256 lines
7.7 KiB
PHP
256 lines
7.7 KiB
PHP
<?php
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namespace App\Models;
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use App\Events\ClaimReceived;
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use App\Events\ClaimRequested;
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use App\Traits\Blameable;
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use Illuminate\Database\Eloquent\Factories\HasFactory;
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use Illuminate\Database\Eloquent\Model;
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use Illuminate\Database\Eloquent\SoftDeletes;
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use Str;
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class ClaimRequest extends Model
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{
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use HasFactory, SoftDeletes, Blameable;
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// protected static $code_prefix_hospital = 'CRQ-H';
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// protected static $code_prefix_client = 'CRQ-R';
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public $fillable = [
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'uuid',
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'submission_date',
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'member_id',
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'payment_type',
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'service_code',
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'policy_id',
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'status',
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'claim_id',
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'code'
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];
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protected $hidden = [
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// 'created_at',
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'updated_at',
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'deleted_at',
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'created_by',
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'updated_by',
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'deleted_by',
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];
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public static $doc_headers_to_field_map = [
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"PAYOR ID" => "payor_id",
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"CORPORATE ID" => "corporate_id",
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"POLICY NUMBER" => "policy_number",
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"MEMBER ID" => "member_id",
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"MEMBER NAME" => "member_name",
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"RECORD TYPE (P/D)" => "record_type",
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"CLAIM TYPE" => "claim_type",
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"CLAIM PROCESS STATUS" => "status",
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"CLIENT CLAIM ID" => "client_claim_id",
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"REFERENCE NO" => "reference_no",
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"ADMEDIKA CLAIM ID" => "admika_claim_id",
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"PROVIDER CODE" => "provider_code",
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"ADMISSION DATE" => "admission_date",
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"DISCUTRGE DATE" => "discutrge_date",
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"DURATION DAYS" => "duration_days",
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"COVERAGE TYPE" => "coverage_type",
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"PLAN ID" => "plan_id",
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"DIAGNOSIS CODE" => "diagnosis_code",
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"DIAGNOSIS DESC" => "diagnosis_desc",
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"TOT AMT INCURRED" => "tot_amt_insurred",
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"TOT AMT APPROVED" => "tot_amt_approved",
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"TOT AMT NOT APPROVED" => "tot_amt_not_approved",
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"TOT EXCESS PAID" => "tot_excess_paid",
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"REMARKS" => "remarks",
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"SECONDARY DIAGNOSIS CODE" => "secondary_diagnosis_code",
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"APPROVED DATE" => "approved_date",
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"APPROVED BY" => "approved_by",
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"DATE RECEIVED" => "data_received",
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"HOSPITAL INVOICE DATE" => "hospital_invoice_date",
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];
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public static $listing_doc_headers = [
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"PAYOR ID",
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"CORPORATE ID",
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"POLICY NUMBER",
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"MEMBER ID",
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"MEMBER NAME",
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"RECORD TYPE (P/D)",
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"CLAIM TYPE",
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"CLAIM PROCESS STATUS",
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"CLIENT CLAIM ID",
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"REFERENCE NO",
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"ADMEDIKA CLAIM ID",
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"PROVIDER CODE",
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"ADMISSION DATE",
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"DISCUTRGE DATE",
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"DURATION DAYS",
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"COVERAGE TYPE",
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"PLAN ID",
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"DIAGNOSIS CODE",
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"DIAGNOSIS DESC",
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"TOT AMT INCURRED",
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"TOT AMT APPROVED",
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"TOT AMT NOT APPROVED",
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"TOT EXCESS PAID",
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"REMARKS",
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"SECONDARY DIAGNOSIS CODE",
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"APPROVED DATE",
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"APPROVED BY",
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"DATE RECEIVED",
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"HOSPITAL INVOICE DATE",
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];
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public static $status = [
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'draft' => 'Draft',
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'requested' => 'Requested',
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'approved' => 'Approved',
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'declined' => 'Declined'
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];
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public static $payment_types = [
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'cashless' => 'Cashless',
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'reimbursement' => 'Reimbursement'
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];
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public $appends = [
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'payment_type_name'
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];
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protected static function boot()
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{
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parent::boot();
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static::creating(function ($model) {
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try {
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$model->uuid = (string) Str::orderedUuid(); // generate uuid
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// $model->code = self::getNextCode();
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} catch (\Exception $e) {
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abort(500, $e->getMessage());
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}
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});
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static::created(function ($model) {
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// try {
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// if (!empty($model->status) && $model->status == 'requested') {
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// $model->histories()->create([
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// 'title' => 'New Claim Requested',
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// 'description' => "Claim Requested for Member : {$model->member->member_id} - ({$model->member->full_name})",
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// 'type' => 'info'
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// ]);
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// }
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// } catch (\Exception $e) {
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// abort(500, $e->getMessage());
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// }
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});
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static::updated(function ($model) {
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if ($model->hasChanges(['status'])) {
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// if ($model->status == 'requested') {
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// $model->histories()->create([
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// 'title' => 'New Claim Requested',
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// 'description' => "Claim Requested for Member : {$model->member->member_id} - ({$model->member->full_name})",
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// 'type' => 'info'
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// ]);
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// }
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// if ($model->status == 'received') {
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// ClaimReceived::dispatch($model);
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// }
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// if ($model->status == 'approved') {
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// ClaimApproved::dispatch($model);
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// }
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// if ($model->status == 'postpone') {
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// ClaimPostpone::dispatch($model);
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// }
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// if ($model->status == 'paid') {
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// ClaimPaid::dispatch($model);
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// }
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// if ($model->status == 'declined') {
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// ClaimDeclined::dispatch($model);
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// }
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}
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});
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}
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// public static function getNextCode()
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// {
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// $last_number = self::withTrashed()->max('code');
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// $next_number = empty($last_number) ? 1 : ((int) explode('-', $last_number)[1] + 1);
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// return self::makeCode($next_number);
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// }
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// public static function makeCode($next_number)
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// {
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// return (string) self::$code_prefix .'-'. str_pad($next_number, 5, 0, STR_PAD_LEFT);
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// }
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public function claim()
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{
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return $this->belongsTo(Claim::class, 'claim_id');
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}
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public function claims()
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{
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return $this->hasMany(Claim::class, 'claim_request_id');
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}
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public function files()
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{
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return $this->morphMany(File::class, 'fileable');
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}
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public function claimResults()
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{
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return $this->files()->where('type', 'claim-result')->whereNull('deleted_at');
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}
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public function claimConditions()
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{
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return $this->files()->where('type', 'claim-kondisi')->whereNull('deleted_at');
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}
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public function claimDiagnosis()
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{
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return $this->files()->where('type', 'claim-diagnosis')->whereNull('deleted_at');
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}
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public function generatedDocuments()
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{
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return $this->morphMany(GeneratedDocument::class, 'generated_documentable');
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}
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public function histories()
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{
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return $this->morphMany(ClaimHistory::class, 'historiable');
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}
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public function member()
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{
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return $this->belongsTo(Member::class, 'member_id', 'id');
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}
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public function service()
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{
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return $this->belongsTo(Service::class, 'service_code', 'code');
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}
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public function getPaymentTypeNameAttribute()
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{
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return self::$payment_types[$this->payment_type] ?? $this->payment_type;
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}
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public function getStatusAttribute($value)
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{
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return self::$payment_types[$value] ?? $value;
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}
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}
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