tbfajri/aso
1
0
Fork 0
Code Issues 2 Pull Requests Actions Packages Projects Releases Wiki Activity

[WIP] Change Check Coverage Appointment

Browse Source
This commit is contained in:
R
2023-01-13 00:43:58 +07:00
parent 3a2dd84500
commit 2f10f913c0
3 changed files with 121 additions and 148 deletions
Download Patch File Download Diff File Expand all files Collapse all files

22
app/Http/Controllers/Api/OLDLMS/ClaimController.php
View File

@@ -6,6 +6,7 @@ use App\Helpers\Helper;
use App\Http\Controllers\Controller;
use App\Models\Icd;
use App\Models\Member;
use App\Models\Speciality;
use App\Services\ClaimService;
use Illuminate\Http\Request;
@@ -16,19 +17,23 @@ class ClaimController extends Controller
$request->validate([
'member_id' => 'required',
'user_id' => 'required',
'type' => 'required|in:consultation-gp,consultation-specialist,medicine',
'type' => 'required|in:consultation,teleconsultation,medicine',
'speciality_code' => 'required',
'total_claim' => 'required',
'detail' => 'required',
]);
$currentSpeciality = Speciality::where('code', $request->speciality_code)->first();
if ($request->type == 'consultation-gp') {
$benefitCode = 'OPCONS1';
}
if ($request->type == 'consultation-specialist') {
$benefitCode = 'OPCONS2';
}
$gpSpecialityName = config('aso.general_practitioner_speciality_name', 'Umum');
$isGp = $gpSpecialityName == ($currentSpeciality ? $currentSpeciality->name : false);
if ($request->type == 'medicine') {
$benefitCode = 'OPMEDI1';
} else if ($isGp) {
$benefitCode = 'OPCONS1';
} else {
$benefitCode = 'OPCONS2';
}
$member = Member::query()
@@ -38,8 +43,7 @@ class ClaimController extends Controller
])
->firstOrFail();
$benefit = $member->currentPlan->benefits()->where('code', $benefitCode)->first();
// $diagnosis = Icd::first();
$claim = ClaimService::storeClaim($member, null, $request->total_claim, $benefit, 'requested');
$claim->status = 'approved';
$claim->save();

243
app/Http/Controllers/Api/OLDLMS/MembershipController.php
View File

@@ -11,7 +11,7 @@ use Illuminate\Http\Request;
class MembershipController extends Controller
{
//
public function check(Request $request)
public function check(Request $request)
{
$request->validate([
'member_id' => 'required',
@@ -25,7 +25,7 @@ class MembershipController extends Controller
}
if (!$member->active) {
return Helper::responseJson(statusCode: 406, message: 'The Member '.$request->member_id.' is Inactive.', status: 'error');
return Helper::responseJson(statusCode: 406, message: 'The Member ' . $request->member_id . ' is Inactive.', status: 'error');
}
return Helper::responseJson(data: $member, message: 'Member Found');
@@ -35,68 +35,30 @@ class MembershipController extends Controller
{
$request->validate([
'member_id' => 'required',
'type' => 'required|in:consultation-gp,consultation-specialist,medicine',
'type' => 'required|in:consultation,teleconsultation,medicine',
// 'speciality_code' => 'sometimes'
]);
if ($request->type == 'consultation-gp') {
$benefitCode = 'OPCONS1';
}
if ($request->type == 'consultation-specialist') {
$benefitCode = 'OPCONS2';
}
if ($request->type == 'medicine') {
$benefitCode = 'OPMEDI1';
}
$member = Member::query()
->where('member_id', $request->member_id)
->with(['currentCorporate', 'currentPolicy', 'currentPlan', 'postponedClaims'])
->first();
$member = Member::where('member_id', $request->member_id)->with(['currentCorporate', 'currentPolicy', 'currentPlan', 'postponedClaims'])->first();
$limits = ClaimService::showMemberBenefitLimit($member, $benefitCode);
$limits['postponed_claims'] = $member->postponedClaims;
$limits['postponed_claims_payment_url'] = route('postpone-pay', $member->member_id);
$limits['postponed_claims_unpaid_total'] = $member->postponedClaims->sum('total_claim');
$corporateService = $member->currentCorporate
->corporateServices()
$corporateService = $member->currentCorporate->corporateServices()
->active()
->where('service_code', 'OP')
->with([
'configs',
'specialities' => function ($speciality) use ($request) {
$speciality->where('code', $request->speciality_code)
->wherePivot('active', 1);
}])
$speciality->where('code', $request->speciality_code ?? null)
->wherePivot('active', 1);
}
])
->first();
$configs = $corporateService->configs->mapWithKeys(function ($config) {
return [$config->name => $config];
});
$coverage = [
'benefit' => false,
'admin_fee' => false,
'medicine_benefit' => true, // TODO Make this into setting ?
'medicine_delivery_fee' => false
];
$coverage['medicine_delivery_fee'] = (($configs['delivery_fee']['value'] ?? 1) == 1);
$coverage['gp_benefit'] = (($configs['gp_internal_doctor_online']['value'] ?? 1) == 1);
$coverage['gp_admin_fee'] = (($configs['general_practitioner_fee']['value'] ?? 1) == 1);
$coverage['sp_benefit'] = (($configs['sp_internal_doctor_online']['value'] ?? 1) == 1);
$coverage['sp_admin_fee'] = (($configs['specialist_practitioner_fee']['value'] ?? 1) == 1);
$currentSpeciality = $corporateService->specialities->first();
if ($request->has('speciality_code') && !empty($request->speciality_code)) {
if (empty($corporateService) || empty($corporateService->specialities)) {
$coverage['benefit'] = false;
$coverage['admin_fee'] = false;
$limits['coverage'] = $coverage;
return Helper::responseJson(data: $limits);
}
$currentSpeciality = $corporateService->specialities->first();
// Load the Relation Data after speciality check is supported
if ($currentSpeciality) {
$corporateService->load([
'corporateServiceSpecialities' => function ($corporateServiceSpeciality) use ($currentSpeciality) {
$corporateServiceSpeciality->where('speciality_id', $currentSpeciality->id);
@@ -106,94 +68,101 @@ class MembershipController extends Controller
},
'corporateServiceSpecialities.exclusions.rules'
]);
$serviceSpeciality = $corporateService->corporateServiceSpecialities->first() ?? null;
$serviceSpecialityRules = $serviceSpeciality->exclusions->first()->rules ?? collect([]);
$serviceSpecialityRules = $serviceSpecialityRules->mapWithKeys(function ($rule) {
return [$rule->name => $rule];
});
$gpSpecialityName = config('aso.general_practitioner_speciality_name', 'Umum');
if ($gpSpecialityName == $currentSpeciality->name) {
// To General Practitioner
if (($configs['gp_internal_doctor_online']['value'] ?? 1) == 1) {
$coverage['benefit'] = true;
}
if (($configs['general_practitioner_fee']['value'] ?? 1) == 1) {
$coverage['admin_fee'] = true;
}
if ($serviceSpeciality->active == 1) {
$coverage['benefit'] = true;
}
} else {
// To Specialist
if (($configs['sp_internal_doctor_online']['value'] ?? 1) == 1) {
$coverage['benefit'] = true;
}
// dd($configs['specialist_practitioner_fee']['value'], $configs['specialist_practitioner_fee']['value'] ?? 1, ($configs['specialist_practitioner_fee']['value'] ?? 1) == 1);
if (($configs['specialist_practitioner_fee']['value'] ?? 1) == 1) {
$coverage['admin_fee'] = true;
}
if ($serviceSpeciality->active == 1) {
$coverage['benefit'] = true;
}
}
// TODO THIS EXCLUSION IS USED AS INCLUSION NOW, MUST BE CHANGE TO USED AS EXCLUSION AND MAYBE MOVE THE TABLE
$excluded = [];
foreach ($serviceSpecialityRules as $ruleName => $rule) {
if ($ruleName == 'msc') {
$values = explode(',', $rule->values);
if (!in_array(strtolower($member->marital_status), $values)) {
$excluded[] = $rule;
}
}
if ($ruleName == 'gender') {
$values = explode(',', $rule->values);
if (!in_array(strtolower($member->gender), $values)) {
$excluded[] = $rule;
}
}
if ($ruleName == 'min_age') {
if (!empty($rule->values) && $member->age < $rule->values) {
$excluded[] = $rule;
}
}
if ($ruleName == 'max_age') {
if (!empty($rule->values) && $member->age > $rule->values) {
$excluded[] = $rule;
}
}
if ($ruleName == 'plan') {
$values = explode(',', $rule->values);
if (!in_array($member->currentPlan->code, $values)) {
$excluded[] = $rule;
}
}
}
if ( count($excluded) ) {
$coverage['benefit'] = false;
$coverage['benefit_exclusion'] = $excluded;
} else {
$coverage['benefit'] = true;
}
}
$corporateServiceSpeciality = $corporateService->corporateServiceSpecialities->first() ?? null;
$serviceSpecialityRules = $corporateServiceSpeciality->exclusions->first()->rules ?? collect([]);
$serviceSpecialityRules = $serviceSpecialityRules->mapWithKeys(function ($rule) {
return [$rule->name => $rule];
});
$configs = $corporateService->configs->mapWithKeys(function ($config) {
return [$config->name => $config];
});
$gpSpecialityName = config('aso.general_practitioner_speciality_name', 'Umum');
$isGp = $gpSpecialityName == ($currentSpeciality ? $currentSpeciality->name : false);
if ($request->type == 'medicine') {
$benefitCode = 'OPMEDI1';
} else if ($isGp) {
$benefitCode = 'OPCONS1';
} else {
$benefitCode = 'OPCONS2';
}
$limits = ClaimService::showMemberBenefitLimit($member, $benefitCode);
$limits['postponed_claims'] = $member->postponedClaims;
$limits['postponed_claims_payment_url'] = route('postpone-pay', $member->member_id);
$limits['postponed_claims_unpaid_total'] = $member->postponedClaims->sum('total_claim');
$coverage['medicine_benefit'] = $benefitCode == 'OPMEDI1'; // TODO Make this into setting ?
$coverage['medicine_delivery_fee'] = (($configs['delivery_fee']['value'] ?? 1) == 1);
if ($currentSpeciality) {
$xCoverage['sp_consultation_benefit'] = (($configs['sp_internal_doctor_offline']['value'] ?? 1) == 1);
$xCoverage['sp_teleconsultation_benefit'] = (($configs['sp_internal_doctor_online']['value'] ?? 1) == 1);
$xCoverage['gp_consultation_benefit'] = (($configs['gp_internal_doctor_offline']['value'] ?? 1) == 1);
$xCoverage['gp_teleconsultation_benefit'] = (($configs['gp_internal_doctor_online']['value'] ?? 1) == 1);
$coverage['consultation_benefit'] = ($isGp)
? $xCoverage['gp_consultation_benefit']
: $xCoverage['sp_consultation_benefit'];
$coverage['teleconsultation_benefit'] = ($isGp)
? $xCoverage['gp_teleconsultation_benefit']
: $xCoverage['sp_teleconsultation_benefit'];
$xCoverage['sp_admin_fee'] = (($configs['specialist_practitioner_fee']['value'] ?? 1) == 1);
$xCoverage['gp_admin_fee'] = (($configs['general_practitioner_fee']['value'] ?? 1) == 1);
$coverage['admin_fee'] = ($isGp)
? $xCoverage['gp_admin_fee']
: $xCoverage['sp_admin_fee'];
} else {
// Not Supported
$coverage['consultation_benefit'] = false;
$coverage['teleconsultation_benefit'] = false;
$coverage['admin_fee'] = false;
}
$limits['coverage'] = $coverage;
// TODO THIS EXCLUSION IS USED AS INCLUSION NOW, MUST BE CHANGE TO USED AS EXCLUSION AND MAYBE MOVE THE TABLE
$excluded = [];
foreach ($serviceSpecialityRules as $ruleName => $rule) {
if ($ruleName == 'msc') {
$values = explode(',', $rule->values);
if (!in_array(strtolower($member->marital_status), $values)) {
$excluded[] = $rule;
}
}
if ($ruleName == 'gender') {
$values = explode(',', $rule->values);
if (!in_array(strtolower($member->gender), $values)) {
$excluded[] = $rule;
}
}
if ($ruleName == 'min_age') {
if (!empty($rule->values) && $member->age < $rule->values) {
$excluded[] = $rule;
}
}
if ($ruleName == 'max_age') {
if (!empty($rule->values) && $member->age > $rule->values) {
$excluded[] = $rule;
}
}
if ($ruleName == 'plan') {
$values = explode(',', $rule->values);
if (!in_array($member->currentPlan->code, $values)) {
$excluded[] = $rule;
}
}
}
return Helper::responseJson(data: $limits);
}
}

4
frontend/dashboard/src/pages/Corporates/Services/Create.tsx
View File

@@ -88,7 +88,7 @@ export default function Divisions() {
// console.log('specialities', specialities);
useEffect(() => {
axios.get('/corporate/' + corporate_id + '/services/' + service_code).then((res) => {
axios.get('/corporates/' + corporate_id + '/services/' + service_code).then((res) => {
setService(res.data.service);
setPlans(
res.data.corporate.plans.map((item: any) => ({
@@ -135,7 +135,7 @@ export default function Divisions() {
const handleConfigChange = (event: ChangeEvent<HTMLInputElement>, service: any) => {
axios
.put(`/corporates/${corporate_id}/services`, {
service_code: service.service_code,
service_code: service_code,
config_name: event.target.name,
config_value: event.target.checked,
})