Files
aso/app/Models/ClaimRequest.php
2023-10-25 08:46:42 +07:00

256 lines
7.7 KiB
PHP

<?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 ClaimRequest 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',
'status',
'claim_id',
'code'
];
protected $hidden = [
// 'created_at',
'updated_at',
'deleted_at',
'created_by',
'updated_by',
'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",
"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_code",
"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',
'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 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;
}
}