Files
aso/Modules/HospitalPortal/Http/Controllers/Api/ProviderOnlineController.php

566 lines
22 KiB
PHP

<?php
namespace Modules\HospitalPortal\Http\Controllers\Api;
use App\Models\Benefit;
use App\Models\CorporateBenefit;
use App\Models\Member;
use App\Models\MemberPlan;
use App\Models\Organization;
use App\Models\Provider;
use App\Models\RequestLog;
use App\Models\RequestLogBenefit;
use Carbon\Carbon;
use Illuminate\Http\Request;
use Illuminate\Routing\Controller;
use Illuminate\Support\Facades\Hash;
use Illuminate\Support\Str;
use PDF;
use Throwable;
class ProviderOnlineController extends Controller
{
public function getHeaderKey(Request $request)
{
$request->validate([
'username' => 'required|string',
'password' => 'required|string',
'kodeprovider' => 'required|string',
]);
$organization = Organization::query()->where('code', $request->kodeprovider)->first();
if (!$organization) {
return $this->headerError('Kode provider tidak ditemukan');
}
$provider = Provider::query()->firstOrNew([
'organization_id' => $organization->id,
'username' => $request->username,
]);
if ($provider->exists) {
$isPasswordValid = Hash::check($request->password, $provider->password) || $provider->password === $request->password;
if (!$isPasswordValid) {
return $this->headerError('Username atau password tidak valid');
}
} else {
$provider->password = Hash::make($request->password);
}
$provider->code = $request->kodeprovider;
$provider->status = 'active';
$provider->header_token = Str::random(64);
$provider->token = Str::random(64);
$provider->save();
return response()->json([
'header-token' => $provider->header_token,
'userid' => $provider->id,
'usertoken' => $provider->token,
'kodeprovider' => $organization->code,
'namaprovider' => $organization->name,
'errornumber' => 0,
'messagestring' => 'Success',
]);
}
public function checkEligibilitasPeserta(Request $request)
{
$request->validate([
'nokartu' => 'required|string',
'kodeprovider' => 'required|string',
'p_user_no' => 'required',
'p_token' => 'required|string',
]);
[$provider, $organization, $authError] = $this->resolveProvider($request->kodeprovider, $request->p_user_no, $request->p_token);
if ($authError) {
return $authError;
}
$member = Member::query()
->with(['person', 'currentCorporate', 'currentPolicy', 'memberPlans.plan'])
->where('member_id', $request->nokartu)
->first();
if (!$member) {
return $this->statusError('Peserta tidak ditemukan');
}
$benefits = $member->memberPlans
->map(function (MemberPlan $memberPlan) {
$plan = $memberPlan->plan;
if (!$plan) {
return null;
}
return [
'kodebenefit' => $plan->code,
'namabenefit' => $plan->corporate_plan_id,
'planid' => $plan->code,
];
})
->filter()
->values();
return response()->json([
'Status' => $this->okStatus(),
'Data' => [
'nokartu' => $member->member_id,
'memberid' => (string) $member->id,
'namapeserta' => $member->full_name,
'nomorbpjs' => $member->bpjs_id,
'jeniskelamin' => $member->gender_code,
'tanggallahir' => $this->isoDate($member->birth_date),
'hubungankeluarga' => $member->relation_with_principal,
'namaperusahaan' => optional($member->currentCorporate)->name,
'pesertavip' => 'N',
'namapenjamin' => optional($organization)->name,
'nomorpolis' => optional($member->currentPolicy)->code,
'tglmulaipolis' => $this->isoDate(optional($member->currentPolicy)->start),
'tglberakhirpolis' => $this->isoDate(optional($member->currentPolicy)->end),
'phone' => optional($member->person)->phone,
'email' => $member->email,
],
'Benefit' => $benefits,
]);
}
public function createPendaftaran(Request $request)
{
$request->validate([
'kodeprovider' => 'required|string',
'kodebenefit' => 'required|string',
'statusrujukan' => 'nullable|string',
'nomorrujukan' => 'nullable|string',
'keterangan' => 'nullable|string',
'nomorsep' => 'nullable|string',
'nokartu' => 'required|string',
'kelaskamar' => 'nullable|string',
'cobbpjs' => 'nullable|numeric',
'notransaksiprovider' => 'nullable|string',
'inacbgscode' => 'nullable|string',
'inacbgsamount' => 'nullable|numeric',
'p_user_no' => 'required',
'p_token' => 'required|string',
]);
[$provider, $organization, $authError] = $this->resolveProvider($request->kodeprovider, $request->p_user_no, $request->p_token);
if ($authError) {
return $authError;
}
$member = Member::query()
->with(['person', 'currentCorporate', 'currentPolicy'])
->where('member_id', $request->nokartu)
->first();
if (!$member) {
return $this->statusError('Peserta tidak ditemukan');
}
$plan = $this->resolvePlan($member, $request->kodebenefit);
$requestLog = RequestLog::query()->create([
'organization_id' => $organization->id,
'member_id' => $member->id,
'plan_id' => optional($plan)->id,
'policy_id' => optional($member->currentPolicy)->id ?? 0,
'payment_type' => 'cashless',
'service_code' => $request->kodebenefit,
'type_of_member' => 'member',
'status' => 'approved',
'source' => 'api',
'keterangan' => $request->keterangan,
'hak_kamar_pasien' => $request->kelaskamar ?? '',
'penempatan_kamar' => $request->kelaskamar,
'total_cob' => $request->cobbpjs,
'nominal' => 0,
'import_system' => 0,
'nomor_sep' => $request->nomorsep,
'inacbgs_code' => $request->inacbgscode,
'inacbgs_amount' => $request->inacbgsamount,
'no_transaksi_provider' => $request->notransaksiprovider,
'diagnosis' => '',
'reason' => '',
'reason_final' => '',
'catatan' => '',
'nomor_rujukan' => $request->nomorrujukan,
'status_rujukan' => $request->statusrujukan,
'submission_date' => now(),
'admission_date' => now(),
]);
$limitSubBenefit = collect();
if ($plan) {
$limitSubBenefit = CorporateBenefit::query()
->with('benefit')
->where('plan_id', $plan->id)
->get()
->map(function (CorporateBenefit $corporateBenefit) {
return [
'kodesubbenefit' => optional($corporateBenefit->benefit)->code,
'namasubbenefit' => optional($corporateBenefit->benefit)->description,
'batasan' => (string) ($corporateBenefit->limit_amount ?? 0),
];
});
}
return response()->json([
'Status' => $this->okStatus(),
'Data' => [[
'noklaim' => $requestLog->code,
'namapeserta' => $member->full_name,
'tanggallahir' => $this->isoDate($member->birth_date),
'nokartu' => $member->member_id,
'nopolis' => optional($member->currentPolicy)->code,
'nobpjs' => $member->bpjs_id,
'nosep' => $requestLog->nomor_sep,
'nomorrujukan' => $requestLog->nomor_rujukan,
'planid' => optional($plan)->code,
'masapolis' => optional($member->currentPolicy)->end ? Carbon::parse($member->currentPolicy->end)->format('d/m/Y') : null,
'namaperusahaan' => optional($member->currentCorporate)->name,
'namapenjamin' => $organization->name,
'tanggalmasuk' => $this->isoDate($requestLog->admission_date),
'tanggalkeluar' => $this->isoDate($requestLog->discharge_date),
'hakkamar' => $requestLog->penempatan_kamar,
'hakicu' => null,
'nosuratjaminan' => $requestLog->code,
'namapegawai' => null,
'namabenefit' => optional($plan)->corporate_plan_id,
'kodediagnosa' => $requestLog->diagnosis,
'keterangan' => $requestLog->keterangan,
'catatanTC1' => null,
'catatanTC2' => null,
'catatanTC3' => null,
'catatanTC4' => null,
'catatanTC5' => null,
'catatanTC6' => null,
'catatanTC7' => null,
'catatanTC8' => null,
'catatanTC9' => null,
'catatanTC10' => null,
'statusrujukan' => $requestLog->status_rujukan,
'statusklaim' => 0,
'notransaksiprovider' => $requestLog->no_transaksi_provider,
'inacbgscode' => $requestLog->inacbgs_code,
'inacbgsamount' => (float) ($requestLog->inacbgs_amount ?? 0),
]],
'LimitSubBenefit' => $limitSubBenefit->values(),
]);
}
public function createPengesahan(Request $request)
{
$request->validate([
'noklaim' => 'required|string',
'kodeprovider' => 'required|string',
'tanggalkeluar' => 'nullable|date',
'kodediagnosa' => 'nullable|string',
'inacbgscode' => 'nullable|string',
'inacbgsamount' => 'nullable|numeric',
'daftarbiaya' => 'nullable|array',
'daftarbiaya.*.kodesubbenefit' => 'required_with:daftarbiaya|string',
'daftarbiaya.*.biayaaju' => 'required_with:daftarbiaya|numeric',
'p_user_no' => 'required',
'p_token' => 'required|string',
]);
[$provider, $organization, $authError] = $this->resolveProvider($request->kodeprovider, $request->p_user_no, $request->p_token);
if ($authError) {
return $authError;
}
$requestLog = RequestLog::query()
->with(['member.person', 'member.currentCorporate', 'member.currentPolicy', 'plan'])
->where('code', $request->noklaim)
->where('organization_id', $organization->id)
->first();
if (!$requestLog) {
return $this->statusError('Nomor klaim tidak ditemukan');
}
$requestLog->update([
'status_final_log' => 'approve',
'final_log' => true,
'discharge_date' => $request->tanggalkeluar,
'diagnosis' => $request->kodediagnosa,
'inacbgs_code' => $request->inacbgscode ?? $requestLog->inacbgs_code,
'inacbgs_amount' => $request->inacbgsamount ?? $requestLog->inacbgs_amount,
]);
foreach (($request->daftarbiaya ?? []) as $biaya) {
$benefit = Benefit::query()->where('code', $biaya['kodesubbenefit'])->first();
if (!$benefit) {
continue;
}
RequestLogBenefit::query()->updateOrCreate(
[
'request_log_id' => $requestLog->id,
'benefit_id' => $benefit->id,
],
[
'amount_incurred' => $biaya['biayaaju'],
'amount_approved' => 0,
'amount_not_approved' => 0,
'excess_paid' => 0,
'keterangan' => null,
]
);
}
$requestLog->load(['requestLogBenefits.benefit']);
$biayaResponse = $requestLog->requestLogBenefits->map(function (RequestLogBenefit $requestLogBenefit) use ($requestLog) {
return [
'noklaim' => $requestLog->code,
'kodesubbenefit' => optional($requestLogBenefit->benefit)->code,
'namasubbenefit' => optional($requestLogBenefit->benefit)->description,
'kodebenefit' => optional($requestLog->plan)->code,
'namabenefit' => optional($requestLog->plan)->corporate_plan_id,
'biayaaju' => (float) ($requestLogBenefit->amount_incurred ?? 0),
'jaminanasuransi' => (float) ($requestLogBenefit->amount_approved ?? 0),
'jaminanpeserta' => (float) ($requestLogBenefit->excess_paid ?? 0),
'keterangan' => $requestLogBenefit->keterangan,
];
})->values();
return response()->json([
'Status' => $this->okStatus(),
'Data' => [[
'noklaim' => $requestLog->code,
'namapeserta' => optional($requestLog->member)->full_name,
'tanggallahir' => $this->isoDate(optional($requestLog->member)->birth_date),
'nokartu' => optional($requestLog->member)->member_id,
'nopolis' => optional(optional($requestLog->member)->currentPolicy)->code,
'nobpjs' => optional($requestLog->member)->bpjs_id,
'nosep' => $requestLog->nomor_sep,
'nomorrujukan' => $requestLog->nomor_rujukan,
'planid' => optional($requestLog->plan)->code,
'masapolis' => optional(optional($requestLog->member)->currentPolicy)->end ? Carbon::parse($requestLog->member->currentPolicy->end)->format('d/m/Y') : null,
'namaperusahaan' => optional(optional($requestLog->member)->currentCorporate)->name,
'namapenjamin' => $organization->name,
'tanggalmasuk' => $this->isoDate($requestLog->admission_date),
'tanggalkeluar' => $this->isoDate($requestLog->discharge_date),
'hakkamar' => $requestLog->penempatan_kamar,
'hakicu' => null,
'nosuratjaminan' => $requestLog->code,
'namapegawai' => null,
'namabenefit' => optional($requestLog->plan)->corporate_plan_id,
'kodediagnosa' => $requestLog->diagnosis,
'keterangan' => $requestLog->keterangan,
'catatanTC1' => null,
'catatanTC2' => null,
'catatanTC3' => null,
'catatanTC4' => null,
'catatanTC5' => null,
'catatanTC6' => null,
'catatanTC7' => null,
'catatanTC8' => null,
'catatanTC9' => null,
'catatanTC10' => null,
'statusrujukan' => $requestLog->status_rujukan,
'statusklaim' => 0,
'notransaksiprovider' => $requestLog->no_transaksi_provider,
'inacbgscode' => $requestLog->inacbgs_code,
'inacbgsamount' => (float) ($requestLog->inacbgs_amount ?? 0),
]],
'Biaya' => $biayaResponse,
]);
}
public function getRincianBiayaKlaim(Request $request)
{
$request->validate([
'noklaim' => 'required|string',
'kodeprovider' => 'required|string',
'p_user_no' => 'required',
'p_token' => 'required|string',
]);
[$provider, $organization, $authError] = $this->resolveProvider($request->kodeprovider, $request->p_user_no, $request->p_token);
if ($authError) {
return $authError;
}
$requestLog = RequestLog::query()
->with(['plan', 'requestLogBenefits.benefit'])
->where('code', $request->noklaim)
->where('organization_id', $organization->id)
->first();
if (!$requestLog) {
return $this->statusError('Nomor klaim tidak ditemukan');
}
$biaya = $requestLog->requestLogBenefits->map(function (RequestLogBenefit $requestLogBenefit) use ($requestLog) {
return [
'noklaim' => $requestLog->code,
'kodesubbenefit' => optional($requestLogBenefit->benefit)->code,
'namasubbenefit' => optional($requestLogBenefit->benefit)->description,
'kodebenefit' => optional($requestLog->plan)->code,
'namabenefit' => optional($requestLog->plan)->corporate_plan_id,
'biayaaju' => (float) ($requestLogBenefit->amount_incurred ?? 0),
'jaminanasuransi' => (float) ($requestLogBenefit->amount_approved ?? 0),
'jaminanpeserta' => (float) ($requestLogBenefit->excess_paid ?? 0),
'keterangan' => $requestLogBenefit->keterangan,
];
})->values();
return response()->json([
'Status' => $this->okStatus(),
'Data' => [
'noklaim' => $requestLog->code,
'kodeprovider' => $organization->code,
'nosep' => $requestLog->nomor_sep,
'keterangan' => $requestLog->keterangan,
'statusklaim' => $requestLog->status,
],
'Biaya' => $biaya,
]);
}
public function downloadStrukPendaftaran(Request $request)
{
$request->validate([
'noklaim' => 'required|string',
'kodeprovider' => 'required|string',
'p_user_no' => 'required',
'p_token' => 'required|string',
]);
[$provider, $organization, $authError] = $this->resolveProvider($request->kodeprovider, $request->p_user_no, $request->p_token);
if ($authError) {
return $authError;
}
$requestLog = RequestLog::query()->where('code', $request->noklaim)->where('organization_id', $organization->id)->first();
if (!$requestLog) {
return $this->statusError('Nomor klaim tidak ditemukan');
}
$member = Member::findOrFail($requestLog->member_id)
->load(['currentPlan', 'currentPolicy', 'currentPlan.corporateBenefits', 'currentPlan.corporateBenefits.benefit']);
$dateOfAdmission = $requestLog->admission_date ? Carbon::parse($requestLog->admission_date) : now();
try {
$pdf = PDF::loadView('pdf.guaranted_leter', compact('member', 'dateOfAdmission'));
return $pdf->download('Struk-Pendaftaran-' . $requestLog->code . '.pdf');
} catch (Throwable $e) {
return $this->statusError('Gagal generate PDF struk pendaftaran: ' . $e->getMessage(), 500);
}
}
public function downloadStrukPengesahan(Request $request)
{
$request->validate([
'noklaim' => 'required|string',
'kodeprovider' => 'required|string',
'p_user_no' => 'required',
'p_token' => 'required|string',
]);
[$provider, $organization, $authError] = $this->resolveProvider($request->kodeprovider, $request->p_user_no, $request->p_token);
if ($authError) {
return $authError;
}
$requestLog = RequestLog::query()->where('code', $request->noklaim)->where('organization_id', $organization->id)->first();
if (!$requestLog) {
return $this->statusError('Nomor klaim tidak ditemukan');
}
$member = Member::findOrFail($requestLog->member_id)
->load(['currentPlan', 'currentPolicy', 'currentPlan.corporateBenefits', 'currentPlan.corporateBenefits.benefit']);
$dateOfAdmission = $requestLog->discharge_date ? Carbon::parse($requestLog->discharge_date) : now();
try {
$pdf = PDF::loadView('pdf.guaranted_leter', compact('member', 'dateOfAdmission'));
return $pdf->download('Struk-Pengesahan-' . $requestLog->code . '.pdf');
} catch (Throwable $e) {
return $this->statusError('Gagal generate PDF struk pengesahan: ' . $e->getMessage(), 500);
}
}
private function resolveProvider(string $kodeProvider, $userId, string $token): array
{
$organization = Organization::query()->where('code', $kodeProvider)->first();
if (!$organization) {
return [null, null, $this->statusError('Kode provider tidak ditemukan')];
}
$provider = Provider::query()
->where('id', $userId)
->where('organization_id', $organization->id)
->where('code', $kodeProvider)
->where('status', 'active')
->first();
if (!$provider) {
return [null, null, $this->statusError('User provider tidak ditemukan')];
}
if ((string) $provider->token !== (string) $token) {
return [null, null, $this->statusError('Token tidak valid')];
}
return [$provider, $organization, null];
}
private function resolvePlan(Member $member, string $serviceCode)
{
$memberPlan = $member->memberPlans()->with('plan')
->where('status', 'active')
->orderByDesc('id')
->get()
->first(function (MemberPlan $item) use ($serviceCode) {
return optional($item->plan)->service_code === $serviceCode;
});
if ($memberPlan && $memberPlan->plan) {
return $memberPlan->plan;
}
return optional($member->memberPlans()->with('plan')->orderByDesc('id')->first())->plan;
}
private function okStatus(): array
{
return [
'errornumber' => 0,
'messagestring' => 'Success',
];
}
private function statusError(string $message, int $statusCode = 400)
{
return response()->json([
'Status' => [
'errornumber' => 1,
'messagestring' => $message,
],
'Data' => null,
], $statusCode);
}
private function headerError(string $message, int $statusCode = 400)
{
return response()->json([
'header-token' => null,
'userid' => 0,
'usertoken' => null,
'kodeprovider' => null,
'namaprovider' => null,
'errornumber' => 1,
'messagestring' => $message,
], $statusCode);
}
private function isoDate($date): ?string
{
if (empty($date)) {
return null;
}
return Carbon::parse($date)->toISOString();
}
}