hamed/clinicpro
1
0
Fork 0
Code Issues Pull Requests Actions Packages Projects Releases Wiki Activity

feat(insurance): bill an appointment with a chosen service kind and insurance

Browse Source 
An appointment can now carry the insurance it is billed with: the service kind
(outpatient/inpatient) and the basic insurance. Confirming it no longer hands the
whole amount to the patient — the visit is split through BillingCalculator with the
coverage percent of that service kind, and the choice travels to the encounter and
the invoice built from it.

The enabled service kinds are a tenant-wide setting (all of that tenant's
insurances share it), so a tenant covering only one kind is never asked which one:
the panel resolves it the same way the server does.

- add tenant_service_category_settings + TenantServiceCategoryService, exposed on
  the existing insurance-pricing endpoint (service_categories,
  default_service_category); at least one kind must stay enabled
- add appointments.insurance_service_category / insurance_base_id with
  AppointmentInsuranceService validating them against the tenant's own settings
  and active contracts (basic only), accepted by PATCH and by confirm
- snapshot the kind on patient_sessions and invoices; the visit's coverage rule is
  resolved per kind (services keep using their own ServiceItem.service_category)
- lib/insuranceShares becomes the single client-side mirror of BillingCalculator,
  shared by the confirm modal, the appointment edit page and the session form
- surface the selection: confirm modal (with live shares), turns timeline chip,
  appointment edit page, patient record service card and invoice summary
- the session form shows the insurance block whenever the tenant has an active
  contract and prefills the patient's own insurance, so it can be changed
- fix: the confirm modal showed a zero visit price when the appointment had none —
  it now falls back to the tenant's free-visit price like the server
- fix: useServiceCategories read one level too shallow, so Persian labels never
  arrived and raw enum keys leaked into the contract summary
- fix: BlogsPage test asserted the public blogs endpoint after the page moved to
  the admin one

Co-Authored-By: Claude Opus 5 (1M context) <noreply@anthropic.com>
This commit is contained in:
hamed
2026-07-25 17:50:14 +03:30
co-authored by Claude Opus 5
parent 58c6d9ac18
commit 1f58b1b9b3
47 changed files with 2693 additions and 86 deletions
Download Patch File Download Diff File Expand all files Collapse all files
docs/api/appointment.md
+35 -3
View File
@@ -351,12 +351,25 @@ Get appointment detail.
"note": "...",
"patient_name": "...",
"patient_mobile": "...",
"insurance_service_category": "inpatient",
"insurance_service_category_label": "خدمات بستری",
"insurance_base_id": 3,
"created_at": 1717000000
}
}
```
> `doctor.specialties` آرایه (ممکن است خالی)؛ `address` اولین آدرس پزشک است (ممکن است `null` اگر پزشک آدرسی ندارد). `address.map.latitude/longitude` رشته یا `null`. تاریخ‌ها Unix.
### انتخاب بیمهٔ نوبت
| فیلد | نوع | توضیح |
|------|-----|-------|
| `insurance_service_category` | string \| null | نوع خدمتِ بیمه‌ایِ این نوبت — یکی از مقادیر [`GET /api/v1/service-categories`](clinic-services.md#get-apiv1service-categories). `null` = انتخاب نشده؛ محاسبه به نوع پیش‌فرضِ tenant برمی‌گردد (`default_service_category` در [insurance.md](insurance.md)) |
| `insurance_service_category_label` | string \| null | برچسب فارسی همان نوع |
| `insurance_base_id` | int \| null | بیمهٔ **پایهٔ** انتخاب‌شده؛ باید قرارداد فعال روی همان پزشک/کلینیک داشته باشد |
نام بیمه در این پاسخ نیست؛ پنل آن را از `GET /api/v1/billing/tenant-insurances` (که کش می‌شود) مپ می‌کند تا لیست‌های نوبت به N+1 نیفتند.
### Errors
| Code | HTTP | Description |
|------|------|-------------|
@@ -530,6 +543,8 @@ transaction**. If any step fails nothing is committed.
```json
{
"version": 3,
"insurance_service_category": "inpatient",
"insurance_base_id": 3,
"payments": [
{ "method": "pos", "amount_rials": 3000000, "payment_method_uuid": "…pos-uuid…", "reference": "TRX-42" },
{ "method": "cash", "amount_rials": 2000000 }
@@ -540,6 +555,8 @@ transaction**. If any step fails nothing is committed.
| Field | Type | Required | Description |
|-------|------|----------|-------------|
| `version` | integer | ❌ | Optimistic lock version; defaults to the stored one |
| `insurance_service_category` | string | ❌ | نوع خدمتِ بیمه‌ای، همان قواعد و خطاهای `PATCH /api/v1/appointment/{uuid}`. قبل از ساخت مراجعه روی نوبت می‌نشیند تا سهم‌ها با همان نوع محاسبه شوند. |
| `insurance_base_id` | integer | ❌ | بیمهٔ پایه، همان قواعد و خطاهای `PATCH`. |
| `payments` | array | ❌ | Empty/absent = confirm without payment. Several rows allowed (split payment). |
| `payments[].method` | string | ✅ | ∈ `wallet\|pos\|cash\|card` |
| `payments[].amount_rials` | integer | ✅ | > 0 |
@@ -554,12 +571,24 @@ Partial payment is normal: the remainder stays as `remaining_rials` on the visit
collected later through `POST /api/v1/session/{uuid}/payments`.
### What happens on the server
1. `pending → confirmed` (state machine still applies).
2. `AppointmentConfirmationService` files the case file for the appointment's environment
1. انتخاب بیمه (اگر در بدنه آمده باشد) روی نوبت می‌نشیند و اعتبارسنجی می‌شود.
2. `pending → confirmed` (state machine still applies).
3. `AppointmentConfirmationService` files the case file for the appointment's environment
(`appointment.clinic` → clinic, otherwise the doctor's personal office): an **existing**
record for that patient in that environment is reused, otherwise a new one is created.
A `PatientSession` is opened with the visit price and one line per attached service.
3. Each payment row is registered on that visit (`wallet` also debits the patient wallet).
4. **تفکیک بیمه** روی همان مراجعه محاسبه می‌شود (`BillingCalculator`): درصد پوشش از
نوع خدمتِ نوبت — یا تنها نوع فعالِ tenant، وگرنه سرپایی — و زنجیرهٔ resolve
([insurance.md](insurance.md#قاعدهٔ-درصد-پوشش-coverage-percent-model)). نوبتِ بدون بیمه
مثل قبل کاملاً سهم بیمار می‌ماند.
5. Each payment row is registered on that visit (`wallet` also debits the patient wallet).
> پیش از این، پرونده‌ای که با قطعی‌کردن ساخته می‌شد همیشه کل مبلغ را سهم بیمار می‌گذاشت
> (`applyShares($gross, 0, 0, $gross)`) و صفحهٔ پرداخت با فاکتور واگرا می‌شد.
پاسخ، `session` را با تفکیک بیمه برمی‌گرداند: `gross_total_rials`، `base_insurance_rials`،
`supplementary_insurance_rials`، `patient_share_rials`، `insurance_service_category`،
`insurance_base_id` — تا مودال همان مبلغی را نشان دهد که ثبت شده است.
### Response `200`
```json
@@ -834,12 +863,15 @@ General update (ویرایش / جا به جایی / انتقال به رزرو /
"service_section_uuid": "…", "service_item_uuid": "…", "staff_uuid": "…",
"deposit_required": true, "deposit_amount_rials": 5000000,
"note": "…", "patient_name": "…", "patient_mobile": "…",
"insurance_service_category": "inpatient", "insurance_base_id": 3,
"status": "confirmed", "version": 3
}
```
- `slot_start`/`slot_end` must be sent together; moving to an occupied slot → `409`.
- Relation uuids: empty string clears; unknown uuid → `422`.
- `insurance_service_category` — نوعِ خدمت باید در تنظیمات بیمهٔ همان tenant **فعال** باشد؛ `null`/`""` انتخاب را پاک می‌کند. نوع نامعتبر یا غیرفعال → `422 ERR_VALIDATION_001` با فیلد `insurance_service_category`.
- `insurance_base_id` — بیمه باید قرارداد فعال روی همان پزشک/کلینیک داشته باشد و **پایه** باشد؛ `null`/`0` انتخاب را پاک می‌کند. بیمهٔ بدون قرارداد فعال یا بیمهٔ تکمیلی → `422 ERR_VALIDATION_001` با فیلد `insurance_base_id`.
- `status` follows the same transition rules as `PATCH /appointment/{uuid}/status`. A transition to `cancelled_by_doctor`/`cancelled_by_user` records a cancellation event (Timeline) + `app_log` warning; an optional `cancel_reason` body field is stored on the event. An inline cancellation is gated on `appointments.cancel` exactly like the dedicated status endpoint, so it cannot be used to bypass a secretary's missing cancel permission.
- Optimistic lock via `version` → `409` on concurrent edit.