Files
aso/app/Services/ClaimService.php
2022-12-08 12:26:29 +07:00

194 lines
6.7 KiB
PHP

<?php
namespace App\Services;
use App\Models\Claim;
use App\Models\Icd;
use App\Models\Member;
use Carbon\Carbon;
use Str;
class ClaimService{
public static function getMemberTotalUsage(Member $member, $startDate = null, $endDate = null)
{
$startDate = empty($startDate) ? Carbon::now()->startOfMonth() : $startDate;
$endDate = empty($endDate) ? Carbon::now()->startOfMonth() : $endDate;
$claims = $member->claims()
->used($startDate, $endDate)
->get();
$total = $claims->sum(function($claim){
return $claim->total_claim;
});
return $total;
}
public static function checkMemberEligibility($member, $benefit, $diagnosis, $totalClaim = 0)
{
$currentPlan = $member->currentPlan;
$policy = $member->currentPolicy;
$corporate = $policy->corporate;
$isEligible = true;
$validationErrors = [];
// Eligibility Validation
if (!in_array($member->marital_status, explode(',', $benefit->msc))) {
$validationErrors[] = [
'error' => 'msc',
'message' => 'Only '.$benefit->msc
];
$isEligible = false;
}
if (!in_array($member->gender_code, explode(',', $benefit->genders))) {
$validationErrors[] = [
'error' => 'genders',
'message' => 'Only '.$benefit->genders
];
$isEligible = false;
}
if (!empty($benefit->min_age) && $member->age < $benefit->min_age) {
$validationErrors[] = [
'error' => 'min_age',
'message' => 'Minimum Age is '.$benefit->min_age
];
$isEligible = false;
}
if (!empty($benefit->max_age) && $member->age > $benefit->max_age) {
$validationErrors[] = [
'error' => 'max_age',
'message' => 'Maximum Age is '.$benefit->min_age
];
$isEligible = false;
}
// TODO complete validations
// Limit Validation
if ($totalClaim > 0) {
if (bcsub($corporate->limit_balance, $totalClaim) < 0) {
$validationErrors[] = [
'error' => 'corporate_limit',
'message' => 'Corporate Limit cannot cover this'
];
$isEligible = false;
}
if (bcsub($benefit->limit_amount, $totalClaim) < 0) {
$validationErrors[] = [
'error' => 'benefit_limit',
'message' => 'Benefit Limit cannot cover this'
];
$isEligible = false;
}
// TODO complete validations
}
return [
'isEligible' => $isEligible,
'errors' => $validationErrors
];
}
public static function getMemberUsageByBenefitLimit($member, $benefit)
{
}
public static function showMemberBenefitLimit($member, $benefit_code)
{
// $plan = $member->currentPlan;
// $policy = $member->currentPolicy;
// $corporate = $member->currentCorporate;
$benefit = $member->currentPlan->benefits()->where('code', $benefit_code)->first();
// dd($benefit->toArray());
// dd(compact(['plan', 'policy', 'corporate', 'benefit']));
$limits = [
'total_limit' => $benefit->limit_amount,
'frequency_limit_name' => $benefit->max_frequency_period_name,
'frequency_limit' => $benefit->max_frequency,
'total_claim' => 0,
'remaining_limit' => $benefit->limit_amount,
'usage_daily' => null,
'usage_weekly' => null,
'usage_monthly' => null,
'usage_yearly' => null
];
switch ($benefit->max_frequency_period) {
case(0) :
$limits['usage_yearly'] = $member->claims()->used(Carbon::now()->firstOfYear(), now())->count();
$limits['total_claim'] = $member->claims()->used(Carbon::now()->firstOfYear(), now())->sum('total_claim');
break;
case(1) :
$limits['usage_daily'] = $member->claims()->used(now()->format('Y-m-d'), now()->addDay(1)->format('Y-m-d'))->count();
$limits['total_claim'] = $member->claims()->used(now()->format('Y-m-d'), now()->addDay(1)->format('Y-m-d'))->sum('total_claim');
break;
case(2) :
$limits['usage_weekly'] = $member->claims()->used(Carbon::parse('Previous Sunday'), now())->count();
$limits['total_claim'] = $member->claims()->used(Carbon::parse('Previous Sunday'), now())->sum('total_claim');
break;
case(3) :
$limits['usage_monthly'] = $member->claims()->used(Carbon::now()->firstOfMonth(), now())->count();
$limits['total_claim'] = $member->claims()->used(Carbon::now()->firstOfMonth(), now())->sum('total_claim');
break;
case(4) :
$limits['usage_yearly'] = $member->claims()->used(Carbon::now()->firstOfYear(), now())->count();
$limits['total_claim'] = $member->claims()->used(Carbon::now()->firstOfYear(), now())->sum('total_claim');
break;
default :
// return null;
break;
}
$limits['remaining_limit'] = $benefit->limit_amount - $limits['total_claim'];
return $limits;
}
public static function storeClaim($member, $diagnosis, $totalClaim, $benefit, $status)
{
try {
DB::beginTransaction();
$claimData = [
'member_id' => $member->id,
'diagnosis_id' => $diagnosis->id,
'total_claim' => $totalClaim,
'currency' => 'IDR',
'plan_id' => $member->currentPlan->id,
'benefit_id' => $benefit->id,
'status' => $status
];
$claimData[$status.'_at'] = now();
$claimData[$status.'_by'] = auth()->user()->id ?? null;
$claim = Claim::create($claimData);
$policy = $member->currentPolicy;
$policy->limitJournals()->create([
'previous_balance' => $policy->limit_balance,
'total_credit' => $totalClaim,
'type' => 'credit',
'balance' => bcsub($policy->limit_balance, $totalClaim),
'description' => 'Log for Claim #'. $claim->code,
]);
DB::commit();
return $claim;
} catch (\Exception $error) {
DB::rollBack();
throw new \Exception($error);
}
}
}