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Merge remote-tracking branch 'origin/staging' into origin/production

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This commit is contained in:
Linksehat Staging Server
2023-12-25 09:43:39 +07:00
parent f4f83b3c7b 89f879cfcc
commit fd15e4f377
577 changed files with 64446 additions and 14205 deletions
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45
app/Builders/MemberBuilder.php
View File

@@ -24,9 +24,24 @@ class MemberBuilder extends Builder
public function joinCorporateEmployees(string $value = 'join'): static
{
// return match ($value) {
// 'join' => $this->join('corporate_employees', 'members.id', '=', 'corporate_employees.member_id'),
// 'left' => $this->leftJoin('corporate_employees', 'members.id', '=', 'corporate_employees.member_id')
// };
return match ($value) {
'join' => $this->join('corporate_employees', 'members.id', '=', 'corporate_employees.member_id'),
'left' => $this->leftJoin('corporate_employees', 'members.id', '=', 'corporate_employees.member_id')
'join' => $this->join('corporate_employees', function ($join) {
$join->on('members.id', '=', 'corporate_employees.member_id')
->orWhere('members.principal_id', '=', 'corporate_employees.member_id');
}),
'left' => $this->leftJoin('corporate_employees', function ($join) {
$join->on('members.id', '=', 'corporate_employees.member_id')
->orWhere('members.principal_id', '=', 'corporate_employees.member_id');
}),
'right' => $this->rightJoin('corporate_employees', function ($join) {
$join->on('members.id', '=', 'corporate_employees.member_id')
->orWhere('members.principal_id', '=', 'corporate_employees.member_id');
})
};
}
@@ -40,11 +55,31 @@ class MemberBuilder extends Builder
public function joinClaimRequests(string $value = 'join'): static
{
// return match ($value) {
// 'join' => $this->join('claim_requests', 'members.id', '=', 'claim_requests.member_id'),
// 'left' => $this->leftJoin('claim_requests', 'members.id', '=', 'claim_requests.member_id'),
// // 'right' => $this->rightJoin('claim_requests', 'members.id', '=', 'claim_requests.member_id')
// 'right' => $this->rightJoin('claim_requests', function ($join) {
// $join->on('members.id', '=', 'claim_requests.member_id')
// ->orWhere('members.principal_id', '=', 'claim_requests.member_id');
// })
// };
return match ($value) {
'join' => $this->join('claim_requests', 'members.id', '=', 'claim_requests.member_id'),
'left' => $this->leftJoin('claim_requests', 'members.id', '=', 'claim_requests.member_id'),
'right' => $this->rightJoin('claim_requests', 'members.id', '=', 'claim_requests.member_id')
'join' => $this->join('claim_requests', function ($join) {
$join->on('members.id', '=', 'claim_requests.member_id')
->orWhere('members.principal_id', '=', 'claim_requests.member_id');
}),
'left' => $this->leftJoin('claim_requests', function ($join) {
$join->on('members.id', '=', 'claim_requests.member_id')
->orWhere('members.principal_id', '=', 'claim_requests.member_id');
}),
'right' => $this->rightJoin('claim_requests', function ($join) {
$join->on('members.id', '=', 'claim_requests.member_id')
->orWhere('members.principal_id', '=', 'claim_requests.member_id');
})
};
}
public function joinMemberPlans(string $value = 'join'): static

138
app/Helpers/Helper.php
View File

@@ -6,24 +6,41 @@ use Carbon\Carbon;
use Carbon\CarbonPeriod;
use Illuminate\Http\JsonResponse;
use Symfony\Component\HttpFoundation\Response;
use PHPMailer\PHPMailer\PHPMailer;
use Illuminate\Support\Facades\DB;
use App\Models\Member;
use App\Models\Service;
class Helper
{
public static function genderNormalization($anyGenderCode)
{
if ($anyGenderCode == 'M') {
return 'male';
return 'Male';
} else if ($anyGenderCode == 'F') {
return 'female';
return 'Female';
} else if ($anyGenderCode == 'O') {
return 'others';
return 'Others';
} else if ($anyGenderCode == 'U') {
return 'unknown';
return 'Unknown';
} else {
return null;
}
}
public static function maritalNormalization($code)
{
if ($code == 'M') {
return 'Married';
} else if ($code == 'D') {
return 'Divorced';
} else if ($code == 'S') {
return 'Single';
} else {
return '-';
}
}
public static function genderPerson($anyGenderCode)
{
if ($anyGenderCode == 'M') {
@@ -39,6 +56,44 @@ class Helper
}
}
public static function memberType($code){
if ($code == 'P') {
return 'Principal';
} else if ($code == 'D') {
return 'Dependent';
} else {
'-';
}
}
public static function relationWithPrincipal($code){
if ($code == 'H') {
return 'Husbund';
}
else if ($code == 'W') {
return 'Wife';
}
else if ($code == 'S') {
return 'Son';
}
else if ($code == 'D') {
return 'Daughter';
}
else {
'-';
}
}
public static function principalName($code){
$principalName = Member::where('member_id', $code)->get()->first();
return $principalName->name;
}
public static function serviceName($code){
$serviceName = Service::where('code', $code)->get()->first();
return $serviceName->name;
}
public static function paginateResources($resource)
{
return [
@@ -216,5 +271,80 @@ class Helper
return $sPaymentMethod[$id];
}
public static function formatDateDB($date){
$convertedDate = Carbon::createFromFormat('d-m-Y', $date)->format('Y-m-d H:i:s');
return $convertedDate;
}
public static function formatDateOnly($date){
// Membuat objek Carbon dengan tanggal asli dan zona waktu UTC
$carbonDate = Carbon::createFromFormat('Y-m-d\TH:i:s.u\Z', $date, 'UTC');
// Mengonversi tanggal ke zona waktu yang diinginkan
$carbonDate->setTimezone('Asia/Jakarta');
$convertedDate = $carbonDate->toDateString();
return $convertedDate;
}
public static function formatTimeOnly($date){
// Membuat objek Carbon dengan tanggal asli dan zona waktu UTC
$carbonDate = Carbon::createFromFormat('Y-m-d\TH:i:s.u\Z', $date, 'UTC');
// Mengonversi tanggal ke zona waktu yang diinginkan
$carbonDate->setTimezone('Asia/Jakarta');
$convertedDate = $carbonDate->toTimeString();
return $convertedDate;
}
public static function insertNotification($data = array())
{
try {
DB::beginTransaction();
DB::table('notifications')->insert($data);
DB::commit();
return true;
}
catch (\Exception $e) {
DB::rollback();
return $e->getMessage();
}
}
public static function sendEmail($data = array())
{
// Buat instance PHPMailer
$mail = new PHPMailer(true);
try {
// Server settings
$mail->isSMTP();
$mail->Host = 'smtp.gmail.com';
$mail->SMTPAuth = true;
$mail->Username = env('EMAIL');
$mail->Password = env('PW_EMAIL');
$mail->SMTPSecure = PHPMailer::ENCRYPTION_STARTTLS;
$mail->Port = 465;
$mail->SMTPSecure = "ssl";
// Penerima email
$mail->setFrom(env('EMAIL'), env('NAME_EMAIL'));
$mail->addAddress($data['email'], $data['name']);
// Konten email
$mail->isHTML(true);
$mail->Subject = $data['subject'];
$mail->Body = $data['body'];
// Kirim email
$mail->send();
return true;
} catch (\Exception $e) {
//var_dump($mail->ErrorInfo);die();
return false;
}
}
}

33
app/Http/Resources/OLDLMS/MemberResource.php
View File

@@ -3,8 +3,10 @@
namespace App\Http\Resources\OLDLMS;
use App\Services\ClaimService;
use App\Models\Corporate;
use Illuminate\Http\Resources\Json\JsonResource;
class MemberResource extends JsonResource
{
/**
@@ -21,28 +23,17 @@ class MemberResource extends JsonResource
$limitTelecon = $this->totalUsage >= 6 ? null : $limitTelecon;
$data = [
'id' => $this->id,
'member_name' => $this->full_name,
'member_id' => $this->member_id,
'birth_date' => $this->birth_date,
'email' => $this->email,
'phone' => $this->person->phone ?? null,
'full_name' => $this->full_name,
'nric' => $this->nric,
'plan' => $currentMemberPlan ? [
'code' => $currentMemberPlan->plan->code ?? null,
'start' => $currentMemberPlan->start,
'end' => $currentMemberPlan->end,
'limit' => $this->currentPlan->limit_rules,
'limit_consultation' => 6
] : null,
'policy_code' => $this->currentPolicy?->code ?? null,
'corporate' => [
'code' => $this->currentPolicy?->corporate->code ?? null,
'name' => $this->currentPolicy?->corporate->name,
'welcome_message' => $this->currentPolicy?->corporate->welcome_message,
'help_text' => $this->currentPolicy?->corporate?->help_text,
'avatar_url' => $this->currentpolicy?->corporate?->avatar_url
],
'limit_usage' => $this->totalUsage ?? null
'policy_holder' => $this->currentPolicy->corporate->name,
'policy_number' => $this->currentPolicy->code ?? null,
'date_of_birth' => $this->birth_date,
'gender' => $this->gender,
'start_date' => $this->members_effective_date,
'corporate_logo' => $_ENV['LMS_APP_STORAGE'] . $this->corporateLogo,
'valid_until' => $this->members_expire_date,
];
return $data;
}

21
app/Models/Claim.php
View File

@@ -29,11 +29,19 @@ class Claim extends Model
'currency',
'plan_id',
'benefit_id',
'organization_id',
'status',
'service_code',
'benefit_code',
'benefit_desc',
'amount_incurred',
'amount_approved',
'amount_not_approved',
'excess_paid',
];
protected $hidden = [
'created_at',
// 'created_at',
'updated_at',
'deleted_at',
'created_by',
@@ -195,6 +203,11 @@ class Claim extends Model
return $this->belongsTo(Member::class, 'member_id');
}
public function organization()
{
return $this->belongsTo(Organization::class, 'organization_id');
}
public function encounters()
{
return $this->belongsToMany(Encounter::class, 'claim_encounter');
@@ -251,5 +264,11 @@ class Claim extends Model
{
return $this->items->sum('nominal_ditagihkan');
}
public function historyHospitalCare()
{
return $this->hasMany(ClaimHistoryCare::class, 'claim_id');
}
}

12
app/Models/ClaimEncounter.php Normal file
View File

@@ -0,0 +1,12 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class ClaimEncounter extends Model
{
use HasFactory;
protected $table = 'claim_encounter';
}

60
app/Models/ClaimHistoryCare.php Normal file
View File

@@ -0,0 +1,60 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class ClaimHistoryCare extends Model
{
use HasFactory;
protected $fillable = [
'service_code',
'admission_date',
'discharge_date',
'claim_id',
'organization_id',
'practitioner_id',
'medical_record_number',
'symptoms',
'sign',
'main_diagnosis_id',
'status'
];
protected $hidden = [
'created_at',
'updated_at',
];
public function organization()
{
return $this->belongsTo(Organization::class, 'organization_id');
}
public function practitioner()
{
return $this->belongsTo(Practitioner::class, 'practitioner_id');
}
public function icd()
{
return $this->belongsTo(Icd::class, 'main_diagnosis_id');
}
public function claim()
{
return $this->hasOne(Claim::class, 'claim_id');
}
public function person()
{
return $this->belongsTo(Person::class, 'practitioner_id');
}
public function comparativeDiagnosis()
{
return $this->hasMany(DiagnosisSecondaryClaimHistoryCare::class, 'claim_history_care_id');
}
}

5
app/Models/ClaimItem.php
View File

@@ -25,6 +25,11 @@ class ClaimItem extends Model
return $this->belongsTo(Claim::class, 'claim_id');
}
public function benefit()
{
return $this->belongsTo(Benefit::class, 'claim_itemable_id');
}
public function claim_itemable()
{
return $this->morphTo();

119
app/Models/ClaimRequest.php
View File

@@ -14,7 +14,8 @@ class ClaimRequest extends Model
{
use HasFactory, SoftDeletes, Blameable;
protected static $code_prefix = 'CRQ';
// protected static $code_prefix_hospital = 'CRQ-H';
// protected static $code_prefix_client = 'CRQ-R';
public $fillable = [
'uuid',
@@ -24,7 +25,10 @@ class ClaimRequest extends Model
'service_code',
'policy_id',
'status',
'claim_id'
'claim_id',
'organization_id',
'code',
'request_log_id'
];
protected $hidden = [
@@ -36,6 +40,73 @@ class ClaimRequest extends Model
'deleted_by',
];
public static $doc_headers_to_field_map = [
"PAYOR ID" => "payor_id",
"CORPORATE ID" => "corporate_id",
"POLICY NUMBER" => "policy_number",
"MEMBER ID" => "member_id",
"MEMBER NAME" => "member_name",
"RECORD TYPE (P/D)" => "record_type",
"BENEFIT CODE" => "benefit_code",
"BENEFIT DESC" => "benefit_desc",
"CLAIM TYPE" => "claim_type",
"CLAIM PROCESS STATUS" => "status",
"CLIENT CLAIM ID" => "client_claim_id",
"REFERENCE NO" => "reference_no",
"ADMEDIKA CLAIM ID" => "admika_claim_id",
"PROVIDER CODE" => "provider_code",
"ADMISSION DATE" => "admission_date",
"DISCUTRGE DATE" => "discutrge_date",
"DURATION DAYS" => "duration_days",
"COVERAGE TYPE" => "coverage_type",
"PLAN ID" => "plan_id",
"DIAGNOSIS CODE" => "diagnosis_code",
"DIAGNOSIS DESC" => "diagnosis_desc",
"TOT AMT INCURRED" => "tot_amt_insurred",
"TOT AMT APPROVED" => "tot_amt_approved",
"TOT AMT NOT APPROVED" => "tot_amt_not_approved",
"TOT EXCESS PAID" => "tot_excess_paid",
"REMARKS" => "remarks",
"SECONDARY DIAGNOSIS CODE" => "secondary_diagnosis",
"APPROVED DATE" => "approved_date",
"APPROVED BY" => "approved_by",
"DATE RECEIVED" => "data_received",
"HOSPITAL INVOICE DATE" => "hospital_invoice_date",
];
public static $listing_doc_headers = [
"PAYOR ID",
"CORPORATE ID",
"POLICY NUMBER",
"MEMBER ID",
"MEMBER NAME",
"RECORD TYPE (P/D)",
"CLAIM TYPE",
"CLAIM PROCESS STATUS",
"CLIENT CLAIM ID",
"REFERENCE NO",
"ADMEDIKA CLAIM ID",
"PROVIDER CODE",
"ADMISSION DATE",
"DISCUTRGE DATE",
"DURATION DAYS",
"COVERAGE TYPE",
"PLAN ID",
"DIAGNOSIS CODE",
"DIAGNOSIS DESC",
"TOT AMT INCURRED",
"TOT AMT APPROVED",
"TOT AMT NOT APPROVED",
"TOT EXCESS PAID",
"REMARKS",
"SECONDARY DIAGNOSIS CODE",
"APPROVED DATE",
"APPROVED BY",
"DATE RECEIVED",
"HOSPITAL INVOICE DATE",
];
public static $status = [
'draft' => 'Draft',
'requested' => 'Requested',
@@ -59,7 +130,7 @@ class ClaimRequest extends Model
static::creating(function ($model) {
try {
$model->uuid = (string) Str::orderedUuid(); // generate uuid
$model->code = self::getNextCode();
// $model->code = self::getNextCode();
} catch (\Exception $e) {
abort(500, $e->getMessage());
}
@@ -112,19 +183,19 @@ class ClaimRequest extends Model
}
});
}
public static function getNextCode()
{
$last_number = self::withTrashed()->max('code');
$next_number = empty($last_number) ? 1 : ((int) explode('-', $last_number)[1] + 1);
return self::makeCode($next_number);
}
// public static function getNextCode()
// {
// $last_number = self::withTrashed()->max('code');
// $next_number = empty($last_number) ? 1 : ((int) explode('-', $last_number)[1] + 1);
public static function makeCode($next_number)
{
return (string) self::$code_prefix .'-'. str_pad($next_number, 5, 0, STR_PAD_LEFT);
}
// return self::makeCode($next_number);
// }
// public static function makeCode($next_number)
// {
// return (string) self::$code_prefix .'-'. str_pad($next_number, 5, 0, STR_PAD_LEFT);
// }
public function claim()
{
@@ -141,6 +212,21 @@ class ClaimRequest extends Model
return $this->morphMany(File::class, 'fileable');
}
public function claimResults()
{
return $this->files()->where('type', 'claim-result')->whereNull('deleted_at');
}
public function claimConditions()
{
return $this->files()->where('type', 'claim-kondisi')->whereNull('deleted_at');
}
public function claimDiagnosis()
{
return $this->files()->where('type', 'claim-diagnosis')->whereNull('deleted_at');
}
public function generatedDocuments()
{
return $this->morphMany(GeneratedDocument::class, 'generated_documentable');
@@ -151,6 +237,11 @@ class ClaimRequest extends Model
return $this->morphMany(ClaimHistory::class, 'historiable');
}
public function organization()
{
return $this->belongsTo(Organization::class, 'organization_id');
}
public function member()
{
return $this->belongsTo(Member::class, 'member_id', 'id');

8
app/Models/CorporateFormularium.php
View File

@@ -6,6 +6,7 @@ use App\Traits\Blameable;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Illuminate\Database\Eloquent\SoftDeletes;
use Altek\Accountant\Contracts\Recordable;
class CorporateFormularium extends Model
{
@@ -15,7 +16,8 @@ class CorporateFormularium extends Model
protected $fillable = [
'corporate_id',
'formularium_id'
'formularium_template_id',
'active'
];
public function corporate()
@@ -23,8 +25,8 @@ class CorporateFormularium extends Model
return $this->belongsTo(Corporate::class);
}
public function formularium()
public function formularium_template()
{
return $this->belongsTo(Formularium::class);
return $this->belongsTo(FormulariumTemplate::class);
}
}

36
app/Models/CorporateHospital.php Normal file
View File

@@ -0,0 +1,36 @@
<?php
namespace App\Models;
use App\Traits\Blameable;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Illuminate\Database\Eloquent\SoftDeletes;
class CorporateHospital extends Model
{
use HasFactory, SoftDeletes, Blameable;
protected $fillable = [
'corporate_id',
'organization_id',
'code',
'name',
'description',
'active',
];
public function corporate()
{
return $this->belongsTo(Corporate::class);
}
public function scopeFilter($query, array $filters)
{
$query->when($filters['search'] ?? false, function ($query, $search) {
return $query
->where('code', 'like', "%" . $search . "%")
->orWhere('name', 'like', "%" . $search . "%");
});
}
}

15
app/Models/CorporateManager.php
View File

@@ -11,4 +11,19 @@ class CorporateManager extends Model
use HasFactory, SoftDeletes;
protected $table = 'corporate_manager';
protected $fillable = [
'user_id',
'corporate_id'
];
public function user()
{
return $this->hasOne(User::class, 'id', 'user_id');
}
public function corporate()
{
return $this->hasOne(Corporate::class, 'id', 'corporate_id');
}
}

4
app/Models/CorporatePlan.php
View File

@@ -18,6 +18,10 @@ class CorporatePlan extends Model
'code',
'name',
'description',
'corporate_plan_id',
'service_code',
'type',
'limit_rules',
'active',
'reason'
];

61
app/Models/DailyMonitoring.php Normal file
View File

@@ -0,0 +1,61 @@
<?php
namespace App\Models;
use DB;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class DailyMonitoring extends Model
{
use HasFactory;
protected $table = "claim_daily_monitoring";
protected $fillable = [
'claim_id',
'subject',
'body_temperature',
'respiration_rate',
'sistole',
'diastole',
'analysis',
'complaints'
];
protected $appends = ['medical_plan'];
public function getBodyTemperatureAttribute()
{
return round($this->attributes['body_temperature'], 0);
}
public function getSistoleAttribute()
{
return round($this->attributes['sistole'], 0);
}
public function getDiastoleAttribute()
{
return round($this->attributes['diastole'], 0);
}
public function getRespirationRateAttribute()
{
return round($this->attributes['respiration_rate'], 0);
}
public function getMedicalPlanAttribute()
{
$arr_medical_plan = [];
$medical_plan = DB::table('medical_plan')->where('claim_daily_monitoring_id','=',$this->attributes['id'])->get();
foreach ($medical_plan as $row) {
$arr_medical_plan[] = [
'medical_plan_str' => $row->plan
];
}
return $arr_medical_plan;
}
}

28
app/Models/DiagnosisSecondaryClaimHistoryCare.php Normal file
View File

@@ -0,0 +1,28 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class DiagnosisSecondaryClaimHistoryCare extends Model
{
use HasFactory;
protected $table = 'diagnosis_secondary_claim_history_care';
protected $fillable = [
'claim_history_care_id',
'icd_id',
];
protected $hidden = [
'created_at',
'updated_at',
];
public function icd()
{
return $this->belongsTo(Icd::class, 'icd_id');
}
}

3
app/Models/Drug.php
View File

@@ -25,7 +25,8 @@ class Drug extends Model
'dosage',
'remark',
'selling_unit_id',
'status'
'status',
'active',
];
public function categories()

3
app/Models/Exclusion.php
View File

@@ -6,6 +6,7 @@ use App\Traits\Blameable;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Illuminate\Database\Eloquent\SoftDeletes;
use Altek\Accountant\Contracts\Recordable;
class Exclusion extends Model
{
@@ -17,6 +18,8 @@ class Exclusion extends Model
'type',
'exclusionable_id',
'exclusionable_type',
'active',
'reason'
];
protected $hidden = [

24
app/Models/ExclusionImport.php Normal file
View File

@@ -0,0 +1,24 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Altek\Accountant\Contracts\Recordable;
class ExclusionImport extends Model
{
use HasFactory;
protected $fillable = [
'corporate_id',
'file_name',
'file_path',
];
protected $hidden = [
'created_at',
'updated_at',
];
}

1
app/Models/ExclusionRules.php
View File

@@ -6,6 +6,7 @@ use App\Traits\Blameable;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Illuminate\Database\Eloquent\SoftDeletes;
use Altek\Accountant\Contracts\Recordable;
class ExclusionRules extends Model
{

10
app/Models/File.php
View File

@@ -19,6 +19,8 @@ class File extends Model
'original_name',
'extension',
'path',
'created_by',
'updated_by',
];
protected $hidden = [
@@ -43,6 +45,12 @@ class File extends Model
'claim-result' => 'claim/',
'claim-diagnosis' => 'claim/',
'claim-kondisi' => 'claim/',
'claim-invoice' => 'claim/',
'final-log-result' => 'final-log/',
'final-log-diagnosis' => 'final-log/',
'final-log-kondisi' => 'final-log/',
'docs' => 'docs/',
'additional-files' => 'additional-files/',
];
public function fileable()
@@ -52,7 +60,7 @@ class File extends Model
public static function getDirectory($type)
{
return self::$file_directories[$type] ?? 'any';
return self::$file_directories[$type] ?? 'any/';
}
public static function getFileName($type, $id)

14
app/Models/FilesDoc.php Normal file
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@@ -0,0 +1,14 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class FilesDoc extends Model
{
use HasFactory;
protected $table = 'files_doc';
protected $primaryKey = 'id';
protected $fillable = ['corporate_id', 'original_name', 'path','status_download', 'created_by','updated_by', 'created_at', 'updated_at'];
}

18
app/Models/Formularium.php
View File

@@ -17,6 +17,19 @@ class Formularium extends Model
protected $fillable = [
'code',
'name',
'description',
'manufacturer',
'category_name',
'kategori_obat',
'uom',
'general_indication',
'composition',
'atc_code',
'class',
'bpom_registration',
'classifications',
'cat_for',
'formularium_template_id'
];
public function setCodeAttribute($value)
@@ -24,11 +37,6 @@ class Formularium extends Model
$this->attributes['code'] = !empty($value) ? $value : Str::upper(Str::random('6'));
}
public function corporateFormulariums()
{
return $this->hasMany(CorporateFormularium::class);
}
public function items()
{
return $this->belongsToMany(Drug::class, 'formularium_items', 'formularium_id', 'item_id');

32
app/Models/FormulariumTemplate.php Normal file
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@@ -0,0 +1,32 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Altek\Accountant\Contracts\Recordable;
class FormulariumTemplate extends Model
{
use HasFactory;
protected $fillable = [
'name',
'description',
'active',
];
protected $hidden = [
'created_at',
'updated_at',
// 'deleted_at',
'created_by',
'updated_by',
// 'deleted_by',
];
// public function corporateFormulariums()
// {
// return $this->hasMany(CorporateFormularium::class, 'formularium_template_id', 'id');
// }
}

23
app/Models/Icd.php
View File

@@ -6,6 +6,7 @@ use App\Traits\Blameable;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Illuminate\Database\Eloquent\SoftDeletes;
use Altek\Accountant\Contracts\Recordable;
class Icd extends Model
{
@@ -20,11 +21,13 @@ class Icd extends Model
'name',
'description',
'parent_code',
'active',
'icd_template_id'
];
public $appends = [
'type',
'active'
// 'active'
];
protected $hidden = [
@@ -41,10 +44,10 @@ class Icd extends Model
return 'ICD-'.$this->rev;
}
public function getActiveAttribute()
{
return empty($this->deleted_at);
}
// public function getActiveAttribute()
// {
// return empty($this->deleted_at);
// }
public function subCategories()
{
@@ -71,4 +74,14 @@ class Icd extends Model
});
}
public function claim_history_care()
{
return $this->hasMany(CliamHistoryCare::class, 'main_diagnosis_id', 'id');
}
public function diagnosis_secondary_claim_history_care()
{
return $this->hasMany(DiagnosisSecondaryCliamHistoryCare::class, 'icd_id', 'id');
}
}

32
app/Models/IcdTemplate.php Normal file
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@@ -0,0 +1,32 @@
<?php
namespace App\Models;
use App\Traits\Blameable;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
// use Illuminate\Database\Eloquent\SoftDeletes;
use Altek\Accountant\Contracts\Recordable;
class IcdTemplate extends Model
{
use HasFactory;
protected $table = 'icd_template';
protected $fillable = [
'code',
'name',
'description',
'active'
];
protected $hidden = [
'created_at',
'updated_at',
// 'deleted_at',
'created_by',
'updated_by',
// 'deleted_by',
];
}

39
app/Models/LaboratoriumResult.php Normal file
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@@ -0,0 +1,39 @@
<?php
namespace App\Models;
use DB;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class LaboratoriumResult extends Model
{
use HasFactory;
protected $table = "laboratorium_result";
protected $fillable = [
'claim_id',
'date',
'location',
'examination',
];
protected $appends = ['lab_result_file'];
protected $path_for_public = 'storage/lab_result';
public function getLabResultFileAttribute()
{
$arr_files = [];
$files = DB::table('files')->select('name','original_name','path','extension')->where("type","=","laboratorium-result")->where('fileable_id','=',$this->attributes['id'])->get();
foreach ($files as $row) {
$row->path = url($this->path_for_public . "/" . $row->original_name);
$arr_files[] = [
'lab_result_file_obj' => $row
];
}
return $arr_files;
}
}

18
app/Models/MedicalPlan.php Normal file
View File

@@ -0,0 +1,18 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class MedicalPlan extends Model
{
use HasFactory;
protected $table = "medical_plan";
protected $fillable = [
'claim_daily_monitoring_id',
'plan'
];
}

49
app/Models/Member.php
View File

@@ -63,6 +63,7 @@ class Member extends Model
"policy_in_force",
"start_no_claim",
"end_no_claim",
"suspended"
];
protected $appends = [
@@ -98,6 +99,12 @@ class Member extends Model
return $this->hasMany(Claim::class, 'member_id', 'id');
}
public function claimRequest()
{
return $this->hasMany(ClaimRequest::class, 'member_id', 'id')->where('claim_id', '!=', null);
}
public function postponedClaims()
{
return $this->hasMany(Claim::class, 'member_id', 'id')->where('status', 'postpone');
@@ -142,12 +149,35 @@ class Member extends Model
return $this->hasManyThrough(Plan::class, MemberPlan::class, 'member_id', 'id', 'id', 'plan_id');
}
public function currentPlans()
{
return $this->hasManyThrough(Plan::class, MemberPlan::class, 'member_id', 'id', 'id', 'plan_id');
// ->latest(); // TODO Fix This
}
public function currentPlan()
{
return $this->hasOneThrough(Plan::class, MemberPlan::class, 'member_id', 'id', 'id', 'plan_id')
->latest(); // TODO Fix This
return $this->hasOneThrough(Plan::class, MemberPlan::class, 'member_id', 'id', 'id', 'plan_id', )
->latest();
// ->where('plans.service_code', $this->claimRequest->service_code); // TODO Fix This
}
// public function currentPlan()
// {
// return $this->hasOneThrough(
// Plan::class,
// MemberPlan::class,
// 'member_id',
// 'id',
// 'id',
// 'plan_id'
// )
// ->join('claim_requests', 'claim_requests.service_code', '=', 'plans.service_code')
// ->latest('claim_requests.created_at') // Atau sesuaikan dengan kolom timestamp yang sesuai
// ->select('plans.*');
// }
public function currentEmployeds()
{
return $this->hasOneThrough(CorporateEmployee::class, Person::class, 'nik', 'id', 'id', 'nik')
@@ -240,5 +270,20 @@ class Member extends Model
get: fn () => $this->person->gender ?? null
);
}
protected function corporateLogo(): Attribute
{
$avatar = File::where(['type' => 'avatar', 'fileable_id' => $this->currentPolicy->corporate->id])->orderBy('id', 'desc')->get()->first();
if ($avatar){
$path = $_ENV['LMS_APP_STORAGE'] . $avatar->path ? $avatar->path :'';
return Attribute::make(
get: fn () => $avatar ? $path : null
);
} else {
return Attribute::make(
get: fn () => null
);
}
}
/* -------------------------------------------------------------------------- */
}

18
app/Models/OLDLMS/PersonalAccessToken.php Normal file
View File

@@ -0,0 +1,18 @@
<?php
namespace App\Models\OLDLMS;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Laravel\Sanctum\PersonalAccessToken as SanctumPersonalAccessToken;
class PersonalAccessToken extends SanctumPersonalAccessToken
{
use HasFactory;
protected $table = 'personal_access_tokens';
protected $connection = 'oldlms';
}

19
app/Models/OLDLMS/User.php
View File

@@ -2,14 +2,20 @@
namespace App\Models\OLDLMS;
use Illuminate\Database\Eloquent\Casts\Attribute;
use Illuminate\Contracts\Auth\MustVerifyEmail;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Foundation\Auth\User as Authenticatable;
use Illuminate\Database\Eloquent\Casts\Attribute;
use Illuminate\Database\Eloquent\Model;
use Illuminate\Database\Eloquent\SoftDeletes;
use Laravel\Sanctum\HasApiTokens;
use Spatie\Permission\Traits\HasRoles;
use Illuminate\Notifications\Notifiable;
class User extends Model
class User extends Authenticatable
{
use HasFactory, SoftDeletes;
use HasFactory, SoftDeletes, HasApiTokens, HasRoles, Notifiable, Notifiable;
const CREATED_AT = 'dCreateOn';
const UPDATED_AT = 'dUpdateOn';
@@ -55,9 +61,14 @@ class User extends Model
{
return $this->hasOne(UserDetail::class, 'nIDUser', 'nID');
}
public function insurances()
{
return $this->hasMany(UserInsurance::class, 'nIDUser', 'nID');
}
public function notificationTokens()
{
return $this->morphMany(NotificationToken::class, 'notifiabletoken');
}
}

4
app/Models/OLDLMS/UserDetail.php
View File

@@ -26,6 +26,10 @@ class UserDetail extends Model
'nIDJenisKelamin',
'sCreateBy',
'sKTP',
'sImages',
'sWeight',
'sHeight',
'nIDGolonganDarah',
];

2
app/Models/OLDLMS/UserInsurance.php
View File

@@ -26,5 +26,7 @@ class UserInsurance extends Model
'dTanggalLahir',
'nNoKTP',
'sNoPolis',
'nIDInsurance',
'sLayanan',
];
}

13
app/Models/Organization.php
View File

@@ -98,4 +98,17 @@ class Organization extends Model
{
return $this->hasMany(PractitionerRole::class, 'organization_id');
}
public function claims()
{
return $this->hasMany(Claim::class, 'organization_id', 'id');
}
public function claim_request()
{
return $this->hasMany(ClaimRequest::class, 'organization_id', 'id');
}
public function claim_history_care()
{
return $this->hasOne(ClaimHistoryCare::class, 'organization_id', 'id');
}
}

20
app/Models/OrganizationUser.php Normal file
View File

@@ -0,0 +1,20 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class OrganizationUser extends Model
{
use HasFactory;
protected $table = 'organization_user';
protected $connection = 'mysql';
protected $fillable = [
'organization_id',
];
public function organization(){
return $this->hasOne(Organization::class, 'id', 'organization_id');
}
}

4
app/Models/Person.php
View File

@@ -71,7 +71,9 @@ class Person extends Model
public function currentAddress()
{
return $this->belongsTo(Address::class, 'main_address_id');
return $this->belongsTo(Address::class, 'main_address_id')->withDefault([
'text' => '',
]);
}
public function domicileAddress()

7
app/Models/Practitioner.php
View File

@@ -47,4 +47,11 @@ class Practitioner extends Model
{
return $this->hasMany(PractitionerRole::class, 'practitioner_id');
}
public function claim_history_care()
{
return $this->hasMany(ClaimHistoryCare::class, 'practitioner_id');
}
}

220
app/Models/RequestLog.php Normal file
View File

@@ -0,0 +1,220 @@
<?php
namespace App\Models;
use App\Events\ClaimReceived;
use App\Events\ClaimRequested;
use App\Traits\Blameable;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
use Illuminate\Database\Eloquent\SoftDeletes;
use Str;
class RequestLog extends Model
{
use HasFactory, SoftDeletes, Blameable;
// protected static $code_prefix_hospital = 'CRQ-H';
// protected static $code_prefix_client = 'CRQ-R';
public $fillable = [
'uuid',
'submission_date',
'member_id',
'payment_type',
'service_code',
'policy_id',
'final_log',
'status',
'status_final_log',
'source',
'claim_id',
'organization_id',
'code'
];
protected $hidden = [
// 'created_at',
'updated_at',
'deleted_at',
'created_by',
'updated_by',
'deleted_by',
];
public static $doc_headers_to_field_map = [
"ID REQUEST LOG" => "id",
"STATUS (approved, declined, requested)" => "status",
];
public static $listing_doc_headers = [
"ID REQUEST LOG",
"STATUS (approved, declined, requested)",
];
public static $listing_data_doc_headers = [
"ID REQUEST LOG",
"CODE",
"NAME",
"DATE OF SUBMISSION",
"SERVICE TYPE",
"CLAIM METHOD",
"STATUS",
];
public static $status = [
'draft' => 'Draft',
'requested' => 'Requested',
'approved' => 'Approved',
'declined' => 'Declined'
];
public static $payment_types = [
'cashless' => 'Cashless',
'reimbursement' => 'Reimbursement'
];
public $appends = [
'payment_type_name'
];
protected static function boot()
{
parent::boot();
static::creating(function ($model) {
try {
$model->uuid = (string) Str::orderedUuid(); // generate uuid
// $model->code = self::getNextCode();
} catch (\Exception $e) {
abort(500, $e->getMessage());
}
});
static::created(function ($model) {
// try {
// if (!empty($model->status) && $model->status == 'requested') {
// $model->histories()->create([
// 'title' => 'New Claim Requested',
// 'description' => "Claim Requested for Member : {$model->member->member_id} - ({$model->member->full_name})",
// 'type' => 'info'
// ]);
// }
// } catch (\Exception $e) {
// abort(500, $e->getMessage());
// }
});
static::updated(function ($model) {
if ($model->hasChanges(['status'])) {
// if ($model->status == 'requested') {
// $model->histories()->create([
// 'title' => 'New Claim Requested',
// 'description' => "Claim Requested for Member : {$model->member->member_id} - ({$model->member->full_name})",
// 'type' => 'info'
// ]);
// }
// if ($model->status == 'received') {
// ClaimReceived::dispatch($model);
// }
// if ($model->status == 'approved') {
// ClaimApproved::dispatch($model);
// }
// if ($model->status == 'postpone') {
// ClaimPostpone::dispatch($model);
// }
// if ($model->status == 'paid') {
// ClaimPaid::dispatch($model);
// }
// if ($model->status == 'declined') {
// ClaimDeclined::dispatch($model);
// }
}
});
}
// public static function getNextCode()
// {
// $last_number = self::withTrashed()->max('code');
// $next_number = empty($last_number) ? 1 : ((int) explode('-', $last_number)[1] + 1);
// return self::makeCode($next_number);
// }
// public static function makeCode($next_number)
// {
// return (string) self::$code_prefix .'-'. str_pad($next_number, 5, 0, STR_PAD_LEFT);
// }
public function claim()
{
return $this->belongsTo(Claim::class, 'claim_id');
}
public function claims()
{
return $this->hasMany(Claim::class, 'claim_request_id');
}
public function files()
{
return $this->morphMany(File::class, 'fileable');
}
public function claimResults()
{
return $this->files()->where('type', 'claim-result')->whereNull('deleted_at');
}
public function claimConditions()
{
return $this->files()->where('type', 'claim-kondisi')->whereNull('deleted_at');
}
public function claimDiagnosis()
{
return $this->files()->where('type', 'claim-diagnosis')->whereNull('deleted_at');
}
public function generatedDocuments()
{
return $this->morphMany(GeneratedDocument::class, 'generated_documentable');
}
public function histories()
{
return $this->morphMany(ClaimHistory::class, 'historiable');
}
public function organization()
{
return $this->belongsTo(Organization::class, 'organization_id');
}
public function member()
{
return $this->belongsTo(Member::class, 'member_id', 'id');
}
public function service()
{
return $this->belongsTo(Service::class, 'service_code', 'code');
}
public function getPaymentTypeNameAttribute()
{
return self::$payment_types[$this->payment_type] ?? $this->payment_type;
}
public function getStatusAttribute($value)
{
return self::$payment_types[$value] ?? $value;
}
}

27
app/Models/RequestLogBenefit.php Normal file
View File

@@ -0,0 +1,27 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class RequestLogBenefit extends Model
{
use HasFactory;
protected $table = 'request_log_benefits';
public $fillable = [
'request_log_id',
'benefit_id',
'amount_incurred',
'amount_approved',
'amount_not_approved',
'excess_paid',
'keterangan',
];
public function benefit(){
return $this->belongsTo(Benefit::class, 'benefit_id', 'id');
}
}

30
app/Models/RequestLogMedicine.php Normal file
View File

@@ -0,0 +1,30 @@
<?php
namespace App\Models;
use Illuminate\Database\Eloquent\Factories\HasFactory;
use Illuminate\Database\Eloquent\Model;
class RequestLogMedicine extends Model
{
use HasFactory;
public $fillable = [
'request_log_id',
'medicine',
'price',
];
protected $hidden = [
'created_at',
'updated_at',
'deleted_at',
'created_by',
'updated_by',
'deleted_by',
];
public function benefit(){
return $this->belongsTo(Benefit::class, 'benefit_id', 'id');
}
}

7
app/Models/User.php
View File

@@ -18,6 +18,8 @@ class User extends Authenticatable
*
* @var array<int, string>
*/
protected $connection = 'mysql';
protected $fillable = [
'person_id',
'name',
@@ -103,4 +105,9 @@ class User extends Authenticatable
{
return $this->morphMany(NotificationToken::class, 'notifiabletoken');
}
public function getOrganization()
{
return $this->hasOne(OrganizationUser::class, 'user_id');
}
}

102
app/Providers/AppServiceProvider.php
View File

@@ -7,12 +7,23 @@ use Illuminate\Support\Facades\Schema;
use Illuminate\Support\Facades\Validator;
use Illuminate\Support\ServiceProvider;
use App\Models\Corporate;
use App\Models\CorporateFormularium;
use App\Models\CorporateService;
use App\Models\CorporatePlan;
use App\Models\CorporateBenefit;
use App\Models\Member;
use App\Models\CorporateHospital;
use App\Models\ExclusionRules;
use App\Models\ExclusionImport;
use App\Models\Icd;
use App\Models\IcdTemplate;
use App\Models\FormulariumTemplate;
use App\Models\AuditTrail;
use Illuminate\Support\Facades\Auth;
use App\Models\OLDLMS\PersonalAccessToken;
use Laravel\Sanctum\Sanctum;
use Str;
class AppServiceProvider extends ServiceProvider
@@ -35,7 +46,7 @@ class AppServiceProvider extends ServiceProvider
public function boot()
{
Schema::defaultStringLength(191);
Str::macro('initials', fn($value, $sep = ' ', $glue = '') => trim(collect(explode($sep, $value))->map(function ($segment) {
return $segment[0] ?? '';
})->join($glue)));
@@ -46,7 +57,7 @@ class AppServiceProvider extends ServiceProvider
// });
Corporate::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
@@ -55,7 +66,7 @@ class AppServiceProvider extends ServiceProvider
});
Member::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
@@ -63,10 +74,20 @@ class AppServiceProvider extends ServiceProvider
$this->logAuditTrail($model, 'deleted');
});
//Hospital
CorporateHospital::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
CorporateHospital::deleted(function ($model) {
$this->logAuditTrail($model, 'deleted');
});
// Corporate Service
CorporateService::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
@@ -76,7 +97,7 @@ class AppServiceProvider extends ServiceProvider
// Corporate Plans
CorporatePlan::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
@@ -86,7 +107,7 @@ class AppServiceProvider extends ServiceProvider
// Corporate Benefits
CorporateBenefit::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
@@ -95,6 +116,60 @@ class AppServiceProvider extends ServiceProvider
});
// Corporate Exclusion
ExclusionRules::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
ExclusionRules::deleted(function ($model) {
$this->logAuditTrail($model, 'deleted');
});
ExclusionImport::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
ExclusionImport::deleted(function ($model) {
$this->logAuditTrail($model, 'deleted');
});
// ICD or exlusion
Icd::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
Icd::deleted(function ($model) {
$this->logAuditTrail($model, 'deleted');
});
// ICD or exlusion
IcdTemplate::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
IcdTemplate::deleted(function ($model) {
$this->logAuditTrail($model, 'deleted');
});
// Formualrium Template
FormulariumTemplate::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
FormulariumTemplate::deleted(function ($model) {
$this->logAuditTrail($model, 'deleted');
});
// Formualrium Template
CorporateFormularium::updated(function ($model) {
$this->logAuditTrail($model, 'updated');
});
CorporateFormularium::deleted(function ($model) {
$this->logAuditTrail($model, 'deleted');
});
Sanctum::usePersonalAccessTokenModel(PersonalAccessToken::class);
}
private function logAuditTrail($model, $action)
@@ -109,6 +184,21 @@ class AppServiceProvider extends ServiceProvider
'user_id' => Auth::id(),
]);
// Simpan jejak audit
$auditTrail->save();
}
private function logAuditTrailExclusion($model, $action)
{
// Membuat jejak audit baru
$auditTrail = new AuditTrail([
'model' => get_class($model),
'model_id' => $model->corporate_id,
'action' => $action,
'old_values' => json_encode($model->getOriginal()),
'new_values' => json_encode($model->getAttributes()),
'user_id' => Auth::id(),
]);
// Simpan jejak audit
$auditTrail->save();
}

144
app/Services/ClaimRequestService.php
View File

@@ -6,32 +6,101 @@ use App\Events\ClaimApproved;
use App\Events\ClaimRequested;
use App\Models\Claim;
use App\Models\ClaimRequest;
use App\Models\Organization;
use App\Helpers\Helper;
use App\Models\Icd;
use App\Models\Member;
use Carbon\Carbon;
use App\Exceptions\ImportRowException;
use Box\Spout\Writer\Common\Creator\WriterEntityFactory;
use DB;
use Str;
class ClaimRequestService{
public static function storeClaimRequest($member, $paymentType, $serviceCode, $submissionDate = null, $status = 'requested')
public static function storeClaimRequest($row = null, $code, $member, $paymentType, $serviceCode, $requestLogID, $submissionDate = null, $status = 'requested', $organization_code = null)
{
try {
// try {
$organization = False;
if($organization_code){
$organization = Organization::where('code', $organization_code)->first();
if (!$organization){
throw new ImportRowException(__('Code Provider Tidak ditemukan', [
'attribute' => 'provider_code',
'code' => $row['provider_code']
]), 403, null, $row);
}
};
DB::beginTransaction();
$claimRequestData = [
'code' => $code,
'request_log_id' => $requestLogID,
'member_id' => $member->id,
'submission_date' => $submissionDate ?? now(),
'status' => $status,
'payment_type' => $paymentType,
'service_code' => $serviceCode,
'policy_id' => $member->currentPolicy->id ?? null,
'organization_id' => $organization ? $organization->id : 0,
];
$claimRequest = ClaimRequest::create($claimRequestData);
DB::commit();
return $claimRequest;
// } catch (\Exception $error) {
// DB::rollBack();
// throw new \Exception($error);
// }
}
public static function storeClaimManagement($row, $member, $claim_request_id){
try {
$organization = 0;
if($row['provider_code']){
$organization = Organization::where('code', $row['provider_code'])->first();
if (!$organization){
throw new ImportRowException(__('Provider Tidak ditemukan'), 0, null, $row);
}
};
if(!$member){
throw new ImportRowException(__('Member Tidak ditemukan'), 0, null, $row);
};
DB::beginTransaction();
$data = [
'member_id' => $member->id,
'currency' => 'IDR',
'plan_id' => $member->currentPlan->id,
'total_claim' => $row['tot_amt_insurred'] ? $row['tot_amt_insurred'] : 0,
'benefit_code' => $row['benefit_code'] ? $row['benefit_code'] : '-',
'benefit_desc' => $row['benefit_desc'] ? $row['benefit_desc'] : '-',
'amount_incurred' => $row['tot_amt_insurred'] ? $row['tot_amt_insurred'] : 0,
'amount_approved' => $row['tot_amt_approved'] ? $row['tot_amt_approved'] : 0,
'amount_not_approved' => $row['tot_amt_not_approved'] ? $row['tot_amt_not_approved'] :0,
'excess_paid' => $row['tot_excess_paid'] ? $row['tot_excess_paid'] : 0,
'claim_request_id' => $claim_request_id,
'organization_id' => $organization ? $organization->id : NULL,
'status' => 'requested'
];
$claimManagement = Claim::create($data);
// update client id di claim request
ClaimRequest::where('id', $claim_request_id)->update([
'claim_id' => $claimManagement->id,
]);
DB::commit();
return $claimManagement;
} catch (\Exception $error) {
DB::rollBack();
@@ -39,4 +108,73 @@ class ClaimRequestService{
}
}
public static function updateClaimRequest($organization_id, $claim_request_id){
try {
$data = [
'organization_id' => $organization_id
];
DB::commit();
$update = ClaimRequest::where('id', $claim_request_id)->update($data);
return ClaimRequest::find($claim_request_id);
} catch (\Exception $error) {
DB::rollBack();
throw new \Exception($error);
}
}
protected function validatePlanRow($row)
{
if (empty($row['member_id'])) {
throw new ImportRowException(__('Member ID Required'), 0, null, $row);
}
}
public function handleClaimRequestRow($row)
{
try {
$member = Member::where('member_id', $row['member_id'])->with(['currentPlan'])->first();
if(!$member){
throw new ImportRowException(__('Member Tidak ditemukan'), 0, null, $row);
};
$code = $row['client_claim_id'];
$organization_id = $row['provider_code'];
$submissionDate = Helper::formatDateDB($row['admission_date']);
$paymentType = $row['claim_type'];
$status = $row['status'];
$serviceCode = $row['coverage_type'];
$newClaimRequest = $this->storeClaimRequest(
row: $row,
code: $code,
member: $member,
paymentType: $paymentType,
serviceCode: $serviceCode,
submissionDate: $submissionDate,
status: $status,
organization_code: $organization_id
);
$newlyCreatedID = $newClaimRequest->id;
$newClaimManangement = $this->storeClaimManagement($row, $member, $newlyCreatedID);
ClaimRequested::dispatch($newClaimRequest);
// Log History
$newClaimRequest->histories()->create([
'title' => 'New Claim Requested',
'description' => "Claim Requested for Member : {$member->member_id} - ({$member->full_name})",
'type' => 'info',
'system_origin' => 'import-internal-aso'
]);
$claim_request_data = $row;
$this->validatePlanRow($claim_request_data);
return $newClaimRequest;
} catch (\Exception $e) {
throw $e;
}
}
}

107
app/Services/CorporateMemberService.php
View File

@@ -6,6 +6,7 @@ use App\Models\Member;
use App\Models\Encounter;
use Illuminate\Database\Eloquent\Builder;
use Illuminate\Http\Request;
use Illuminate\Support\Facades\DB;
class CorporateMemberService
{
@@ -34,7 +35,7 @@ class CorporateMemberService
'division' => 'corporate_divisions.name',
default => ''
};
if ($request->order){
if ($request->order) {
$query->getQuery()->orderBy($orderBy, $request->order);
}
})
@@ -44,14 +45,57 @@ class CorporateMemberService
}
public function getAllMemberClaimReports(int $corporateId, Request $request)
{
$limit = $request->has('per_page') ? $request->input('per_page') : 10;
$results = DB::table('claim_requests')
->leftJoin('claims', 'claim_requests.id', '=', 'claims.claim_request_id')
->leftJoin('members', 'claim_requests.member_id', '=', 'members.id')
->leftJoin('corporate_employees', 'members.id', '=', 'corporate_employees.member_id')
->leftJoin('corporate_divisions', 'corporate_employees.division_id', '=', 'corporate_divisions.id')
->where('corporate_employees.corporate_id', '=', $corporateId)
->when($request->input('search'), function ($query, $search) {
$query->where(function ($query) use ($search) {
$query->orWhere('claim_requests.code', 'like', "%" . $search . "%")
->orWhere('members.member_id', 'like', "%" . $search . "%")
->orWhere('members.name', 'like', "%" . $search . "%")
->orWhere('corporate_divisions.name', 'like', "%" . $search . "%")
->orWhere('claim_requests.status', 'like', "%" . $search . "%")
->orWhere('claim_requests.submission_date', 'like', "%" . $search . "%");
});
})
->when($request->has('orderBy'), function ($query) use ($request) {
$orderBy = $request->orderBy;
$direction = $request->order ?? 'asc';
$query->orderBy($orderBy, $direction);
})
->select('members.id', 'claim_requests.code','members.member_id', 'members.name as full_name', 'corporate_divisions.name AS division_name',
DB::raw('
CASE
WHEN claim_requests.status = "requested" THEN "requested"
WHEN claim_requests.status = "approved" AND claims.status = "approved" THEN "approved"
WHEN claim_requests.status = "approved" AND claims.status = "declined" THEN "declined"
WHEN claim_requests.status = "approved" AND claims.status = "disbrusmented" THEN "disbrusmented"
/*WHEN claim_requests.status = "approved" AND claims.status = "received" THEN "pending"*/
WHEN claim_requests.status = "approved" AND claims.status = "received" THEN "reviewed"
ELSE ""
END AS status
'),
'claim_requests.id AS claim_request_id', 'claim_requests.submission_date')
->paginate($limit);
return $results;
}
public function getAllMemberClaimSubmits(int $corporateId, Request $request)
{
$limit = $request->has('perPage') ? $request->input('perPage') : 10;
return Member::query()
->joinClaimRequests('right')
// ->joinClaimRequests('right')
->joinCorporateEmployees('left')
->joinCorporateDivisions('left')
->with('currentPlan')
->with('currentPlans')
->withSum('claims', 'total_claim')
->whereHas('employeds', function (Builder $corporateEmployee) use ($corporateId) {
$corporateEmployee->where('corporate_id', $corporateId);
@@ -80,11 +124,62 @@ class CorporateMemberService
$query->getQuery()->orderBy('corporate_divisions.name', $request->order);
}
})
->select(['members.id', 'members.person_id', 'members.member_id', 'members.name', 'corporate_divisions.name AS division_name', 'members.active', 'claim_requests.id', 'claim_requests.member_id', 'claim_requests.submission_date'])
// ->select(['members.id', 'members.person_id', 'members.member_id', 'members.name', 'corporate_divisions.name AS division_name', 'members.active', 'claim_requests.id', 'claim_requests.member_id', 'claim_requests.submission_date'])
->select(['members.id', 'members.person_id', 'members.member_id', 'members.name', 'corporate_divisions.name AS division_name', 'members.active', ])
->paginate($limit);
}
public function getAllMemberAlarmCenter(int $corporateId, Request $request)
{
$limit = $request->has('perPage') ? $request->input('perPage') : 10;
$start_date = date('Y-m-d', strtotime($request->input('start_date') . ' +1 day'));
$end_date = date('Y-m-d', strtotime($request->input('end_date') . ' +1 day'));
// dd($request);
return Member::query()
->joinCorporateEmployees('left')
->joinMemberPlans('left')
->joinPlans('left')
->with(['currentPlan', 'person'])
->where('corporate_employees.corporate_id', $corporateId)
->when($request->input('search'), function (Builder $query, $search) {
$query->where(function (Builder $query) use ($search) {
$query->orWhere('members.member_id', 'like', "%" . $search . "%")
->orWhere('members.name', 'like', "%" . $search . "%");
});
})
->when($request->input('start_date'), function (Builder $query, $start) {
$query->where('member_plans.start', '>=', $start);
})
->when($request->input('end_date'), function (Builder $query, $end) {
$query->where('member_plans.end', '<', $end);
})
->when($request->input('division'), function (Builder $query, $value) {
$query->where('corporate_employees.division_id', $value);
})
->when($request->input('status'), function (Builder $query, $value) {
$query->where('plans.active', $value);
})
->when($request->has('orderBy'), function (Builder $query) use ($request) {
$orderBy = match ($request->input('orderBy')) {
'memberId' => 'member_id',
'fullName' => 'name',
'status' => 'active',
'start_date' => 'member_plans.start',
'end_date' => 'member_plans.end',
'service' => 'plans.service_code',
default => ''
};
$query->getQuery()->orderBy($orderBy, $request->order);
})
->select(['members.id', 'members.person_id', 'members.member_id', 'members.name', 'members.members_effective_date AS start_date', 'members.members_expire_date AS end_date', 'plans.active', 'plans.service_code'])
->selectRaw("(select sum(`claims`.`total_claim`) from `claims` where `members`.`id` = `claims`.`member_id` AND `claims`.`deleted_at` IS NULL) AS `claims_sum_total_claim`")
->paginate($limit);
}
public function getAllMemberEmployeeData(int $corporateId, Request $request)
{
$limit = $request->has('perPage') ? $request->input('perPage') : 10;
@@ -122,8 +217,8 @@ class CorporateMemberService
->paginate($limit);
}
public function getAllEncounter(int $corporateId){
public function getAllEncounter(int $corporateId)
{
return Encounter::query()->select(['id'])->paginate(10);
}
}

171
app/Services/RequestLogService.php Normal file
View File

@@ -0,0 +1,171 @@
<?php
namespace App\Services;
use App\Events\ClaimApproved;
use App\Events\ClaimRequested;
use App\Models\Claim;
use App\Models\RequestLog;
use App\Models\Organization;
use App\Helpers\Helper;
use App\Models\Icd;
use App\Models\Member;
use Carbon\Carbon;
use App\Exceptions\ImportRowException;
use Box\Spout\Writer\Common\Creator\WriterEntityFactory;
use DB;
use Str;
class RequestLogService{
public static function storeRequestLog(
$row = null,
$code,
$member,
$paymentType,
$serviceCode,
$submissionDate = null,
$status, $organization_id = null,
$source
)
{
try {
$organization = False;
if($organization_id){
$organization = Organization::where('id', $organization_id)->first();
if (!$organization){
throw new ImportRowException(__('Code Provider Tidak ditemukan', [
'attribute' => 'provider_code',
'code' => $row['provider_code']
]), 403, null, $row);
}
};
DB::beginTransaction();
$requestLogData = [
'code' => $code,
'member_id' => $member->id,
'submission_date' => $submissionDate ?? now(),
'status' => $status,
'payment_type' => $paymentType,
'service_code' => $serviceCode,
'policy_id' => $member->currentPolicy->id ?? null,
'organization_id' => $organization ? $organization->id : 0,
'source' => $source,
];
$requestLog = RequestLog::create($requestLogData);
DB::commit();
return $requestLog;
} catch (\Exception $error) {
DB::rollBack();
throw new \Exception($error);
}
}
public static function storeClaimManagement($row, $member, $claim_request_id){
try {
$organization = 0;
if($row['provider_code']){
$organization = Organization::where('code', $row['provider_code'])->first();
if (!$organization){
throw new ImportRowException(__('Provider Tidak ditemukan'), 0, null, $row);
}
};
if(!$member){
throw new ImportRowException(__('Member Tidak ditemukan'), 0, null, $row);
};
DB::beginTransaction();
$data = [
'member_id' => $member->id,
'currency' => 'IDR',
'plan_id' => $member->currentPlan->id,
'total_claim' => $row['tot_amt_insurred'] ? $row['tot_amt_insurred'] : 0,
'benefit_code' => $row['benefit_code'] ? $row['benefit_code'] : '-',
'benefit_desc' => $row['benefit_desc'] ? $row['benefit_desc'] : '-',
'amount_incurred' => $row['tot_amt_insurred'] ? $row['tot_amt_insurred'] : 0,
'amount_approved' => $row['tot_amt_approved'] ? $row['tot_amt_approved'] : 0,
'amount_not_approved' => $row['tot_amt_not_approved'] ? $row['tot_amt_not_approved'] :0,
'excess_paid' => $row['tot_excess_paid'] ? $row['tot_excess_paid'] : 0,
'claim_request_id' => $claim_request_id,
'organization_id' => $organization ? $organization->id : NULL,
'status' => 'requested'
];
$claimManagement = Claim::create($data);
// update client id di claim request
ClaimRequest::where('id', $claim_request_id)->update([
'claim_id' => $claimManagement->id,
]);
DB::commit();
return $claimManagement;
} catch (\Exception $error) {
DB::rollBack();
throw new \Exception($error);
}
}
public static function updateClaimRequest($organization_id, $claim_request_id){
try {
$data = [
'organization_id' => $organization_id
];
DB::commit();
$update = ClaimRequest::where('id', $claim_request_id)->update($data);
return ClaimRequest::find($claim_request_id);
} catch (\Exception $error) {
DB::rollBack();
throw new \Exception($error);
}
}
protected function validatePlanRow($row)
{
if (empty($row['member_id'])) {
throw new ImportRowException(__('Member ID Required'), 0, null, $row);
}
}
public function handleRequestLogRow($row)
{
try {
$requestLog = RequestLog::where('id', $row['id'])->first();
if(!$requestLog){
throw new ImportRowException(__('Request LOG Tidak ditemukan'), 0, null, $row);
};
$status = RequestLog::$status;
if (!array_key_exists($row['status'], $status)){
throw new ImportRowException(__('Status Request LOG Tidak ditemukan'), 0, null, $row);
}
// Update Request LOG Status & Link with Claim
DB::beginTransaction();
$requestLog->update([
'status' => $row['status']
]);
$requestLog->save();
DB::commit();
return $requestLog;
} catch (\Exception $e) {
DB::rollBack();
throw $e;
}
}
}