. Otherwise the child's own address is used.
Trigger	`clsProviderAddress.GetAddress(child, parent, type)`.
Enforcement	`clsProviderAddress.vb:270–299`.
Outcome	Parent-preferred address with child identity retained.
Source	`SAIF.Business.View.Provider/clsProviderAddress.vb`

BR-PADR-006 Address type codes are fixed¶

Field	Value
Statement	Address type codes are fixed: Correspondence = `COR`, Payment = `PAY`, Physical = `PHY`; any other value raises an error.
Trigger	`GetAddressTypeCode(addressType)`.
Enforcement	`clsProviderAddress.vb:302–314`.
Outcome	Returns the code or throws `Exception("Invalid Address Type.")`.
Source	`SAIF.Business.View.Provider/clsProviderAddress.vb`

BR-PREL-001 Works-for relationships are WRK code¶

Field	Value
Statement	A "works for" relationship is a relationship whose code is `WRK`.
Trigger	Read of `WorksFor` / `WorksFor(date)`.
Enforcement	`clsProviderRelationshipCollection.vb:89–111`.
Outcome	Only `WRK` relationships are returned.
Tables	PROVIDER_RELATIONSHIP
SQL	SQL-PREL-01, SQL-PREL-02
Source	`SAIF.Business.View.Provider/clsProviderRelationshipCollection.vb`

BR-PREL-002 Works-for defaults to active relationships only¶

Field	Value
Statement	By default only currently active relationships are included in the works-for list; `ActiveOnly = False` disables the date test.
Trigger	Read of `WorksFor`.
Enforcement	`clsProviderRelationshipCollection.vb:93–98` (with `ActiveOnly`, `:56–64`).
Outcome	Expired relationships are excluded unless opted out.
Source	`SAIF.Business.View.Provider/clsProviderRelationshipCollection.vb`

BR-PREL-003 Relationship active-date determination¶

Field	Value
Statement	A relationship is active when today is on or after its start date and on or before its termination date; a missing termination date is treated as `Date.MaxValue`.
Trigger	Read of `clsProviderRelationship.IsActive`; `WorksFor(activeDate)`.
Enforcement	`clsProviderRelationship.vb:95–112`; `clsProviderRelationshipCollection.vb:106–110`.
Outcome	Open-ended relationships stay active.
Source	`SAIF.Business.View.Provider/clsProviderRelationship.vb`, `SAIF.Business.View.Provider/clsProviderRelationshipCollection.vb`

BR-PREL-004 Destination relationship type is the opposite of the source¶

Field	Value
Statement	The destination end of a relationship is always the opposite of the source end (source Child → destination Parent, otherwise destination Child).
Trigger	Read of `DestinationRelationshipType` / `DestinationProviderLocation`.
Enforcement	`clsProviderRelationship.vb:135–160`.
Outcome	Callers always navigate to the other party.
Source	`SAIF.Business.View.Provider/clsProviderRelationship.vb`

BR-PINE-001 Ineligibility periods without termination default to Date MaxValue¶

Field	Value
Statement	An ineligibility period with no termination date is treated as terminating at `Date.MaxValue`.*
Trigger	Read of `clsProviderIneligibilityPeriod.TerminationDate`.
Enforcement	`clsProviderIneligibilityPeriod.vb:~127–140`.
Outcome	Open-ended ineligibility never expires.
Tables	PROVIDER_INELIG_PERIOD
SQL	SQL-PINE-01, SQL-PINE-02
Source	`SAIF.Business.View.Provider/clsProviderIneligibilityPeriod.vb`

BR-DATE-001 Dated records are in effect within their date window¶

Field	Value
Statement	A dated record (MCO enrollment, DCBS cost charge, service contract) is in effect on a date when the date is on/after the effective date and either there is no expiration date or the date is on/before it.
Trigger	`IsInEffect(date)`, `IsActive`, `IsExpired`.
Enforcement	`clsMCOProvider.vb:~155–178`; `clsDCBSCostCharge.vb:41–68`; `clsProviderServiceContract.vb:~130–160`.
Outcome	Uniform date-window evaluation.
Tables	PROVIDER_DCBS_COST_CHARGE, MCO_PROVIDER, PROVIDER_SERVICE_CONTRACT
SQL	SQL-DCBS-01, SQL-MCO-01, SQL-PSVC-02
Source	`SAIF.Business.View.Provider/clsMCOProvider.vb`, `SAIF.Business.View.Provider/clsDCBSCostCharge.vb`, `SAIF.Business.View.Provider/clsProviderServiceContract.vb`

BR-MCO-001 MCO plan must match the assigned plan ID¶

Field	Value
Statement	An MCO plan attached to an enrollment or service contract must match the plan ID already assigned to that record.
Trigger	`SetPlan(inPlan)` during list construction.
Enforcement	`clsMCOProvider.vb:106–112`; `clsProviderServiceContract.vb:102–108`.
Outcome	Throws `ApplicationException("MCO plan submitted does not match plan assigned.")`.
Tables	MCO_PROVIDER, PROVIDER_SERVICE_CONTRACT
SQL	SQL-MCO-01, SQL-PSVC-02
Source	`SAIF.Business.View.Provider/clsMCOProvider.vb`, `SAIF.Business.View.Provider/clsProviderServiceContract.vb`

BR-PSVC-001 Service contracts are limited to the offset window¶

Field	Value
Statement	Service contracts are limited to those still open or expired within the offset window (default 721 days); an offset of zero or less removes the restriction.
Trigger	`clsProviderServiceContractList..ctor`.
Enforcement	`clsProviderServiceContract.vb:216–229`.
Outcome	Older expired contracts are excluded.
Tables	PROVIDER_SERVICE_CONTRACT
SQL	SQL-PSVC-02
Source	`SAIF.Business.View.Provider/clsProviderServiceContract.vb`

BR-SRCH-001 At least one search field is required¶

Field	Value
Statement	At least one search field must be supplied before a provider search is considered valid.
Trigger	Rule-engine validation of `clsSearchCriteria.ProviderName`.
Enforcement	`clsProviderSearch.Rule_ValidCriteria`, `clsProviderSearch.vb:411, 416–430`.
Outcome	Broken rule "Error: Enter your search criteria".
Source	`SAIF.Business.View.Provider/clsProviderSearch.vb`

BR-SRCH-002 Zip code must be numeric¶

Field	Value
Statement	A supplied zip code must be numeric (an empty zip code is allowed).
Trigger	Rule-engine validation of `ZipCode`.
Enforcement	`clsProviderSearch.Rule_ValidZipCode`, `clsProviderSearch.vb:412, 432–436`.
Outcome	Broken rule "Error: Zip code must be numeric".
Source	`SAIF.Business.View.Provider/clsProviderSearch.vb`

BR-SRCH-003 Tax ID length limit¶

Field	Value
Statement	A supplied tax ID, with hyphens removed, must be fewer than 10 characters.
Trigger	Rule-engine validation of `TaxId`.
Enforcement	`clsProviderSearch.Rule_ValidTaxId`, `clsProviderSearch.vb:413, 437–440`.
Outcome	Broken rule "Error: The tax id is too long".
Source	`SAIF.Business.View.Provider/clsProviderSearch.vb`

BR-SRCH-004 Businessperson selector maps to business flag¶

Field	Value
Statement	The business/person selector maps to `BUSINESS_FLAG = 'Y'` for BUSINESS, `'N'` for PERSON, and no flag filter for any other value.
Trigger	`searchForProvider`.
Enforcement	`clsProviderSearch.vb:96–121`.
Outcome	Result scope restricted or unrestricted accordingly.
Tables	PROVIDER_LOCATION
SQL	SQL-SRCH-01
Source	`SAIF.Business.View.Provider/clsProviderSearch.vb`

BR-SRCH-005 Provider name search also matches registered names¶

Field	Value
Statement	When a provider name is supplied, the search also matches registered names by unioning a second query joined to `provider_tax_id`.
Trigger	`searchForProvider`.
Enforcement	`clsProviderSearch.vb:143–155, 224–229`.
Outcome	Registered-name matches are included.
Tables	PROVIDER_TAX_ID
SQL	SQL-SRCH-01
Source	`SAIF.Business.View.Provider/clsProviderSearch.vb`

BR-SRCH-006 Sort name derivation¶

Field	Value
Statement	A person's sort name is derived by taking the text before the first space and re-appending everything from the first comma; business rows and rows without a comma sort on the full name.
Trigger	`FormatSortName` during result materialisation.
Enforcement	`clsProviderSearch.vb:253–267`.
Outcome	Consistent person/business sort ordering.
Source	`SAIF.Business.View.Provider/clsProviderSearch.vb`

BR-SRCH-007 Search results capped at 300 rows¶

Field	Value
Statement	A provider search returns at most 300 result rows; loading stops once the collection exceeds 299 entries.
Trigger	Result loop in `searchForProvider`.
Enforcement	`clsProviderSearch.vb:246–249`.
Outcome	Extra rows are silently discarded.
Tables	PROVIDER_LOCATION
SQL	SQL-SRCH-01
Source	`SAIF.Business.View.Provider/clsProviderSearch.vb`

BR-SRCH-008 Search text normalization¶

Field	Value
Statement	Search text values are upper-cased and trimmed, name/street/phone comparisons are prefix matches, and phone input has `-` and `.` removed.
Trigger	`searchForProvider` parameter construction.
Enforcement	`clsProviderSearch.vb:126–214`.
Outcome	Case-insensitive prefix matching.
Source	`SAIF.Business.View.Provider/clsProviderSearch.vb`

BR-DATA-001 No write operations are supported¶

Field	Value
Statement	This library performs no create, insert, update, or delete operations; every non-retrieve SQL property raises an error.
Trigger	Any access to `CreateSQL`, `InsertSQL`, `UpdateSQL`, `DeleteSQL` on any criteria class.
Enforcement	All 12 criteria classes (e.g. `clsProvider.vb:416–447`).
Outcome	`ApplicationException(clsConstants.Messages.InvalidSQLProperty)`.
Source	`SAIF.Business.View.Provider/clsProvider.vb` (and the other 11 criteria classes)

Notes¶

No confirmed dependency-doc-sourced (inherited) rules were found for this library.

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.

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¶

SAIF.Business.View.Provider/clsProvider.vb
SAIF.Business.View.Provider/clsProviderCollection.vb
SAIF.Business.View.Provider/clsProviderLocation.vb
SAIF.Business.View.Provider/clsProviderLocationCollection.vb
SAIF.Business.View.Provider/clsProviderAddress.vb
SAIF.Business.View.Provider/clsProviderAddressCollection.vb
SAIF.Business.View.Provider/clsProviderRelationship.vb
SAIF.Business.View.Provider/clsProviderRelationshipCollection.vb
SAIF.Business.View.Provider/clsProviderIneligibilityPeriod.vb
SAIF.Business.View.Provider/clsProviderIneligibilityPeriodCollection.vb
SAIF.Business.View.Provider/clsProviderTaxID.vb
SAIF.Business.View.Provider/clsProviderTaxIDCollection.vb
SAIF.Business.View.Provider/clsProviderType.vb
SAIF.Business.View.Provider/clsProviderTypeCollection.vb
SAIF.Business.View.Provider/clsProviderSearch.vb
SAIF.Business.View.Provider/clsDCBSCostCharge.vb
SAIF.Business.View.Provider/clsMCOProvider.vb
SAIF.Business.View.Provider/clsProviderServices.vb
SAIF.Business.View.Provider/clsProviderServiceContract.vb

SAIF.Business.View.Provider business rules¶

BR-PRV-001 Primary tax ID must be a 9-digit number¶

BR-PRV-002 Payee address resolution order¶

BR-PRV-003 Provider-set retrieval uses unparameterized SQL¶

BR-PRV-004 Providers retrieved via factory methods are read-only¶

BR-PRV-005 Payee type is always Provider¶

BR-PRV-006 Primary location selection¶

BR-PLOC-001 Provider location ID must be positive¶

BR-PLOC-002 Provider ID must be positive¶

BR-PLOC-003 Provider type code must be non-empty¶

BR-PLOC-004 Ineligible locations are excluded from filtered lists¶

BR-PLOC-005 Provider location dirty state is composite¶

BR-PADR-001 Addresses without expiration default to Date MaxValue¶

BR-PADR-002 Address active-on-date determination¶

BR-PADR-003 Primary address fallback chain¶

BR-PADR-004 Empty address returned when none match¶

BR-PADR-005 Parent address preferred with child identity retained¶

BR-PADR-006 Address type codes are fixed¶

BR-PREL-001 Works-for relationships are WRK code¶

BR-PREL-002 Works-for defaults to active relationships only¶

BR-PREL-003 Relationship active-date determination¶

BR-PREL-004 Destination relationship type is the opposite of the source¶

BR-PINE-001 Ineligibility periods without termination default to Date MaxValue¶

BR-DATE-001 Dated records are in effect within their date window¶

BR-MCO-001 MCO plan must match the assigned plan ID¶

BR-PSVC-001 Service contracts are limited to the offset window¶

BR-SRCH-001 At least one search field is required¶

BR-SRCH-002 Zip code must be numeric¶

BR-SRCH-003 Tax ID length limit¶

BR-SRCH-004 Businessperson selector maps to business flag¶

BR-SRCH-005 Provider name search also matches registered names¶

BR-SRCH-006 Sort name derivation¶

BR-SRCH-007 Search results capped at 300 rows¶

BR-SRCH-008 Search text normalization¶

BR-DATA-001 No write operations are supported¶

Notes¶

Related documentation¶

Sources¶