499 lines
23 KiB
PHP
Executable File
499 lines
23 KiB
PHP
Executable File
<?php
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namespace Modules\HospitalPortal\Http\Controllers\Api;
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use App\Events\ClaimRequested;
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use App\Helpers\Helper;
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use App\Models\ClaimRequest;
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use App\Models\File;
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use App\Models\Member;
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use App\Models\RequestLog;
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use App\Models\Organization;
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use App\Services\ClaimRequestService;
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use App\Services\ClaimService;
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use Exception;
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use Illuminate\Contracts\Support\Renderable;
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use Illuminate\Http\Request;
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use Illuminate\Routing\Controller;
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use Modules\HospitalPortal\Transformers\ClaimRequestResource;
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use Modules\HospitalPortal\Transformers\ClaimRequestShowResource;
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use PDF;
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use Illuminate\Support\Facades\DB;
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use Modules\HospitalPortal\Helpers\ApiResponse;
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use Illuminate\Support\Facades\Validator;
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class ClaimRequestController extends Controller
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{
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/**
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* Display a listing of the resource.
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* @return Renderable
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*/
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private static $code_prefix = 'CLAIM';
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public function index(request $request)
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{
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$claimRequests = ClaimRequest::query()
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->when($request->search, function ($q, $search) {
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$q->where('code', 'LIKE', "%".$search."%");
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})
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->when($request->orderBy, function ($q, $orderBy) use ($request) {
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if (in_array($orderBy, ['submission_date', 'code'])) {
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$q->orderBy($orderBy, $request->order);
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}
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})
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->when($request->status, function($q, $status) {
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$q->where('status', $status);
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})
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->with(['member'])
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->orderBy('created_at', 'DESC')
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->paginate();
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return Helper::responseJson($claimRequests);
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}
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/**
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* Show the form for creating a new resource.
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* @return Renderable
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*/
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public function create()
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{
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return view('hospitalportal::create');
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}
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/**
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* Store a newly created resource in storage.
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* @param Request $request
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* @return Renderable
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*/
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public function store(Request $request)
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{
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$data = [
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'request_logs_id' => $request->request_logs_id,
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'member_id' => $request->member_id,
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'service_code' => $request->service_code
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];
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$validator = Validator::make($request->all(), [
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'request_logs_id' => 'required',
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'member_id' => 'required',
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'service_code' => 'required'
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], [
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'request_logs_id.required' => trans('Validation.required',['attribute' => 'Request Log ID']),
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'member_id.required' => trans('Validation.required',['attribute' => 'Member ID']),
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'service_code.required' => trans('Validation.required',['attribute' => 'Service Code'])
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]);
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if ($validator->fails())
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{
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return ApiResponse::apiResponse('Bad Request', $data, $validator->errors(), 400);
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}
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else
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{
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$check_claim_requests = DB::table('claim_requests')
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->where('claim_requests.request_log_id', '=', $request->request_logs_id)
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->first();
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if(!$check_claim_requests)
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{
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try {
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DB::beginTransaction();
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$code = $this->getNextCode($request->request_logs_id);
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$member = Member::find($request->member_id);
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$requestLogData = RequestLog::where('id',$request->request_logs_id)->first();
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$organization = Organization::where(['id' => $requestLogData->organization_id, 'type' => 'hospital'])->first('code');
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$provideCode = $organization ? $organization->code : '';
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$newClaimRequest = ClaimRequestService::storeClaimRequest(
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row: [],
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code: $code,
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member: $member,
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paymentType: 'cashless',
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serviceCode: $request->service_code,
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requestLogID: $request->request_logs_id,
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organization_code: $provideCode,
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);
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// Log History
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$newClaimRequest->histories()->create([
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'title' => 'New Claim Requested',
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'description' => "Claim Requested for Member : {$member->member_id} - ({$member->full_name})",
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'type' => 'info',
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'system_origin' => 'hospital-portal'
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]);
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// Claim Log
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DB::table('claim_logs')
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->insert([
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'claim_request_id' => $newClaimRequest->id,
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'status' => 'requested',
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'date' => date('Y-m-d H:i:s'),
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'description' => "Claim Requested for Member : {$member->member_id} - ({$member->full_name})",
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'system_origin' => 'hospital-portal',
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'created_by' => auth()->user()->id,
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'created_at' => date('Y-m-d H:i:s'),
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'updated_at'=> date('Y-m-d H:i:s'),
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]);
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if ($request->hasFile('additional_files')) {
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foreach ($request->additional_files as $file) {
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$pathFile = File::storeFile('additional-files', $request->request_logs_id, $file);
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// $newClaimRequest->files()->updateOrCreate([
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// 'type' => 'additional-files',
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// 'name' => File::getFileName('additional-files', $newClaimRequest->id, $file),
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// 'original_name' => $file->getClientOriginalName(),
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// 'extension' => $file->getClientOriginalExtension(),
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// 'path' => $pathFile,
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// 'created_by' => auth()->user()->id,
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// 'updated_by' => auth()->user()->id,
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// ]);
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File::updateOrCreate([
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'fileable_type' => 'App\Models\RequestLog',
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'fileable_id' => $request->request_logs_id,
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'type' => 'additional-files',
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'name' => File::getFileName('additional-files', $request->request_logs_id, $file),
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'original_name' => $file->getClientOriginalName(),
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'extension' => $file->getClientOriginalExtension(),
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'path' => $pathFile,
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'created_by' => auth()->user()->id,
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'updated_by' => auth()->user()->id,
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]);
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}
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}
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DB::commit();
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return ApiResponse::apiResponse('Success', $data, trans('Message.success'), 200);
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}
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catch (\Exception $e) {
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DB::rollback();
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return ApiResponse::apiResponse("Error", $data, $e->getMessage(), 500);
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}
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}
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else
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{
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return ApiResponse::apiResponse("Error", $data, trans('Message.already_exists'), 409);
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}
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}
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}
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/**
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* Show the specified resource.
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* @param int $id
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* @return Renderable
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*/
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public function show($id)
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{
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$claimRequest = ClaimRequest::findOrFail($id);
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$claimRequest->load([
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'histories' => function ($history) {
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$history->latest();
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},
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'files',
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]);
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return Helper::responseJson(data: ClaimRequestShowResource::make($claimRequest));
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}
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/**
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* Show the form for editing the specified resource.
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* @param int $id
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* @return Renderable
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*/
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public function edit($id)
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{
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return view('hospitalportal::edit');
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}
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/**
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* Update the specified resource in storage.
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* @param Request $request
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* @param int $id
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* @return Renderable
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*/
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public function update(Request $request, $id)
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{
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//
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}
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/**
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* Remove the specified resource from storage.
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* @param int $id
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* @return Renderable
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*/
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public function destroy($id)
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{
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//
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}
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public function generateLog($claim_request_id)
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{
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$claimRequest = ClaimRequest::findOrFail($claim_request_id);
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$service_code = $claimRequest->service_code;
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if ($claimRequest->status != 'approved') {
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throw new Exception("Belum Teverifikasi", 1);
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}
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$member = Member::findOrFail($claimRequest->member_id)
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->load([
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// 'currentPlan',
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'currentPlan' => function ($plan) use ($claim_request_id, $service_code) {
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$plan->where('plans.service_code', $service_code);
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},
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'currentPolicy',
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'currentPlan.corporateBenefits',
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'currentPlan.corporateBenefits.benefit'
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]);
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$pdf = PDF::loadView('pdf.guaranted_leter', compact('member', 'claimRequest'));
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return $pdf->download('Guaranted Letter - '.$member->full_name.'.pdf');
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return $claimRequest;
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}
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public static function getNextCode($request_log_id = 0)
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{
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$last_numeric_code = ClaimRequest::select(DB::raw('MAX(CAST(SUBSTRING_INDEX(code, ".", -1) AS SIGNED)) as max_numeric_code'))
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->whereRaw('SUBSTRING_INDEX(code, ".", -1) REGEXP "^[0-9]+$"')
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->value('max_numeric_code');
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// $next_number = 1;
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if ($last_numeric_code) {
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// // Jika ada kode sebelumnya, pecah kode dan tambahkan 1 ke angka terakhir
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// $parts = explode('-', $last_code);
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// $last_number = (int) end($parts);
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$next_number = $last_numeric_code + 1;
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} else {
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$next_number = 1;
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}
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return self::makeCode($next_number, $request_log_id);
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}
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public static function makeCode($next_number, $request_log_id)
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{
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// Pastikan $next_number adalah integer positif
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$next_number = max(1, (int) $next_number);
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$requestLogData = RequestLog::where('id', $request_log_id)->first();
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$organization = Organization::where(['id' => $requestLogData->organization_id, 'type' => 'hospital'])->first('code');
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$provideCode = $organization ? $organization->code : '';
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$member = Member::with('currentCorporate')->where(['id' => $requestLogData->member_id])->first();
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$sparator = '.';
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$date = date('ymd');
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// Menghasilkan kode dengan format yang diinginkan
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return self::$code_prefix . $sparator. 'H' . $sparator. $provideCode . $sparator. $date. $sparator . $member->currentPolicy->code . $sparator. $member->member_id . $sparator. str_pad($next_number, 5, '0', STR_PAD_LEFT);
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}
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public function get_claim_requests(Request $request)
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{
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$limit = $request->has('per_page') ? $request->input('per_page') : 10;
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$results = DB::table('claim_requests')
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->leftJoin('claims', 'claim_requests.id', '=', 'claims.claim_request_id')
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->leftJoin('members', 'claim_requests.member_id', '=', 'members.id')
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->leftJoin('corporate_employees', 'members.id', '=', 'corporate_employees.member_id')
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->leftJoin('corporate_divisions', 'corporate_employees.division_id', '=', 'corporate_divisions.id')
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->when($request->input('search'), function ($query, $search) {
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$query->where(function ($query) use ($search) {
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$query->orWhere('claim_requests.code', 'like', "%" . ($search == 'outpatient' || $search == 'Outpatient' ? 'OP' : 'IP') . "%")
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->orWhere('members.member_id', 'like', "%" . $search . "%")
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->orWhere('members.name', 'like', "%" . $search . "%")
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->orWhere('corporate_divisions.name', 'like', "%" . $search . "%")
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->orWhere('claim_requests.status', 'like', "%" . $search . "%")
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->orWhere('claim_requests.submission_date', 'like', "%" . $search . "%")
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->orWhere('claims.status', 'like', "%" . $search . "%");
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});
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})
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->when($request->has('orderBy'), function ($query) use ($request) {
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$orderBy = $request->orderBy;
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$direction = $request->order ?? 'asc';
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$query->orderBy($orderBy, $direction);
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})
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->when($request->input('start_date') && !$request->input('end_date'), function ($query, $start_date) {
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$query->where(function ($query) use ($start_date) {
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$query->where('claim_requests.submission_date', '<', $start_date);
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});
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})
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->when($request->input('status'), function ($query, $status) {
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$query->where(function ($query) use ($status) {
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if ($status === 'requested') {
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$query->where('claim_requests.status', '=', 'requested');
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}
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if ($status === 'reviewed') {
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$query->where('claim_requests.status', '=', 'approved');
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$query->where('claims.status', '=', 'received');
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}
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if ($status === 'approved') {
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$query->where('claim_requests.status', '=', 'approved');
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$query->where('claims.status', '=', 'approved');
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}
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if ($status === 'declined') {
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$query->where('claim_requests.status', '=', 'approved');
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$query->where('claims.status', '=', 'declined');
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}
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});
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})
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->select(
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'members.id',
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'claim_requests.code',
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'members.member_id',
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'members.name as full_name',
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'corporate_divisions.name AS division_name',
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DB::raw('
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CASE
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WHEN claim_requests.status = "requested" THEN "requested"
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WHEN claim_requests.status = "approved" AND claims.status = "approved" THEN "approved"
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WHEN claim_requests.status = "approved" AND claims.status = "declined" THEN "declined"
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WHEN claim_requests.status = "approved" AND claims.status = "disbrusmented" THEN "disbrusmented"
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/*WHEN claim_requests.status = "approved" AND claims.status = "received" THEN "pending"*/
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WHEN claim_requests.status = "approved" AND claims.status = "received" THEN "reviewed"
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ELSE ""
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END AS status
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'),
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'claim_requests.id AS claim_request_id',
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'claim_requests.submission_date',
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DB::raw('
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CASE
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WHEN service_code = "OP" THEN "Outpatient"
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WHEN service_code = "IP" THEN "Inpatient"
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ELSE ""
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END AS service_type
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')
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)
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->paginate($limit);
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return response()->json(Helper::paginateResources($results));
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}
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public function detail_claim_requests($claimRequestId)
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{
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$status = DB::table('claim_requests')
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->leftJoin('claims', 'claim_requests.id', '=', 'claims.claim_request_id')
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->leftJoin('members', 'claim_requests.member_id', '=', 'members.id')
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->leftJoin('corporate_employees', 'members.id', '=', 'corporate_employees.member_id')
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->leftJoin('corporate_divisions', 'corporate_employees.division_id', '=', 'corporate_divisions.id')
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->where('claim_requests.id', '=', $claimRequestId)
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->select(
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'claim_requests.submission_date',
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DB::raw('
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CASE
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WHEN claim_requests.status = "requested" THEN "requested"
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WHEN claim_requests.status = "approved" AND claims.status = "approved" THEN "approved"
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WHEN claim_requests.status = "approved" AND claims.status = "declined" THEN "declined"
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WHEN claim_requests.status = "approved" AND claims.status = "disbrusmented" THEN "disbrusmented"
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/*WHEN claim_requests.status = "approved" AND claims.status = "received" THEN "pending"*/
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WHEN claim_requests.status = "approved" AND claims.status = "received" THEN "reviewed"
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ELSE ""
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END AS status
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')
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)
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->first();
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$results['status'] = $status;
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$timeline = DB::table('claim_logs')
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->where('claim_logs.claim_request_id', '=', $claimRequestId)
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->select(
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DB::raw('
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CASE
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WHEN claim_logs.status = "requested" THEN "Request"
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WHEN claim_logs.status = "reviewed" THEN "Review"
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WHEN claim_logs.status = "approved" THEN "Approval"
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WHEN claim_logs.status = "declined" THEN "Decline"
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ELSE "-"
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END AS txt_status
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'),
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DB::raw('
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CASE
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WHEN claim_logs.status = "requested" THEN "#159C9C"
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WHEN claim_logs.status = "reviewed" THEN "#0C53B7"
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WHEN claim_logs.status = "approved" THEN "#229A16"
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WHEN claim_logs.status = "declined" THEN "#FF4842"
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ELSE "-"
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END AS txt_status_color
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'),
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DB::raw('
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CASE
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WHEN claim_logs.status = "requested" THEN "#00AB5529"
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WHEN claim_logs.status = "reviewed" THEN "#1890FF29"
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WHEN claim_logs.status = "approved" THEN "#54D62C29"
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WHEN claim_logs.status = "declined" THEN "#FF48427A"
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ELSE "-"
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END AS txt_status_backgroundColor
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'),
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'claim_logs.date',
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'claim_logs.description',
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'claim_logs.status'
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)
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->orderBy('claim_logs.id', 'desc')
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->get();
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$results['timeline'] = $timeline;
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$request_files = DB::table('claim_request_files')
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->where('claim_request_files.claim_request_id', '=', $claimRequestId)
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->select(
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'claim_request_files.*',
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DB::raw('(SELECT files.fileable_id FROM files WHERE files.fileable_id = claim_request_files.claim_request_id AND files.type = claim_request_files.type LIMIT 1) AS check_files'),
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)
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->get();
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$results['request_files'] = $request_files;
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return Helper::responseJson($results);
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}
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public function requestFiles(Request $request, $claim_id)
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{
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if ($request->hasFile('fileDiagnosis')) {
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foreach ($request->fileDiagnosis as $file) {
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$pathFile = File::storeFile('claim-diagnosis', $claim_id, $file);
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File::updateOrCreate([
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'fileable_type'=>'App\Models\ClaimRequest',
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'fileable_id' => $claim_id,
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'type' => 'claim-diagnosis',
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'name' => File::getFileName('claim-diagnosis', $claim_id, $file),
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'original_name' => $file->getClientOriginalName(),
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'extension' => $file->getClientOriginalExtension(),
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'path' => $pathFile,
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'created_by' => auth()->user()->id,
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'updated_by' => auth()->user()->id,
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]);
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}
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}
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if ($request->hasFile('fileKondisis')) {
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foreach ($request->fileKondisis as $file) {
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$pathFile = File::storeFile('claim-kondisi', $claim_id, $file);
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File::updateOrCreate([
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'fileable_type'=>'App\Models\ClaimRequest',
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'fileable_id' => $claim_id,
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'type' => 'claim-kondisi',
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'name' => File::getFileName('claim-kondisi', $claim_id, $file),
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'original_name' => $file->getClientOriginalName(),
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'extension' => $file->getClientOriginalExtension(),
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'path' => $pathFile,
|
|
'created_by' => auth()->user()->id,
|
|
'updated_by' => auth()->user()->id,
|
|
]);
|
|
}
|
|
}
|
|
|
|
if ($request->hasFile('fileResults')) {
|
|
foreach ($request->fileResults as $file) {
|
|
$pathFile = File::storeFile('claim-result', $claim_id, $file);
|
|
File::updateOrCreate([
|
|
'fileable_type'=>'App\Models\ClaimRequest',
|
|
'fileable_id' => $claim_id,
|
|
'type' => 'claim-result',
|
|
'name' => File::getFileName('claim-result', $claim_id, $file),
|
|
'original_name' => $file->getClientOriginalName(),
|
|
'extension' => $file->getClientOriginalExtension(),
|
|
'path' => $pathFile,
|
|
'created_by' => auth()->user()->id,
|
|
'updated_by' => auth()->user()->id,
|
|
]);
|
|
}
|
|
}
|
|
|
|
return Helper::responseJson(data: $request->toArray(), message: 'Invoice Success Uploaded');
|
|
}
|
|
}
|