220 lines
8.1 KiB
PHP
220 lines
8.1 KiB
PHP
<?php
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namespace App\Http\Controllers\Api\OLDLMS;
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use App\Helpers\Helper;
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use App\Http\Controllers\Controller;
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use App\Models\Member;
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use App\Services\ClaimService;
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use Illuminate\Http\Request;
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class MembershipController extends Controller
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{
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//
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public function check(Request $request)
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{
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$request->validate([
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'member_id' => 'required',
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// 'birth_date' => 'required',
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]);
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$member = Member::where('member_id', $request->member_id)->first();
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if (!$member) {
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return Helper::responseJson(statusCode: 404, message: 'Member not found.', status: 'error');
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}
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if (!$member->active) {
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return Helper::responseJson(statusCode: 406, message: 'The Member '.$request->member_id.' is Inactive.', status: 'error');
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}
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return Helper::responseJson(data: $member, message: 'Member Found');
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}
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public function checkLimit(Request $request)
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{
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$request->validate([
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'member_id' => 'required',
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'type' => 'required|in:consultation-gp,consultation-specialist,medicine',
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// 'speciality_code' => 'sometimes'
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]);
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if ($request->type == 'consultation-gp') {
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$benefitCode = 'OPCONS1';
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}
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if ($request->type == 'consultation-specialist') {
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$benefitCode = 'OPCONS2';
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}
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if ($request->type == 'medicine') {
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$benefitCode = 'OPMEDI1';
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}
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$member = Member::where('member_id', $request->member_id)->with(['currentCorporate', 'currentPolicy', 'currentPlan', 'postponedClaims'])->first();
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$limits = ClaimService::showMemberBenefitLimit($member, $benefitCode);
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$limits['postponed_claims'] = $member->postponedClaims;
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$limits['postponed_claims_payment_url'] = "http://google.com";
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$limits['postponed_claims_unpaid_total'] = $member->postponedClaims->sum('total_claim');
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if ($request->has('speciality_code') && !empty($request->speciality_code)) {
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$corporateService = $member->currentCorporate
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->corporateServices()
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->active()
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->where('service_code', 'OP')
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->with([
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'specialities' => function ($speciality) use ($request) {
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$speciality->where('code', $request->speciality_code)
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->wherePivot('active', 1);
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}])
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->first();
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// $rules = $corporateServiceConfigs->
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// dd($corporateServiceConfigs->toArray());
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if (empty($corporateService)) {
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$limit['coverage'] = [
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'benefit' => false,
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'admin_fee' => false,
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'delivery_fee' => false
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];
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return Helper::responseJson(data: $limits);
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}
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if (empty($corporateService->specialities)) {
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$limit['coverage'] = [
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'benefit' => false,
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'admin_fee' => false,
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'delivery_fee' => false
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];
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return Helper::responseJson(data: $limits);
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}
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$currentSpeciality = $corporateService->specialities->first();
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// Load the Relation Data after speciality check is supported
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$corporateService->load([
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'configs',
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// 'configs.exclusions.rules',
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'corporateServiceSpecialities' => function ($corporateServiceSpeciality) use ($currentSpeciality) {
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$corporateServiceSpeciality->where('speciality_id', $currentSpeciality->id);
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},
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'corporateServiceSpecialities.exclusions' => function ($exclusion) {
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$exclusion->where('service_code', 'OP');
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},
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'corporateServiceSpecialities.exclusions.rules'
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]);
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$configs = $corporateService->configs->mapWithKeys(function ($config) {
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return [$config->name => $config];
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});
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$serviceSpeciality = $corporateService->corporateServiceSpecialities->first() ?? null;
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$serviceSpecialityRules = $serviceSpeciality->exclusions->first()->rules ?? collect([]);
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$serviceSpecialityRules = $serviceSpecialityRules->mapWithKeys(function ($rule) {
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return [$rule->name => $rule];
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});
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$gpSpecialityName = config('aso.general_practitioner_speciality_name', 'Umum');
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// dd($serviceSpecialityRules->toArray());
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$coverage = [
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'benefit' => false,
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'admin_fee' => false,
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'delivery_fee' => false
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];
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// dd($configs->toArray());
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// dd($gpSpecialityName, $currentSpeciality->name);
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if ($gpSpecialityName == $currentSpeciality->name) {
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// To General Practitioner
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if (($configs['gp_internal_doctor_online']['value'] ?? 1) == 1) {
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$coverage['benefit'] = true;
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}
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if (($configs['general_practitioner_fee']['value'] ?? 1) == 1) {
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$coverage['admin_fee'] = true;
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}
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if ($serviceSpeciality->active == 1) {
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$coverage['benefit'] = true;
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}
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} else {
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// To Specialist
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if (($configs['sp_internal_doctor_online']['value'] ?? 1) == 1) {
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$coverage['benefit'] = true;
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}
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// dd($configs['specialist_practitioner_fee']['value'], $configs['specialist_practitioner_fee']['value'] ?? 1, ($configs['specialist_practitioner_fee']['value'] ?? 1) == 1);
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if (($configs['specialist_practitioner_fee']['value'] ?? 1) == 1) {
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$coverage['admin_fee'] = true;
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}
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if ($serviceSpeciality->active == 1) {
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$coverage['benefit'] = true;
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}
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}
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// TODO THIS EXCLUSION IS USED AS INCLUSION NOW, MUST BE CHANGE TO USED AS EXCLUSION AND MAYBE MOVE THE TABLE
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$excluded = [];
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foreach ($serviceSpecialityRules as $ruleName => $rule) {
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if ($ruleName == 'msc') {
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$values = explode(',', $rule->values);
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if (!in_array(strtolower($member->marital_status), $values)) {
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$excluded[] = $rule;
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}
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}
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if ($ruleName == 'gender') {
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$values = explode(',', $rule->values);
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if (!in_array(strtolower($member->gender), $values)) {
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$excluded[] = $rule;
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}
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}
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if ($ruleName == 'min_age') {
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if (!empty($rule->values) && $member->age < $rule->values) {
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$excluded[] = $rule;
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}
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}
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if ($ruleName == 'max_age') {
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if (!empty($rule->values) && $member->age > $rule->values) {
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$excluded[] = $rule;
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}
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}
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if ($ruleName == 'plan') {
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$values = explode(',', $rule->values);
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if (!in_array($member->currentPlan->code, $values)) {
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$excluded[] = $rule;
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}
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}
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}
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if ( count($excluded) ) {
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$coverage['benefit'] = false;
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$coverage['benefit_exclusion'] = $excluded;
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} else {
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$coverage['benefit'] = true;
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}
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$limits['coverage'] = $coverage;
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} else {
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$limits['coverage'] = [
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'benefit' => true,
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'admin_fee' => true,
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'delivery_fee' => true
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];
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}
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return Helper::responseJson(data: $limits);
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}
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}
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