feat: insurance & medical billing system (6 phases)
Multi-tenant insurance contracts, service coverage, versioned tariffs, invoice calculation, and insurance claims with debt reporting. - TenantInsurance: per-tenant insurance contracts (coverage/franchise/ceiling, versioning, soft-deactivate) + active guard - ServiceItem.insuranceCovered + TenantServiceCoverage per-service overrides - Tariff: versioned yearly tariffs with fallback to ServiceItem price - Billing domain: Money/ShareBreakdown VOs, BillingCalculator (unit-tested), Invoice/InvoiceItem aggregate, InvoiceService.createFromSession - Claim/ClaimItem with state machine (pending->submitted->approved/rejected->paid), ClaimService, insurance-debt report - ClaimSubmitterInterface + ManualClaimSubmitter (future insurance API ready) - Admin UI: insurance-pricing page, claims page, service tariff modal, service insurance toggle; routes + sidebar entries - Architecture doc + billing/insurance/clinic-services API docs Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>
This commit is contained in:
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# قیمتگذاری ویزیت بر اساس بیمه در پروفایل کلینیک/مطب
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## پروژه
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`clinicpro` (backend + admin frontend)
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## زمینه
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در حال حاضر قیمت ویزیت پزشک نسبت به بیمه فقط با موجودیت `DoctorInsurance` ذخیره میشود که **یک فیلد قیمت تکی** (`price`) دارد:
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```php
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// src/Insurance/Entity/DoctorInsurance.php
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#[ORM\Column(type: 'integer', nullable: true)]
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private ?int $price = null;
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```
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این کافی نیست. کاربر (کلینیک یا مطب شخصی) باید بتواند در پروفایل خود مشخص کند:
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- مبلغ **ویزیت آزاد** (بدون بیمه) چقدر است
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- اگر **بیمه پایه** اعمال شود، مبلغ نهایی/سهم بیمار چقدر میشود
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- اگر علاوه بر آن **بیمه مکمل** هم اضافه شود، مبلغ نهایی چقدر میشود
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## مشکل / هدف
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افزودن یک ساختار قیمتگذاری ویزیت بر اساس بیمه در پروفایل entity (هم `doctor` و هم `clinic`)، با سه لایه:
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1. **قیمت پایه آزاد** (free / بدون بیمه)
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2. **سهم/مبلغ با بیمه پایه** — به ازای هر بیمه پایهای که entity میپذیرد
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3. **سهم/مبلغ با بیمه مکمل** — به ازای هر بیمه مکمل
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این مقادیر بعداً در «ثبت مراجعه جدید» (پرامپت `new-visit-modal-ux.md`) برای پر کردن خودکار قیمت ویزیت و درصد/مبلغ تخفیف استفاده میشوند.
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## فایلهای مرتبط
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| فایل | نقش |
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|------|-----|
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| `src/Insurance/Entity/DoctorInsurance.php` | رابطه فعلی پزشک↔بیمه با یک قیمت |
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| `src/Insurance/Entity/Insurance.php` | موجودیت بیمه؛ دارای `type` (enum `InsuranceType`) |
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| `src/Insurance/Enum/InsuranceType.php` | نوع بیمه (پایه/مکمل) — بخوان و مقادیر را تأیید کن |
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| `src/Insurance/Controller/InsuranceController.php` | CRUD بیمه + `DoctorInsurance` (از خط ۱۸۶) |
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| `src/Insurance/Repository/DoctorInsuranceRepository.php` | کوئریها |
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| `assets/admin/pages/MyClinicPage.tsx` و `DoctorProfilePage.tsx` | پروفایل کلینیک/مطب در پنل |
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| `docs/api/insurance.md` | مستندات API بیمه |
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## وضعیت فعلی
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`DoctorInsurance.toArray()`:
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```php
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return [
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'id' => $this->id,
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'doctor_id' => $this->doctor->getId(),
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'insurance_id' => $this->insurance->getId(),
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'insurance_name' => $this->insurance->getName(),
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'type' => $this->insurance->getType()->value,
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'price' => $this->price,
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];
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```
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- فقط برای `doctor` است؛ معادل `clinic` وجود ندارد.
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- فقط یک `price` تکی دارد؛ تفکیک آزاد/پایه/مکمل ندارد.
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## وظایف
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### ۱. تحلیل و طراحی مدل قیمتگذاری
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ابتدا `InsuranceType` و `DoctorInsurance` و `InsuranceController` (بخش DoctorInsurance) را کامل بخوان. سپس تصمیم بگیر:
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- آیا «ویزیت آزاد» یک فیلد روی پروفایل entity است (یک مقدار) و هر `DoctorInsurance` فقط مبلغ سهم بیمار با آن بیمه را نگه میدارد؟ (پیشنهاد: بله)
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- آیا باید برای `clinic` هم معادل `DoctorInsurance` ساخت (مثلاً عمومیسازی به entity-type/entity-id مثل `PatientRecord`)، یا یک موجودیت جدید `EntityInsurancePricing(entityType, entityId, insuranceId, patientShareRials)` ساخت؟
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> توصیه: یک موجودیت polymorphic جدید `EntityInsurancePricing` با کلیدهای `entity_type` (`doctor|clinic`)، `entity_id`، `insurance_id`، `patient_share_rials` بساز و `DoctorInsurance` را بهمرور کنار بگذار (اما دادهی فعلی را migrate کن). قیمت ویزیت آزاد را روی پروفایل entity (یک کلید config یا ستون) نگهدار.
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طرح نهایی را قبل از پیادهسازی بهصورت یک پاراگراف توضیح بده.
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### ۲. Entity + Migration
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- موجودیت/فیلدهای جدید را بساز (طبق طرح مرحله ۱).
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- مقدار «ویزیت آزاد» را برای entity ذخیره کن.
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- `doctrine:migrations:diff` سپس `migrate`.
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- دادهی موجود `doctor_insurances.price` را به مدل جدید migrate کن (در همان migration یا یک migration دادهای).
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### ۳. API
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Endpointها برای خواندن/ذخیره قیمتگذاری بیمهی entity جاری (از `#[CurrentUser]` → resolve به `doctor` یا `clinic` مثل الگوی `PatientController::resolveEntity`):
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- `GET /api/v1/insurance-pricing` — لیست قیمتگذاری entity جاری + قیمت ویزیت آزاد
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- `PUT|PATCH /api/v1/insurance-pricing` — ذخیرهی قیمت آزاد + آرایهی سهم هر بیمه
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از `BaseController` و helperهای `$this->success()` / `$this->error()` استفاده کن.
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### ۴. Admin Frontend
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در `MyClinicPage.tsx` و `DoctorProfilePage.tsx` یک بخش «قیمتگذاری ویزیت بر اساس بیمه» اضافه کن:
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- ورودی «مبلغ ویزیت آزاد (ریال)»
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- جدول/لیست بیمههای پایه و مکمل (از `GET /api/v1/insurances`) با یک ورودی مبلغ سهم بیمار به ازای هر کدام
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- پیشنمایش: «آزاد: X — با بیمه پایه Y: Z — با بیمه مکمل W: …»
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- ذخیره با TanStack Query `useMutation`
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### ۵. مستندات
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`docs/api/insurance.md` را با endpointهای جدید (method/path/permission، body کامل، نمونه پاسخ JSON واقعی، error codeها) بهروز کن.
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## نکات مهم
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- entity جاری از `#[CurrentUser]` resolve میشود؛ الگو را از `PatientController::resolveEntity` بگیر (نقش `ROLE_DOCTOR` → doctor، `ROLE_CLINIC` → clinic).
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- تاریخها/قیمتها همه integer ریال هستند.
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- این پرامپت پیشنیاز `new-visit-modal-ux.md` است؛ خروجی قیمتها آنجا مصرف میشود.
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- مهاجرت دادهی `DoctorInsurance` نباید قیمتهای موجود را از بین ببرد.
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@@ -0,0 +1,98 @@
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# مشخصکردن شمول بیمه برای هر خدمت
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## پروژه
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`clinicpro` (backend + admin frontend)
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## زمینه
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هر خدمت کلینیک با موجودیت `ServiceItem` نگهداری میشود. در حال حاضر هیچ فیلدی ندارد که بگوید این خدمت **شامل بیمه میشود یا نه**.
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## مشکل / هدف
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افزودن قابلیت تعیین «شمول بیمه» به هر `ServiceItem`:
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- یک پرچم: آیا این خدمت شامل بیمه میشود؟
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- اگر شامل میشود، اطلاعات لازم برای محاسبهی درست (مثلاً سهم بیمار / درصد پوشش / لیست بیمههای پذیرفتهشده) ذخیره و نمایش داده شود.
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## فایلهای مرتبط
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| فایل | نقش |
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|------|-----|
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| `src/ClinicService/Entity/ServiceItem.php` | موجودیت خدمت |
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| `src/ClinicService/Controller/ClinicServiceController.php` | CRUD خدمات/بخشها |
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| `src/ClinicService/Repository/ServiceItemRepository.php` | کوئریها |
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| `assets/admin/pages/ClinicServicesPage.tsx` | صفحهی مدیریت خدمات در پنل |
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| `src/Patient/Service/PatientService.php` | محاسبهی قیمت مراجعه (مصرفکنندهی خدمت) |
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| `docs/api/clinic-services.md` | مستندات API خدمات |
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## وضعیت فعلی
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`ServiceItem` فیلدهای موجود:
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```php
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private string $name;
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#[ORM\Column(name: 'price_rials', type: 'integer')]
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private int $priceRials = 0;
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#[ORM\Column(type: 'boolean')]
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private bool $active = true;
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```
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`toArray()`:
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```php
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return [
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'uuid' => $this->uuid,
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'section_uuid' => $this->section->getUuid(),
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'staff_uuid' => $this->staff?->getUuid(),
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'staff_name' => $this->staff?->getFullName(),
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'name' => $this->name,
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'price_rials' => $this->priceRials,
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'active' => $this->active,
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'created_at' => $this->createdAt,
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'updated_at' => $this->updatedAt,
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];
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```
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هیچ مفهوم بیمهای ندارد.
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## وظایف
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### ۱. طراحی فیلد شمول بیمه
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تصمیم بگیر مدل داده چه باشد:
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- ساده: یک `bool $insuranceCovered = false`.
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- کاملتر: `bool $insuranceCovered` + `?int $patientShareRials` (سهم بیمار وقتی بیمه اعمال شود) یا `?float $coveragePercent`.
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> توصیه: `insuranceCovered` (bool) + `?int $insurancePriceRials` (قیمت/سهم بیمار با بیمه). اگر `insuranceCovered=false`، فیلد دوم نادیده گرفته شود.
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طرح را قبل از پیادهسازی توضیح بده.
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### ۲. Entity + Migration
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- فیلد(ها) را به `ServiceItem` اضافه کن + getter/setter.
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- در `toArray()` اضافه کن.
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- `doctrine:migrations:diff` سپس `migrate`.
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### ۳. API
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`ClinicServiceController` (create/update خدمت) باید فیلدهای جدید را از body بپذیرد و ذخیره کند. validation مناسب (اگر `insurance_covered=true` و قیمت بیمه خالی، خطا یا صفر منطقی).
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### ۴. Admin Frontend
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در `ClinicServicesPage.tsx` فرم خدمت:
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- یک toggle/checkbox «شامل بیمه میشود»
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- وقتی روشن شد، ورودی «قیمت با بیمه (ریال)» نمایش داده شود
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- در لیست خدمات، یک badge نشان دهد خدمت شامل بیمه است یا خیر
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### ۵. مستندات
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`docs/api/clinic-services.md` را با فیلدهای جدید در request/response بهروز کن.
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## نکات مهم
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- قیمتها integer ریال.
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- این فیلد بعداً در محاسبهی قیمت مراجعه (`PatientService::createSession`) قابل استفاده است؛ در این پرامپت فقط ذخیره/نمایش کافی است مگر اینکه ساده باشد همانجا هم اعمال شود.
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- الگوی frontend خدمات موجود را رعایت کن (همان فرم/modal فعلی).
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@@ -30,6 +30,8 @@ import MyClinicPage from './pages/MyClinicPage';
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import SettingsPage from './pages/SettingsPage';
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import DoctorProfilePage from './pages/DoctorProfilePage';
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import MyPatientsPage from './pages/MyPatientsPage';
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import InsurancePricingPage from './pages/InsurancePricingPage';
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import ClaimsPage from './pages/ClaimsPage';
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import MyFinancialPage from './pages/MyFinancialPage';
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import ClinicFormPage from './pages/ClinicFormPage';
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import PreRegistrationsPage from './pages/PreRegistrationsPage';
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@@ -168,6 +170,8 @@ export default function App() {
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{/* دکتر / منشی / کلینیک */}
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<Route path="my-patients" element={<RoleRoute roles={['doctor', 'secretary', 'clinic']} blockClinicScope><MyPatientsPage /></RoleRoute>} />
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<Route path="insurance-pricing" element={<RoleRoute roles={['doctor', 'clinic']} blockClinicScope><InsurancePricingPage /></RoleRoute>} />
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<Route path="claims" element={<RoleRoute roles={['doctor', 'clinic']} blockClinicScope><ClaimsPage /></RoleRoute>} />
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<Route path="my-financial" element={<RoleRoute roles={['doctor', 'secretary', 'clinic']}><MyFinancialPage /></RoleRoute>} />
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{/* فاز ۲ — دکتر / کلینیک */}
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@@ -0,0 +1,169 @@
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import { useEffect, useState } from 'react';
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import { useQuery, useMutation, useQueryClient } from '@tanstack/react-query';
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import { toast } from 'sonner';
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import { api } from '../lib/api';
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import { formatRial } from '../lib/utils';
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interface InsuranceRow {
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insurance_id: number;
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insurance_name: string;
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type: string;
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patient_share_rials: number | null;
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}
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interface PricingResponse {
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free_visit_price_rials: number;
|
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insurances: InsuranceRow[];
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}
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const TYPE_LABEL: Record<string, string> = {
|
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basic: 'بیمه پایه',
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supplementary: 'بیمه تکمیلی',
|
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};
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|
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export default function InsurancePricingSection() {
|
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const qc = useQueryClient();
|
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const [freeVisit, setFreeVisit] = useState('');
|
||||
const [shares, setShares] = useState<Record<number, string>>({});
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||||
|
||||
const { data, isLoading } = useQuery<{ data: PricingResponse }>({
|
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queryKey: ['insurance-pricing'],
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queryFn: () => api.get('/api/v1/insurance-pricing'),
|
||||
});
|
||||
|
||||
const pricing = (data as any)?.data as PricingResponse | undefined;
|
||||
|
||||
useEffect(() => {
|
||||
if (!pricing) return;
|
||||
setFreeVisit(String(pricing.free_visit_price_rials ?? 0));
|
||||
const next: Record<number, string> = {};
|
||||
pricing.insurances.forEach((i) => {
|
||||
next[i.insurance_id] = i.patient_share_rials != null ? String(i.patient_share_rials) : '';
|
||||
});
|
||||
setShares(next);
|
||||
}, [pricing]);
|
||||
|
||||
const saveMut = useMutation({
|
||||
mutationFn: () =>
|
||||
api.put('/api/v1/insurance-pricing', {
|
||||
free_visit_price_rials: Number(freeVisit) || 0,
|
||||
insurances: (pricing?.insurances ?? []).map((i) => ({
|
||||
insurance_id: i.insurance_id,
|
||||
patient_share_rials:
|
||||
shares[i.insurance_id] === '' || shares[i.insurance_id] == null
|
||||
? null
|
||||
: Number(shares[i.insurance_id]) || 0,
|
||||
})),
|
||||
}),
|
||||
onSuccess: () => {
|
||||
toast.success('قیمتگذاری بیمه ذخیره شد');
|
||||
qc.invalidateQueries({ queryKey: ['insurance-pricing'] });
|
||||
},
|
||||
onError: (e: Error) => toast.error(e.message),
|
||||
});
|
||||
|
||||
const basics = (pricing?.insurances ?? []).filter((i) => i.type === 'basic');
|
||||
const supps = (pricing?.insurances ?? []).filter((i) => i.type === 'supplementary');
|
||||
|
||||
const renderRow = (i: InsuranceRow) => {
|
||||
const share = shares[i.insurance_id] ?? '';
|
||||
const preview =
|
||||
share !== '' && freeVisit !== ''
|
||||
? `سهم بیمار: ${formatRial(Number(share) || 0)}`
|
||||
: 'تعیین نشده';
|
||||
return (
|
||||
<div
|
||||
key={i.insurance_id}
|
||||
style={{
|
||||
display: 'flex',
|
||||
alignItems: 'center',
|
||||
gap: 12,
|
||||
padding: '10px 12px',
|
||||
borderRadius: 10,
|
||||
border: '1px solid var(--border)',
|
||||
background: 'var(--surface)',
|
||||
}}
|
||||
>
|
||||
<div style={{ flex: 1, minWidth: 0 }}>
|
||||
<div style={{ fontWeight: 600, fontSize: 13.5 }}>{i.insurance_name}</div>
|
||||
<div style={{ fontSize: 11.5, color: 'var(--text-3)', marginTop: 2 }}>{preview}</div>
|
||||
</div>
|
||||
<div style={{ display: 'flex', alignItems: 'center', gap: 6 }}>
|
||||
<input
|
||||
type="number"
|
||||
min={0}
|
||||
dir="ltr"
|
||||
className="input"
|
||||
style={{ width: 150 }}
|
||||
placeholder="سهم بیمار (ریال)"
|
||||
value={share}
|
||||
onChange={(e) =>
|
||||
setShares((p) => ({ ...p, [i.insurance_id]: e.target.value }))
|
||||
}
|
||||
/>
|
||||
</div>
|
||||
</div>
|
||||
);
|
||||
};
|
||||
|
||||
return (
|
||||
<div className="card" style={{ padding: 20 }}>
|
||||
<div style={{ marginBottom: 14 }}>
|
||||
<h2 style={{ fontSize: 14, fontWeight: 700, margin: 0 }}>قیمتگذاری ویزیت بر اساس بیمه</h2>
|
||||
<p style={{ fontSize: 12, color: 'var(--text-3)', marginTop: 4, lineHeight: 1.7 }}>
|
||||
مبلغ ویزیت آزاد و سهم بیمار به ازای هر بیمه را تعیین کنید. خالیگذاشتن یک بیمه یعنی پذیرفته نمیشود.
|
||||
</p>
|
||||
</div>
|
||||
|
||||
{isLoading ? (
|
||||
<div className="muted" style={{ fontSize: 13 }}>در حال بارگذاری...</div>
|
||||
) : (
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 18 }}>
|
||||
<div className="field" style={{ flexDirection: 'column', alignItems: 'stretch', height: 'auto', gap: 6, padding: 0, border: 'none', background: 'none' }}>
|
||||
<label style={{ fontSize: 12.5, fontWeight: 600 }}>مبلغ ویزیت آزاد (ریال)</label>
|
||||
<input
|
||||
type="number"
|
||||
min={0}
|
||||
dir="ltr"
|
||||
className="input"
|
||||
style={{ maxWidth: 220 }}
|
||||
value={freeVisit}
|
||||
onChange={(e) => setFreeVisit(e.target.value)}
|
||||
/>
|
||||
<span style={{ fontSize: 11.5, color: 'var(--text-3)' }}>
|
||||
{freeVisit !== '' ? formatRial(Number(freeVisit) || 0) : '—'}
|
||||
</span>
|
||||
</div>
|
||||
|
||||
{basics.length > 0 && (
|
||||
<div>
|
||||
<div style={{ fontSize: 12.5, fontWeight: 600, marginBottom: 8, color: 'var(--text-2)' }}>{TYPE_LABEL.basic}</div>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 8 }}>{basics.map(renderRow)}</div>
|
||||
</div>
|
||||
)}
|
||||
|
||||
{supps.length > 0 && (
|
||||
<div>
|
||||
<div style={{ fontSize: 12.5, fontWeight: 600, marginBottom: 8, color: 'var(--text-2)' }}>{TYPE_LABEL.supplementary}</div>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 8 }}>{supps.map(renderRow)}</div>
|
||||
</div>
|
||||
)}
|
||||
|
||||
{basics.length === 0 && supps.length === 0 && (
|
||||
<div style={{ fontSize: 12.5, color: 'var(--text-3)' }}>بیمه فعالی در سیستم تعریف نشده است.</div>
|
||||
)}
|
||||
|
||||
<div>
|
||||
<button
|
||||
className="btn primary sm"
|
||||
disabled={saveMut.isPending}
|
||||
onClick={() => saveMut.mutate()}
|
||||
>
|
||||
{saveMut.isPending ? 'در حال ذخیره...' : 'ذخیره قیمتگذاری'}
|
||||
</button>
|
||||
</div>
|
||||
</div>
|
||||
)}
|
||||
</div>
|
||||
);
|
||||
}
|
||||
@@ -0,0 +1,94 @@
|
||||
import { useState } from 'react';
|
||||
import { useQuery, useMutation, useQueryClient } from '@tanstack/react-query';
|
||||
import { toast } from 'sonner';
|
||||
import { api } from '../lib/api';
|
||||
import { formatRial, formatNumber } from '../lib/utils';
|
||||
import Modal from './ui/Modal';
|
||||
import type { ServiceItem } from '../types';
|
||||
|
||||
interface TariffRow {
|
||||
uuid: string;
|
||||
year: number;
|
||||
price_rials: number;
|
||||
is_active: boolean;
|
||||
}
|
||||
|
||||
interface TariffResponse {
|
||||
current_year: number;
|
||||
default_price_rials: number;
|
||||
data: TariffRow[];
|
||||
}
|
||||
|
||||
export default function ServiceTariffModal({ item, onClose }: { item: ServiceItem | null; onClose: () => void }) {
|
||||
const qc = useQueryClient();
|
||||
const [year, setYear] = useState('');
|
||||
const [price, setPrice] = useState('');
|
||||
|
||||
const { data, isLoading } = useQuery<{ data: TariffResponse }>({
|
||||
queryKey: ['service-tariffs', item?.uuid],
|
||||
queryFn: () => api.get(`/api/v1/service-items/${item!.uuid}/tariffs`),
|
||||
enabled: !!item,
|
||||
});
|
||||
|
||||
const resp = (data as any)?.data as TariffResponse | undefined;
|
||||
const tariffs = resp?.data ?? [];
|
||||
const currentYear = resp?.current_year;
|
||||
|
||||
const saveMut = useMutation({
|
||||
mutationFn: () =>
|
||||
api.put(`/api/v1/service-items/${item!.uuid}/tariffs/${Number(year)}`, {
|
||||
price_rials: Number(price) || 0,
|
||||
}),
|
||||
onSuccess: () => {
|
||||
toast.success('تعرفه ذخیره شد');
|
||||
setYear('');
|
||||
setPrice('');
|
||||
qc.invalidateQueries({ queryKey: ['service-tariffs', item?.uuid] });
|
||||
},
|
||||
onError: (e: Error) => toast.error(e.message),
|
||||
});
|
||||
|
||||
return (
|
||||
<Modal open={!!item} onClose={onClose} title={`تعرفههای سالانه — ${item?.name ?? ''}`}>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 14 }}>
|
||||
{resp && (
|
||||
<div style={{ fontSize: 12.5, color: 'var(--text-3)', lineHeight: 1.7 }}>
|
||||
قیمت پیشفرض خدمت: <b>{formatRial(resp.default_price_rials)}</b>. اگر تعرفهی سالی ثبت نشود، همین قیمت اعمال میشود.
|
||||
</div>
|
||||
)}
|
||||
|
||||
<div style={{ display: 'flex', flexWrap: 'wrap', gap: 10, alignItems: 'flex-end', padding: 12, borderRadius: 10, border: '1px solid var(--border)', background: 'var(--surface)' }}>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 4 }}>
|
||||
<label style={{ fontSize: 11.5, fontWeight: 600 }}>سال (شمسی)</label>
|
||||
<input type="number" dir="ltr" className="input" style={{ width: 100 }} placeholder={currentYear ? String(currentYear) : '۱۴۰۴'} value={year} onChange={(e) => setYear(e.target.value)} />
|
||||
</div>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 4 }}>
|
||||
<label style={{ fontSize: 11.5, fontWeight: 600 }}>تعرفه (ریال)</label>
|
||||
<input type="number" min={0} dir="ltr" className="input" style={{ width: 150 }} value={price} onChange={(e) => setPrice(e.target.value)} />
|
||||
</div>
|
||||
<button className="btn primary sm" disabled={!year || saveMut.isPending} onClick={() => saveMut.mutate()}>
|
||||
{saveMut.isPending ? '...' : 'ذخیره'}
|
||||
</button>
|
||||
</div>
|
||||
|
||||
{isLoading ? (
|
||||
<div className="muted" style={{ fontSize: 13 }}>در حال بارگذاری...</div>
|
||||
) : tariffs.length === 0 ? (
|
||||
<div style={{ fontSize: 12.5, color: 'var(--text-3)' }}>هنوز تعرفهی سالانهای ثبت نشده است.</div>
|
||||
) : (
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 6 }}>
|
||||
{tariffs.map((t) => (
|
||||
<div key={t.uuid} style={{ display: 'flex', justifyContent: 'space-between', alignItems: 'center', padding: '8px 12px', borderRadius: 8, border: '1px solid var(--border)' }}>
|
||||
<span style={{ fontWeight: 600, fontSize: 13 }}>
|
||||
سال {formatNumber(t.year)}
|
||||
{t.year === currentYear && <span className="badge green" style={{ fontSize: 10, marginInlineStart: 6 }}><span className="bdot" />جاری</span>}
|
||||
</span>
|
||||
<span style={{ color: 'var(--primary)', fontWeight: 600, fontSize: 13 }}>{formatRial(t.price_rials)}</span>
|
||||
</div>
|
||||
))}
|
||||
</div>
|
||||
)}
|
||||
</div>
|
||||
</Modal>
|
||||
);
|
||||
}
|
||||
@@ -0,0 +1,164 @@
|
||||
import { useState } from 'react';
|
||||
import { useQuery, useMutation, useQueryClient } from '@tanstack/react-query';
|
||||
import { TrashIcon, PlusIcon } from '@heroicons/react/24/outline';
|
||||
import { toast } from 'sonner';
|
||||
import { api } from '../lib/api';
|
||||
import { formatRial } from '../lib/utils';
|
||||
|
||||
interface Contract {
|
||||
uuid: string;
|
||||
insurance_id: number;
|
||||
insurance_name: string | null;
|
||||
insurance_kind: string | null;
|
||||
version: number;
|
||||
coverage_percent: number;
|
||||
franchise_rials: number;
|
||||
annual_ceiling_rials: number | null;
|
||||
}
|
||||
|
||||
interface InsuranceOption {
|
||||
insurance_id: number;
|
||||
insurance_name: string;
|
||||
type: string;
|
||||
}
|
||||
|
||||
const KIND_LABEL: Record<string, string> = {
|
||||
basic: 'پایه',
|
||||
supplementary: 'تکمیلی',
|
||||
};
|
||||
|
||||
export default function TenantInsuranceContracts() {
|
||||
const qc = useQueryClient();
|
||||
const [addOpen, setAddOpen] = useState(false);
|
||||
const [insuranceId, setInsuranceId] = useState('');
|
||||
const [coverage, setCoverage] = useState('');
|
||||
const [franchise, setFranchise] = useState('');
|
||||
const [ceiling, setCeiling] = useState('');
|
||||
|
||||
const contractsQuery = useQuery<{ data: Contract[] }>({
|
||||
queryKey: ['tenant-insurances'],
|
||||
queryFn: () => api.get('/api/v1/billing/tenant-insurances'),
|
||||
});
|
||||
|
||||
const pricingQuery = useQuery<{ data: { insurances: InsuranceOption[] } }>({
|
||||
queryKey: ['insurance-pricing'],
|
||||
queryFn: () => api.get('/api/v1/insurance-pricing'),
|
||||
});
|
||||
|
||||
const contracts = (contractsQuery.data as any)?.data?.data ?? [];
|
||||
const allInsurances: InsuranceOption[] = (pricingQuery.data as any)?.data?.insurances ?? [];
|
||||
const activeIds = new Set(contracts.map((c: Contract) => c.insurance_id));
|
||||
const available = allInsurances.filter((i) => !activeIds.has(i.insurance_id));
|
||||
|
||||
const resetForm = () => {
|
||||
setInsuranceId('');
|
||||
setCoverage('');
|
||||
setFranchise('');
|
||||
setCeiling('');
|
||||
setAddOpen(false);
|
||||
};
|
||||
|
||||
const addMut = useMutation({
|
||||
mutationFn: () =>
|
||||
api.post('/api/v1/billing/tenant-insurances', {
|
||||
insurance_id: Number(insuranceId),
|
||||
coverage_percent: Number(coverage) || 0,
|
||||
franchise_rials: Number(franchise) || 0,
|
||||
annual_ceiling_rials: ceiling === '' ? null : Number(ceiling),
|
||||
}),
|
||||
onSuccess: () => {
|
||||
toast.success('قرارداد بیمه فعال شد');
|
||||
resetForm();
|
||||
qc.invalidateQueries({ queryKey: ['tenant-insurances'] });
|
||||
},
|
||||
onError: (e: Error) => toast.error(e.message),
|
||||
});
|
||||
|
||||
const delMut = useMutation({
|
||||
mutationFn: (uuid: string) => api.delete(`/api/v1/billing/tenant-insurances/${uuid}`),
|
||||
onSuccess: () => {
|
||||
toast.success('قرارداد غیرفعال شد');
|
||||
qc.invalidateQueries({ queryKey: ['tenant-insurances'] });
|
||||
},
|
||||
onError: (e: Error) => toast.error(e.message),
|
||||
});
|
||||
|
||||
return (
|
||||
<div className="card" style={{ padding: 20, marginBottom: 16 }}>
|
||||
<div style={{ display: 'flex', justifyContent: 'space-between', alignItems: 'flex-start', marginBottom: 14 }}>
|
||||
<div>
|
||||
<h2 style={{ fontSize: 14, fontWeight: 700, margin: 0 }}>قراردادهای بیمه</h2>
|
||||
<p style={{ fontSize: 12, color: 'var(--text-3)', marginTop: 4, lineHeight: 1.7 }}>
|
||||
بیمههایی که با آنها قرارداد دارید. درصد پوشش، فرانشیز و سقف تعهد هر بیمه را تعیین کنید.
|
||||
</p>
|
||||
</div>
|
||||
{!addOpen && available.length > 0 && (
|
||||
<button className="btn primary sm" onClick={() => setAddOpen(true)}>
|
||||
<PlusIcon style={{ width: 14 }} /> افزودن بیمه
|
||||
</button>
|
||||
)}
|
||||
</div>
|
||||
|
||||
{addOpen && (
|
||||
<div style={{ display: 'flex', flexWrap: 'wrap', gap: 10, alignItems: 'flex-end', padding: 14, borderRadius: 10, border: '1px solid var(--border)', background: 'var(--surface)', marginBottom: 14 }}>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 4 }}>
|
||||
<label style={{ fontSize: 11.5, fontWeight: 600 }}>بیمه</label>
|
||||
<select className="input" style={{ minWidth: 160 }} value={insuranceId} onChange={(e) => setInsuranceId(e.target.value)}>
|
||||
<option value="">انتخاب...</option>
|
||||
{available.map((i) => (
|
||||
<option key={i.insurance_id} value={i.insurance_id}>{i.insurance_name} ({KIND_LABEL[i.type] ?? i.type})</option>
|
||||
))}
|
||||
</select>
|
||||
</div>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 4 }}>
|
||||
<label style={{ fontSize: 11.5, fontWeight: 600 }}>درصد پوشش</label>
|
||||
<input type="number" min={0} max={100} dir="ltr" className="input" style={{ width: 100 }} value={coverage} onChange={(e) => setCoverage(e.target.value)} />
|
||||
</div>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 4 }}>
|
||||
<label style={{ fontSize: 11.5, fontWeight: 600 }}>فرانشیز (ریال)</label>
|
||||
<input type="number" min={0} dir="ltr" className="input" style={{ width: 130 }} value={franchise} onChange={(e) => setFranchise(e.target.value)} />
|
||||
</div>
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 4 }}>
|
||||
<label style={{ fontSize: 11.5, fontWeight: 600 }}>سقف تعهد (ریال)</label>
|
||||
<input type="number" min={0} dir="ltr" className="input" style={{ width: 130 }} placeholder="بینهایت" value={ceiling} onChange={(e) => setCeiling(e.target.value)} />
|
||||
</div>
|
||||
<div style={{ display: 'flex', gap: 6 }}>
|
||||
<button className="btn primary sm" disabled={!insuranceId || addMut.isPending} onClick={() => addMut.mutate()}>
|
||||
{addMut.isPending ? '...' : 'ذخیره'}
|
||||
</button>
|
||||
<button className="btn ghost sm" onClick={resetForm}>لغو</button>
|
||||
</div>
|
||||
</div>
|
||||
)}
|
||||
|
||||
{contractsQuery.isLoading ? (
|
||||
<div className="muted" style={{ fontSize: 13 }}>در حال بارگذاری...</div>
|
||||
) : contracts.length === 0 ? (
|
||||
<div style={{ fontSize: 12.5, color: 'var(--text-3)', padding: '12px 0' }}>
|
||||
هنوز با هیچ بیمهای قرارداد فعال ندارید.
|
||||
</div>
|
||||
) : (
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 8 }}>
|
||||
{contracts.map((c: Contract) => (
|
||||
<div key={c.uuid} style={{ display: 'flex', alignItems: 'center', gap: 12, padding: '10px 12px', borderRadius: 10, border: '1px solid var(--border)' }}>
|
||||
<div style={{ flex: 1, minWidth: 0 }}>
|
||||
<div style={{ fontWeight: 600, fontSize: 13.5 }}>
|
||||
{c.insurance_name ?? `#${c.insurance_id}`}
|
||||
{c.insurance_kind && <span className="badge gray" style={{ fontSize: 10, marginInlineStart: 6 }}>{KIND_LABEL[c.insurance_kind] ?? c.insurance_kind}</span>}
|
||||
</div>
|
||||
<div style={{ fontSize: 11.5, color: 'var(--text-3)', marginTop: 2 }}>
|
||||
پوشش {c.coverage_percent}٪
|
||||
{c.franchise_rials > 0 && ` · فرانشیز ${formatRial(c.franchise_rials)}`}
|
||||
{c.annual_ceiling_rials != null && ` · سقف ${formatRial(c.annual_ceiling_rials)}`}
|
||||
</div>
|
||||
</div>
|
||||
<button className="mini-btn danger" title="غیرفعالسازی" disabled={delMut.isPending} onClick={() => delMut.mutate(c.uuid)}>
|
||||
<TrashIcon style={{ width: 15 }} />
|
||||
</button>
|
||||
</div>
|
||||
))}
|
||||
</div>
|
||||
)}
|
||||
</div>
|
||||
);
|
||||
}
|
||||
@@ -16,6 +16,7 @@ import {
|
||||
IdentificationIcon,
|
||||
KeyIcon,
|
||||
LockClosedIcon,
|
||||
ShieldCheckIcon,
|
||||
StarIcon,
|
||||
TagIcon,
|
||||
UserCircleIcon,
|
||||
@@ -192,6 +193,16 @@ function buildSections(
|
||||
label: "پرونده بیماران",
|
||||
feature: "patient_records",
|
||||
},
|
||||
{
|
||||
to: "/admin/insurance-pricing",
|
||||
icon: ShieldCheckIcon,
|
||||
label: "قیمتگذاری بیمه",
|
||||
},
|
||||
{
|
||||
to: "/admin/claims",
|
||||
icon: DocumentTextIcon,
|
||||
label: "مطالبات بیمه",
|
||||
},
|
||||
{ to: "/admin/staff", icon: UserPlusIcon, label: "پرسنل" },
|
||||
{
|
||||
to: "/admin/my-secretaries",
|
||||
@@ -261,6 +272,16 @@ function buildSections(
|
||||
label: "پرونده بیماران",
|
||||
feature: "patient_records",
|
||||
},
|
||||
{
|
||||
to: "/admin/insurance-pricing",
|
||||
icon: ShieldCheckIcon,
|
||||
label: "قیمتگذاری بیمه",
|
||||
},
|
||||
{
|
||||
to: "/admin/claims",
|
||||
icon: DocumentTextIcon,
|
||||
label: "مطالبات بیمه",
|
||||
},
|
||||
{ to: "/admin/staff", icon: UserPlusIcon, label: "پرسنل" },
|
||||
{
|
||||
to: "/admin/my-secretaries",
|
||||
@@ -320,6 +341,16 @@ function buildSections(
|
||||
label: "پرونده بیماران",
|
||||
feature: "patient_records",
|
||||
},
|
||||
{
|
||||
to: "/admin/insurance-pricing",
|
||||
icon: ShieldCheckIcon,
|
||||
label: "قیمتگذاری بیمه",
|
||||
},
|
||||
{
|
||||
to: "/admin/claims",
|
||||
icon: DocumentTextIcon,
|
||||
label: "مطالبات بیمه",
|
||||
},
|
||||
],
|
||||
},
|
||||
];
|
||||
|
||||
@@ -0,0 +1,187 @@
|
||||
import { useState } from 'react';
|
||||
import { useQuery, useMutation, useQueryClient } from '@tanstack/react-query';
|
||||
import { CheckIcon, XMarkIcon, PaperAirplaneIcon, BanknotesIcon } from '@heroicons/react/24/outline';
|
||||
import { toast } from 'sonner';
|
||||
import { api } from '../lib/api';
|
||||
import { formatRial, formatNumber } from '../lib/utils';
|
||||
import PageHeader from '../components/ui/PageHeader';
|
||||
import Modal from '../components/ui/Modal';
|
||||
|
||||
interface ClaimItem {
|
||||
invoice_item_id: number;
|
||||
claimed_rials: number;
|
||||
approved_rials: number | null;
|
||||
}
|
||||
|
||||
interface Claim {
|
||||
uuid: string;
|
||||
insurance_id: number;
|
||||
insurance_kind: string;
|
||||
total_claimed_rials: number;
|
||||
total_approved_rials: number | null;
|
||||
total_paid_rials: number | null;
|
||||
status: string;
|
||||
reject_reason: string | null;
|
||||
items: ClaimItem[];
|
||||
}
|
||||
|
||||
interface DebtRow {
|
||||
insurance_id: number;
|
||||
claimed: number;
|
||||
approved: number;
|
||||
paid: number;
|
||||
debt: number;
|
||||
}
|
||||
|
||||
const STATUS_META: Record<string, { label: string; cls: string }> = {
|
||||
pending: { label: 'در انتظار', cls: 'gray' },
|
||||
submitted: { label: 'ارسالشده', cls: 'blue' },
|
||||
approved: { label: 'تأییدشده', cls: 'amber' },
|
||||
rejected: { label: 'ردشده', cls: 'red' },
|
||||
paid: { label: 'پرداختشده', cls: 'green' },
|
||||
};
|
||||
|
||||
const KIND_LABEL: Record<string, string> = { base: 'پایه', supplementary: 'تکمیلی' };
|
||||
const STATUS_FILTERS = ['', 'pending', 'submitted', 'approved', 'rejected', 'paid'];
|
||||
|
||||
export default function ClaimsPage() {
|
||||
const qc = useQueryClient();
|
||||
const [statusFilter, setStatusFilter] = useState('');
|
||||
const [rejectTarget, setRejectTarget] = useState<Claim | null>(null);
|
||||
const [rejectReason, setRejectReason] = useState('');
|
||||
|
||||
const claimsQuery = useQuery<{ data: { data: Claim[] } }>({
|
||||
queryKey: ['claims', statusFilter],
|
||||
queryFn: () => api.get(`/api/v1/billing/claims${statusFilter ? `?status=${statusFilter}` : ''}`),
|
||||
});
|
||||
|
||||
const debtQuery = useQuery<{ data: { data: DebtRow[] } }>({
|
||||
queryKey: ['insurance-debt'],
|
||||
queryFn: () => api.get('/api/v1/billing/reports/insurance-debt'),
|
||||
});
|
||||
|
||||
const claims = (claimsQuery.data as any)?.data?.data ?? [];
|
||||
const debt = (debtQuery.data as any)?.data?.data ?? [];
|
||||
|
||||
const transitionMut = useMutation({
|
||||
mutationFn: ({ uuid, action, body }: { uuid: string; action: string; body?: object }) =>
|
||||
api.post(`/api/v1/billing/claims/${uuid}/${action}`, body ?? {}),
|
||||
onSuccess: () => {
|
||||
toast.success('وضعیت مطالبه بهروزرسانی شد');
|
||||
setRejectTarget(null);
|
||||
setRejectReason('');
|
||||
qc.invalidateQueries({ queryKey: ['claims'] });
|
||||
qc.invalidateQueries({ queryKey: ['insurance-debt'] });
|
||||
},
|
||||
onError: (e: Error) => toast.error(e.message),
|
||||
});
|
||||
|
||||
return (
|
||||
<div className="fade-in">
|
||||
<PageHeader title="مطالبات بیمه" description="پیگیری مطالبات و بدهی بیمهها" />
|
||||
|
||||
<div className="card" style={{ padding: 18, marginBottom: 16 }}>
|
||||
<div style={{ display: 'flex', alignItems: 'center', gap: 8, marginBottom: 12 }}>
|
||||
<BanknotesIcon style={{ width: 18, color: 'var(--text-3)' }} />
|
||||
<h2 style={{ fontSize: 14, fontWeight: 700, margin: 0 }}>بدهی بیمهها</h2>
|
||||
</div>
|
||||
{debtQuery.isLoading ? (
|
||||
<div className="muted" style={{ fontSize: 13 }}>در حال بارگذاری...</div>
|
||||
) : debt.length === 0 ? (
|
||||
<div style={{ fontSize: 12.5, color: 'var(--text-3)' }}>بدهیای ثبت نشده است.</div>
|
||||
) : (
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 6 }}>
|
||||
{debt.map((d: DebtRow) => (
|
||||
<div key={d.insurance_id} style={{ display: 'flex', justifyContent: 'space-between', alignItems: 'center', padding: '8px 12px', borderRadius: 8, border: '1px solid var(--border)', fontSize: 13 }}>
|
||||
<span style={{ fontWeight: 600 }}>بیمه #{formatNumber(d.insurance_id)}</span>
|
||||
<span style={{ color: 'var(--text-3)' }}>ادعا {formatRial(d.claimed)} · پرداخت {formatRial(d.paid)}</span>
|
||||
<span style={{ fontWeight: 700, color: d.debt > 0 ? 'var(--danger)' : 'var(--success, #16a34a)' }}>بدهی {formatRial(d.debt)}</span>
|
||||
</div>
|
||||
))}
|
||||
</div>
|
||||
)}
|
||||
</div>
|
||||
|
||||
<div className="card" style={{ padding: 18 }}>
|
||||
<div style={{ display: 'flex', justifyContent: 'space-between', alignItems: 'center', marginBottom: 12 }}>
|
||||
<h2 style={{ fontSize: 14, fontWeight: 700, margin: 0 }}>مطالبات</h2>
|
||||
<select className="input" style={{ maxWidth: 160 }} value={statusFilter} onChange={(e) => setStatusFilter(e.target.value)}>
|
||||
{STATUS_FILTERS.map((s) => (
|
||||
<option key={s} value={s}>{s === '' ? 'همه وضعیتها' : STATUS_META[s]?.label}</option>
|
||||
))}
|
||||
</select>
|
||||
</div>
|
||||
|
||||
{claimsQuery.isLoading ? (
|
||||
<div className="muted" style={{ fontSize: 13 }}>در حال بارگذاری...</div>
|
||||
) : claims.length === 0 ? (
|
||||
<div style={{ fontSize: 12.5, color: 'var(--text-3)', padding: '12px 0' }}>مطالبهای یافت نشد.</div>
|
||||
) : (
|
||||
<div style={{ display: 'flex', flexDirection: 'column', gap: 8 }}>
|
||||
{claims.map((c: Claim) => {
|
||||
const meta = STATUS_META[c.status] ?? { label: c.status, cls: 'gray' };
|
||||
return (
|
||||
<div key={c.uuid} style={{ padding: '12px 14px', borderRadius: 10, border: '1px solid var(--border)' }}>
|
||||
<div style={{ display: 'flex', justifyContent: 'space-between', alignItems: 'flex-start', gap: 10 }}>
|
||||
<div>
|
||||
<div style={{ fontWeight: 600, fontSize: 13.5 }}>
|
||||
بیمه #{formatNumber(c.insurance_id)}
|
||||
<span className="badge gray" style={{ fontSize: 10, marginInlineStart: 6 }}>{KIND_LABEL[c.insurance_kind] ?? c.insurance_kind}</span>
|
||||
<span className={`badge ${meta.cls}`} style={{ fontSize: 10, marginInlineStart: 4 }}><span className="bdot" />{meta.label}</span>
|
||||
</div>
|
||||
<div style={{ fontSize: 11.5, color: 'var(--text-3)', marginTop: 3 }}>
|
||||
ادعا {formatRial(c.total_claimed_rials)}
|
||||
{c.total_approved_rials != null && ` · تأیید ${formatRial(c.total_approved_rials)}`}
|
||||
{c.total_paid_rials != null && ` · پرداخت ${formatRial(c.total_paid_rials)}`}
|
||||
{c.reject_reason && ` · دلیل رد: ${c.reject_reason}`}
|
||||
</div>
|
||||
</div>
|
||||
<div style={{ display: 'flex', gap: 6, flexShrink: 0 }}>
|
||||
{c.status === 'pending' && (
|
||||
<button className="btn primary sm" disabled={transitionMut.isPending} onClick={() => transitionMut.mutate({ uuid: c.uuid, action: 'submit' })}>
|
||||
<PaperAirplaneIcon style={{ width: 13 }} /> ارسال
|
||||
</button>
|
||||
)}
|
||||
{c.status === 'submitted' && (
|
||||
<>
|
||||
<button className="btn primary sm" disabled={transitionMut.isPending} onClick={() => transitionMut.mutate({ uuid: c.uuid, action: 'approve' })}>
|
||||
<CheckIcon style={{ width: 13 }} /> تأیید
|
||||
</button>
|
||||
<button className="btn danger sm" onClick={() => { setRejectTarget(c); setRejectReason(''); }}>
|
||||
<XMarkIcon style={{ width: 13 }} /> رد
|
||||
</button>
|
||||
</>
|
||||
)}
|
||||
{c.status === 'approved' && (
|
||||
<button className="btn primary sm" disabled={transitionMut.isPending} onClick={() => transitionMut.mutate({ uuid: c.uuid, action: 'pay' })}>
|
||||
<BanknotesIcon style={{ width: 13 }} /> پرداخت
|
||||
</button>
|
||||
)}
|
||||
</div>
|
||||
</div>
|
||||
</div>
|
||||
);
|
||||
})}
|
||||
</div>
|
||||
)}
|
||||
</div>
|
||||
|
||||
<Modal open={!!rejectTarget} onClose={() => setRejectTarget(null)} title="رد مطالبه"
|
||||
footer={
|
||||
<>
|
||||
<button className="btn ghost sm" onClick={() => setRejectTarget(null)}>انصراف</button>
|
||||
<button className="btn danger sm" disabled={!rejectReason || transitionMut.isPending}
|
||||
onClick={() => rejectTarget && transitionMut.mutate({ uuid: rejectTarget.uuid, action: 'reject', body: { reason: rejectReason } })}>
|
||||
رد کردن
|
||||
</button>
|
||||
</>
|
||||
}
|
||||
>
|
||||
<div className="field">
|
||||
<label>دلیل رد</label>
|
||||
<textarea className="input" rows={3} dir="rtl" value={rejectReason} onChange={(e) => setRejectReason(e.target.value)} placeholder="دلیل رد را بنویسید..." />
|
||||
</div>
|
||||
</Modal>
|
||||
</div>
|
||||
);
|
||||
}
|
||||
@@ -1,6 +1,6 @@
|
||||
import React, { useState } from 'react';
|
||||
import { useQuery, useMutation, useQueryClient } from '@tanstack/react-query';
|
||||
import { PlusIcon, PencilIcon, TrashIcon, WrenchScrewdriverIcon } from '@heroicons/react/24/outline';
|
||||
import { PlusIcon, PencilIcon, TrashIcon, WrenchScrewdriverIcon, BanknotesIcon } from '@heroicons/react/24/outline';
|
||||
import { useForm } from 'react-hook-form';
|
||||
import { zodResolver } from '@hookform/resolvers/zod';
|
||||
import { z } from 'zod';
|
||||
@@ -13,14 +13,17 @@ import Modal from '../components/ui/Modal';
|
||||
import PriceInput from '../components/ui/PriceInput';
|
||||
import ConfirmDialog from '../components/ui/ConfirmDialog';
|
||||
import PageHeader from '../components/ui/PageHeader';
|
||||
import ServiceTariffModal from '../components/ServiceTariffModal';
|
||||
import SearchableSelect from '../components/ui/SearchableSelect';
|
||||
import FeatureGate from '../components/ui/FeatureGate';
|
||||
|
||||
const sectionSchema = z.object({ name: z.string().min(1, 'نام بخش الزامی است') });
|
||||
const itemSchema = z.object({
|
||||
name: z.string().min(1, 'نام سرویس الزامی است'),
|
||||
price_rials: z.coerce.number().min(0, 'مبلغ نمیتواند منفی باشد'),
|
||||
staff_uuid: z.string().optional(),
|
||||
name: z.string().min(1, 'نام سرویس الزامی است'),
|
||||
price_rials: z.coerce.number().min(0, 'مبلغ نمیتواند منفی باشد'),
|
||||
staff_uuid: z.string().optional(),
|
||||
insurance_covered: z.boolean().optional(),
|
||||
insurance_price_rials: z.coerce.number().min(0).optional(),
|
||||
});
|
||||
type SectionForm = z.infer<typeof sectionSchema>;
|
||||
type ItemForm = z.infer<typeof itemSchema>;
|
||||
@@ -36,6 +39,7 @@ function ClinicServicesPageInner() {
|
||||
const [deleteSection, setDeleteSection] = useState<ServiceSection | null>(null);
|
||||
const [itemModal, setItemModal] = useState<'create' | ServiceItem | null>(null);
|
||||
const [deleteItem, setDeleteItem] = useState<ServiceItem | null>(null);
|
||||
const [tariffItem, setTariffItem] = useState<ServiceItem | null>(null);
|
||||
|
||||
const { data: sectionsData, isLoading: sectionsLoading } = useQuery<ApiResponse<ServiceSection[]>>({
|
||||
queryKey: ['service-sections'],
|
||||
@@ -123,6 +127,8 @@ function ClinicServicesPageInner() {
|
||||
name: item.name,
|
||||
price_rials: item.price_rials,
|
||||
staff_uuid: item.staff?.uuid ?? '',
|
||||
insurance_covered: item.insurance_covered ?? false,
|
||||
insurance_price_rials: item.insurance_price_rials ?? 0,
|
||||
});
|
||||
setItemModal(item);
|
||||
};
|
||||
@@ -234,7 +240,7 @@ function ClinicServicesPageInner() {
|
||||
<button
|
||||
className="btn primary sm"
|
||||
style={{ display: 'flex', alignItems: 'center', gap: 4 }}
|
||||
onClick={() => { itemForm.reset({ price_rials: 0, staff_uuid: '' }); setItemModal('create'); }}
|
||||
onClick={() => { itemForm.reset({ price_rials: 0, staff_uuid: '', insurance_covered: false, insurance_price_rials: 0 }); setItemModal('create'); }}
|
||||
>
|
||||
<PlusIcon style={{ width: 14 }} /> سرویس جدید
|
||||
</button>
|
||||
@@ -249,7 +255,7 @@ function ClinicServicesPageInner() {
|
||||
<button
|
||||
className="btn primary sm"
|
||||
style={{ marginTop: 12 }}
|
||||
onClick={() => { itemForm.reset({ price_rials: 0, staff_uuid: '' }); setItemModal('create'); }}
|
||||
onClick={() => { itemForm.reset({ price_rials: 0, staff_uuid: '', insurance_covered: false, insurance_price_rials: 0 }); setItemModal('create'); }}
|
||||
>
|
||||
افزودن سرویس
|
||||
</button>
|
||||
@@ -273,7 +279,14 @@ function ClinicServicesPageInner() {
|
||||
background: idx % 2 === 1 ? 'oklch(0.985 0.005 256)' : 'transparent',
|
||||
}}
|
||||
>
|
||||
<td style={{ padding: '11px 16px', fontWeight: 500 }}>{item.name}</td>
|
||||
<td style={{ padding: '11px 16px', fontWeight: 500 }}>
|
||||
{item.name}
|
||||
{item.insurance_covered && (
|
||||
<span className="badge green" style={{ fontSize: 10, marginInlineStart: 6 }}>
|
||||
<span className="bdot" />بیمه
|
||||
</span>
|
||||
)}
|
||||
</td>
|
||||
<td style={{ padding: '11px 16px', color: 'var(--primary)', fontWeight: 600 }}>
|
||||
{formatRial(item.price_rials)}
|
||||
</td>
|
||||
@@ -299,6 +312,9 @@ function ClinicServicesPageInner() {
|
||||
<button className="btn sm" onClick={() => openEditItem(item)} title="ویرایش">
|
||||
<PencilIcon style={{ width: 13 }} />
|
||||
</button>
|
||||
<button className="btn sm" onClick={() => setTariffItem(item)} title="تعرفههای سالانه">
|
||||
<BanknotesIcon style={{ width: 13 }} />
|
||||
</button>
|
||||
<button className="btn sm" onClick={() => setDeleteItem(item)} title="حذف">
|
||||
<TrashIcon style={{ width: 13 }} />
|
||||
</button>
|
||||
@@ -378,6 +394,25 @@ function ClinicServicesPageInner() {
|
||||
isClearable
|
||||
/>
|
||||
</div>
|
||||
<label style={{ display: 'flex', alignItems: 'center', gap: 8, cursor: 'pointer', fontSize: 13.5 }}>
|
||||
<input
|
||||
type="checkbox"
|
||||
checked={itemForm.watch('insurance_covered') ?? false}
|
||||
onChange={(e) => itemForm.setValue('insurance_covered', e.target.checked)}
|
||||
/>
|
||||
این خدمت شامل بیمه میشود
|
||||
</label>
|
||||
{itemForm.watch('insurance_covered') && (
|
||||
<div className="field">
|
||||
<label>قیمت با بیمه (ریال)</label>
|
||||
<PriceInput
|
||||
value={itemForm.watch('insurance_price_rials') ?? 0}
|
||||
onChange={(v) => itemForm.setValue('insurance_price_rials', v)}
|
||||
placeholder="سهم بیمار با بیمه"
|
||||
min={0}
|
||||
/>
|
||||
</div>
|
||||
)}
|
||||
</div>
|
||||
<div style={{ display: 'flex', gap: 8, marginTop: 16 }}>
|
||||
<button type="submit" className="btn primary" disabled={createItem.isPending || editItem.isPending}>ذخیره</button>
|
||||
@@ -386,6 +421,8 @@ function ClinicServicesPageInner() {
|
||||
</form>
|
||||
</Modal>
|
||||
|
||||
<ServiceTariffModal item={tariffItem} onClose={() => setTariffItem(null)} />
|
||||
|
||||
{/* Confirm حذف بخش */}
|
||||
<ConfirmDialog
|
||||
open={!!deleteSection}
|
||||
|
||||
@@ -0,0 +1,16 @@
|
||||
import PageHeader from '../components/ui/PageHeader';
|
||||
import InsurancePricingSection from '../components/InsurancePricingSection';
|
||||
import TenantInsuranceContracts from '../components/TenantInsuranceContracts';
|
||||
|
||||
export default function InsurancePricingPage() {
|
||||
return (
|
||||
<div className="fade-in">
|
||||
<PageHeader
|
||||
title="بیمه و قیمتگذاری"
|
||||
description="قراردادهای بیمه، درصد پوشش و مبلغ ویزیت"
|
||||
/>
|
||||
<TenantInsuranceContracts />
|
||||
<InsurancePricingSection />
|
||||
</div>
|
||||
);
|
||||
}
|
||||
@@ -396,6 +396,8 @@ export interface ServiceItem {
|
||||
price_rials: number;
|
||||
staff: { uuid: string; full_name: string } | null;
|
||||
active: boolean;
|
||||
insurance_covered?: boolean;
|
||||
insurance_price_rials?: number | null;
|
||||
}
|
||||
|
||||
export interface SmsWalletBalance {
|
||||
|
||||
@@ -0,0 +1,144 @@
|
||||
# Billing API — صورتحساب (فاز ۴ سیستم صورتحساب/بیمه)
|
||||
|
||||
> **Prefix:** `/api/v1/billing`
|
||||
> دامنه: `App\Billing`. مرجع معماری: `docs/architecture/insurance-billing-system.md`.
|
||||
> tenant از `#[CurrentUser]` resolve میشود (`ROLE_DOCTOR`→doctor، `ROLE_CLINIC`→clinic).
|
||||
|
||||
صورتحساب (`Invoice`) از یک Encounter (`PatientSession`) ساخته میشود. برای هر آیتم سهم بیمهی پایه، بیمهی مکمل و بیمار با `BillingCalculator` محاسبه میشود:
|
||||
|
||||
- تعرفهی خدمت از `Tariff` سال جاری (با fallback به `ServiceItem.priceRials`).
|
||||
- قانون پوشش از قرارداد بیمهی tenant (`TenantInsurance`) + override خدمت (`TenantServiceCoverage`).
|
||||
- ترتیب محاسبه: کل → پوشش پایه (با سقف) → باقیمانده → پوشش مکمل → فرانشیز سهم بیمار.
|
||||
|
||||
نمونه: کل ۶۰۰٬۰۰۰ · پایه ۷۰٪ → ۴۲۰٬۰۰۰ · مکمل روی باقیمانده → ۱۲۰٬۰۰۰ · بیمار ۶۰٬۰۰۰.
|
||||
|
||||
---
|
||||
|
||||
## POST /api/v1/billing/invoices
|
||||
|
||||
ساخت صورتحساب از یک مراجعه. اگر صورتحساب برای آن مراجعه قبلاً ساخته شده، همان برگردانده میشود (idempotent).
|
||||
|
||||
**Permission:** `AUTH` (مالک مراجعه)
|
||||
|
||||
**Body:**
|
||||
```json
|
||||
{ "session_uuid": "…" }
|
||||
```
|
||||
|
||||
**Response 201:**
|
||||
```json
|
||||
{
|
||||
"success": true,
|
||||
"data": {
|
||||
"data": {
|
||||
"uuid": "…",
|
||||
"entity_type": "doctor",
|
||||
"entity_id": 7,
|
||||
"patient_session_id": 33,
|
||||
"base_insurance_id": 3,
|
||||
"supplementary_insurance_id": 9,
|
||||
"total_rials": 600000,
|
||||
"base_insurance_rials": 420000,
|
||||
"supplementary_rials": 120000,
|
||||
"patient_rials": 60000,
|
||||
"status": "draft",
|
||||
"issued_at": 1718900000,
|
||||
"items": [
|
||||
{
|
||||
"uuid": "…",
|
||||
"service_item_id": 12,
|
||||
"title": "ویزیت",
|
||||
"tariff_rials": 600000,
|
||||
"quantity": 1,
|
||||
"total_rials": 600000,
|
||||
"base_insurance_rials": 420000,
|
||||
"supplementary_rials": 120000,
|
||||
"patient_rials": 60000
|
||||
}
|
||||
]
|
||||
}
|
||||
}
|
||||
}
|
||||
```
|
||||
|
||||
**Errors:** `422 ERR_VALIDATION_001` session_uuid الزامی · `404 ERR_NOT_FOUND_001` مراجعه یافت نشد · `403 ERR_FORBIDDEN_001` پروفایل یافت نشد.
|
||||
|
||||
---
|
||||
|
||||
## GET /api/v1/billing/invoices/{uuid}
|
||||
|
||||
دریافت صورتحساب (فقط مالک tenant).
|
||||
|
||||
**Response 200:** همان ساختار بالا.
|
||||
**Errors:** `404 ERR_NOT_FOUND_001`.
|
||||
|
||||
---
|
||||
|
||||
## POST /api/v1/billing/invoices/{uuid}/finalize
|
||||
|
||||
نهاییسازی صورتحساب (`draft` → `finalized`). صورتحساب نهاییشده مبنای ساخت Claim (فاز ۵) است.
|
||||
|
||||
**Response 200:** صورتحساب با `status: "finalized"`.
|
||||
**Errors:** `404 ERR_NOT_FOUND_001`.
|
||||
|
||||
---
|
||||
|
||||
## وضعیتهای Invoice
|
||||
`draft` (پیشنویس، قابل بازسازی) → `finalized` (نهایی) → `paid` (پرداختشده) · `void` (باطل).
|
||||
|
||||
## نکات
|
||||
- پول: integer ریال. تاریخ: Unix timestamp.
|
||||
- `BillingCalculator` خالص و واحد-تستشده است (`tests/Billing/BillingCalculatorTest.php`).
|
||||
- این فاز جایگزین تدریجی `PatientService::calculateFinalPrice` است؛ آن متد فعلاً برای سازگاری باقی مانده.
|
||||
|
||||
---
|
||||
|
||||
# Claims — مطالبات بیمه (فاز ۵)
|
||||
|
||||
مطالبه (`Claim`) از یک صورتحساب **نهاییشده** ساخته میشود: یک Claim برای بیمهی پایه و یک Claim برای بیمهی مکمل (فقط اگر سهم بیمه > ۰). هر `ClaimItem` به یک `InvoiceItem` ارجاع میدهد. چرخهی وضعیت با state machine.
|
||||
|
||||
**وضعیتها:** `pending → submitted → {approved → paid | rejected}`. از `paid`/`rejected` خروجی ندارد.
|
||||
|
||||
## POST /api/v1/billing/claims
|
||||
ساخت مطالبات از یک صورتحساب نهاییشده.
|
||||
|
||||
**Body:** `{ "invoice_uuid": "…" }`
|
||||
**Response 201:** `{ success, data: [ …claims ] }` (یک یا دو مطالبه: پایه/مکمل).
|
||||
**Errors:** `422` صورتحساب نهایی نشده / سهم بیمه ندارد · `404` صورتحساب یافت نشد.
|
||||
|
||||
## GET /api/v1/billing/claims?status=
|
||||
لیست مطالبات tenant. فیلتر اختیاری `status` (`pending|submitted|approved|rejected|paid`).
|
||||
|
||||
## POST /api/v1/billing/claims/{uuid}/{action}
|
||||
انتقال وضعیت. `action` ∈ `submit|approve|reject|pay`.
|
||||
|
||||
| action | body اختیاری | اثر |
|
||||
|--------|--------------|-----|
|
||||
| submit | — | pending → submitted |
|
||||
| approve | `approved_rials` | submitted → approved (پیشفرض = کل ادعا) |
|
||||
| reject | `reason` (الزامی) | submitted → rejected |
|
||||
| pay | `paid_rials` | approved → paid (پیشفرض = approved) |
|
||||
|
||||
**Errors:** `422` انتقال نامعتبر یا دلیل رد خالی · `404` مطالبه یافت نشد.
|
||||
|
||||
## GET /api/v1/billing/reports/insurance-debt
|
||||
گزارش بدهی بیمهها برای tenant (group بر اساس بیمه).
|
||||
|
||||
**Response 200:**
|
||||
```json
|
||||
{
|
||||
"success": true,
|
||||
"data": {
|
||||
"data": [
|
||||
{ "insurance_id": 3, "claimed": 840000, "approved": 800000, "paid": 500000, "debt": 340000 }
|
||||
]
|
||||
}
|
||||
}
|
||||
```
|
||||
`debt = claimed - paid` (حداقل صفر).
|
||||
|
||||
---
|
||||
|
||||
## ارسال مطالبه (ClaimSubmitter)
|
||||
|
||||
عملِ `submit` از طریق interface `App\Billing\Contract\ClaimSubmitterInterface` انجام میشود. پیادهسازی پیشفرض `ManualClaimSubmitter` است (ارسال دستی/آفلاین — همیشه موفق). برای اتصال آینده به API شرکتهای بیمهی ایران کافی است یک پیادهسازی جدید از این interface ساخته و در `config/services.yaml` bind شود؛ `ClaimService` تغییر نمیکند (Dependency Inversion). اگر `submit` ناموفق باشد، انتقال وضعیت با `422` متوقف میشود.
|
||||
@@ -111,7 +111,9 @@
|
||||
"section_uuid": "...",
|
||||
"name": "رادیوگرافی مستقیم",
|
||||
"price_rials": 500000,
|
||||
"staff_uuid": "..."
|
||||
"staff_uuid": "...",
|
||||
"insurance_covered": true,
|
||||
"insurance_price_rials": 200000
|
||||
}
|
||||
```
|
||||
|
||||
@@ -121,8 +123,10 @@
|
||||
| name | string | ✅ |
|
||||
| price_rials | integer | ❌ (پیشفرض 0) |
|
||||
| staff_uuid | UUID | ❌ |
|
||||
| insurance_covered | boolean | ❌ (پیشفرض false) — آیا خدمت شامل بیمه میشود |
|
||||
| insurance_price_rials | integer\|null | ❌ — سهم/قیمت بیمار با بیمه |
|
||||
|
||||
**Response 201:** ServiceItem object
|
||||
**Response 201:** ServiceItem object (شامل `insurance_covered` و `insurance_price_rials`)
|
||||
|
||||
---
|
||||
|
||||
@@ -135,7 +139,9 @@
|
||||
"name": "رادیوگرافی دیجیتال",
|
||||
"price_rials": 600000,
|
||||
"staff_uuid": null,
|
||||
"active": false
|
||||
"active": false,
|
||||
"insurance_covered": true,
|
||||
"insurance_price_rials": 250000
|
||||
}
|
||||
```
|
||||
|
||||
@@ -160,3 +166,46 @@
|
||||
| ERR_SUBSCRIPTION_REQUIRED | 403 | نیاز به پنل Basic+ |
|
||||
| ERR_SERVICE_NOT_FOUND | 404 | سرویس یافت نشد |
|
||||
| ERR_SERVICE_ITEM_IN_USE | 409 | سرویس در پرونده بیمار استفاده شده |
|
||||
|
||||
---
|
||||
|
||||
## تعرفهی نسخهدار سالانه (Tariff) — فاز ۳ سیستم صورتحساب
|
||||
|
||||
هر خدمت میتواند برای هر سال شمسی یک تعرفه داشته باشد. اگر تعرفهی سالی ثبت نشود، به `price_rials` خود خدمت fallback میشود (`TariffService::resolvePrice`). سال جاری شمسی سمت سرور با `IntlDateFormatter` (تقویم persian) محاسبه میشود.
|
||||
|
||||
### GET /api/v1/service-items/{uuid}/tariffs
|
||||
|
||||
لیست تعرفههای یک خدمت + قیمت پیشفرض + سال جاری.
|
||||
|
||||
**Permission:** `IS_AUTHENTICATED_FULLY` (مالک خدمت)
|
||||
|
||||
```json
|
||||
{
|
||||
"success": true,
|
||||
"data": {
|
||||
"current_year": 1405,
|
||||
"default_price_rials": 500000,
|
||||
"data": [
|
||||
{ "uuid": "…", "service_item_id": 12, "year": 1405, "price_rials": 600000, "is_active": true },
|
||||
{ "uuid": "…", "service_item_id": 12, "year": 1404, "price_rials": 500000, "is_active": true }
|
||||
]
|
||||
}
|
||||
}
|
||||
```
|
||||
|
||||
### PUT /api/v1/service-items/{uuid}/tariffs/{year}
|
||||
|
||||
ثبت/بهروزرسانی تعرفهی یک سال (upsert). `year` بین ۱۳۹۰ تا ۱۵۰۰.
|
||||
|
||||
**Body:**
|
||||
```json
|
||||
{ "price_rials": 600000 }
|
||||
```
|
||||
|
||||
**Response 200:** `{ success, data: { …tariff } }`
|
||||
|
||||
**Errors:**
|
||||
| Code | HTTP | توضیح |
|
||||
|------|------|-------|
|
||||
| ERR_SERVICE_NOT_FOUND | 404 | سرویس یافت نشد |
|
||||
| ERR_VALIDATION_001 | 422 | سال نامعتبر |
|
||||
|
||||
@@ -265,3 +265,190 @@ Remove an insurance from a doctor's list.
|
||||
```json
|
||||
{ "success": true, "data": { "message": "بیمه از لیست حذف شد" } }
|
||||
```
|
||||
|
||||
---
|
||||
|
||||
## EntityInsurancePricing — قیمتگذاری ویزیت بر اساس بیمه
|
||||
|
||||
قیمتگذاری ویزیت برای entity جاری (پزشک یا کلینیک)، با تفکیک:
|
||||
- **ویزیت آزاد** (بدون بیمه) — یک مبلغ پایه (ردیفی با `insurance_id = null`)
|
||||
- **سهم بیمار به ازای هر بیمه** پایه/مکمل
|
||||
|
||||
entity جاری از `#[CurrentUser]` resolve میشود: نقش `ROLE_DOCTOR` → `doctor`، نقش `ROLE_CLINIC` → `clinic`. ذخیرهسازی polymorphic در جدول `entity_insurance_pricing` (`entity_type`, `entity_id`, `insurance_id` nullable, `patient_share_rials`).
|
||||
|
||||
---
|
||||
|
||||
## GET `/api/v1/insurance-pricing`
|
||||
|
||||
قیمتگذاری بیمهی entity جاری + لیست همهی بیمههای فعال (با سهم بیمار اگر تعیین شده).
|
||||
|
||||
**Permission:** `AUTH` (`ROLE_DOCTOR` یا `ROLE_CLINIC`)
|
||||
|
||||
### Response `200`
|
||||
```json
|
||||
{
|
||||
"success": true,
|
||||
"data": {
|
||||
"entity_type": "doctor",
|
||||
"entity_id": 7,
|
||||
"free_visit_price_rials": 5000000,
|
||||
"insurances": [
|
||||
{
|
||||
"insurance_id": 3,
|
||||
"insurance_name": "تأمین اجتماعی",
|
||||
"type": "basic",
|
||||
"patient_share_rials": 1500000
|
||||
},
|
||||
{
|
||||
"insurance_id": 9,
|
||||
"insurance_name": "دانا",
|
||||
"type": "supplementary",
|
||||
"patient_share_rials": null
|
||||
}
|
||||
]
|
||||
}
|
||||
}
|
||||
```
|
||||
|
||||
- `patient_share_rials = null` یعنی این بیمه پذیرفته نمیشود (قیمتگذاری ندارد).
|
||||
|
||||
### خطاها
|
||||
- `403` `ERR_FORBIDDEN_001` — پروفایل (doctor/clinic) برای کاربر یافت نشد.
|
||||
|
||||
---
|
||||
|
||||
## PUT `/api/v1/insurance-pricing`
|
||||
|
||||
ذخیره/بهروزرسانی قیمت ویزیت آزاد و سهم بیمار هر بیمه. عملیات upsert؛ ردیفی که `patient_share_rials = null` بفرستد حذف میشود.
|
||||
|
||||
**Permission:** `AUTH` (`ROLE_DOCTOR` یا `ROLE_CLINIC`)
|
||||
|
||||
### Request Body
|
||||
```json
|
||||
{
|
||||
"free_visit_price_rials": 5000000,
|
||||
"insurances": [
|
||||
{ "insurance_id": 3, "patient_share_rials": 1500000 },
|
||||
{ "insurance_id": 9, "patient_share_rials": null }
|
||||
]
|
||||
}
|
||||
```
|
||||
|
||||
| فیلد | نوع | توضیح |
|
||||
|------|-----|-------|
|
||||
| `free_visit_price_rials` | int | مبلغ ویزیت آزاد (ریال). اختیاری؛ اگر نباشد تغییر نمیکند. |
|
||||
| `insurances[].insurance_id` | int | شناسهی بیمه (الزامی برای هر ردیف). |
|
||||
| `insurances[].patient_share_rials` | int \| null | سهم بیمار با این بیمه. `null` → ردیف حذف میشود. |
|
||||
|
||||
### Response `200`
|
||||
همان ساختار `GET /api/v1/insurance-pricing` (وضعیت پس از ذخیره).
|
||||
|
||||
### خطاها
|
||||
- `403` `ERR_FORBIDDEN_001` — پروفایل یافت نشد.
|
||||
|
||||
---
|
||||
|
||||
## TenantInsurance — قراردادهای بیمهی tenant (فاز ۱ سیستم صورتحساب)
|
||||
|
||||
قرارداد یک پزشک/کلینیک با یک بیمه: درصد پوشش، فرانشیز، سقف تعهد سالانه، نسخهبندی و وضعیت فعال. مبنای محاسبهی سهم در سیستم صورتحساب (`docs/architecture/insurance-billing-system.md`). tenant از `#[CurrentUser]` (`ROLE_DOCTOR`→doctor، `ROLE_CLINIC`→clinic). جدول `tenant_insurances`.
|
||||
|
||||
### GET `/api/v1/billing/tenant-insurances`
|
||||
لیست قراردادهای فعال tenant جاری.
|
||||
|
||||
**Permission:** `AUTH` (doctor/clinic)
|
||||
|
||||
```json
|
||||
{
|
||||
"success": true,
|
||||
"data": {
|
||||
"data": [
|
||||
{
|
||||
"uuid": "…",
|
||||
"insurance_id": 3,
|
||||
"insurance_name": "تأمین اجتماعی",
|
||||
"insurance_kind": "basic",
|
||||
"version": 1,
|
||||
"is_active": true,
|
||||
"coverage_percent": 70,
|
||||
"franchise_rials": 0,
|
||||
"annual_ceiling_rials": null,
|
||||
"effective_from": 1718900000,
|
||||
"effective_to": null
|
||||
}
|
||||
]
|
||||
}
|
||||
}
|
||||
```
|
||||
|
||||
### POST `/api/v1/billing/tenant-insurances`
|
||||
فعالسازی/بهروزرسانی قرارداد. اگر قرارداد فعالی برای آن بیمه باشد ویرایش میشود، وگرنه نسخهی جدید.
|
||||
|
||||
**Body:**
|
||||
| فیلد | نوع | توضیح |
|
||||
|------|-----|-------|
|
||||
| `insurance_id` | int | الزامی |
|
||||
| `coverage_percent` | float | درصد پوشش (۰–۱۰۰) |
|
||||
| `franchise_rials` | int | فرانشیز ثابت سهم بیمار |
|
||||
| `annual_ceiling_rials` | int \| null | سقف تعهد (null = بینهایت) |
|
||||
|
||||
پاسخ `201`: `{ success, data: { …contract } }`.
|
||||
خطاها: `404 ERR_NOT_FOUND_001` بیمه یافت نشد · `422 ERR_VALIDATION_001` insurance_id الزامی · `403 ERR_FORBIDDEN_001` پروفایل یافت نشد.
|
||||
|
||||
### PATCH `/api/v1/billing/tenant-insurances/{uuid}`
|
||||
ویرایش `coverage_percent` / `franchise_rials` / `annual_ceiling_rials`. فقط قرارداد متعلق به tenant جاری.
|
||||
|
||||
### DELETE `/api/v1/billing/tenant-insurances/{uuid}`
|
||||
غیرفعالسازی نرم (soft) — `is_active=false` و `effective_to=now`. داده حذف نمیشود.
|
||||
|
||||
```json
|
||||
{ "success": true, "data": { "message": "قرارداد بیمه غیرفعال شد" } }
|
||||
```
|
||||
|
||||
> **Guard:** `TenantInsuranceService::assertActive()` هنگام پذیرش/صورتحساب فقط بیمههای فعالِ همان tenant را مجاز میداند؛ در غیر این صورت `422 ERR_VALIDATION_001` («این بیمه برای این کلینیک/پزشک فعال نیست»).
|
||||
|
||||
---
|
||||
|
||||
## TenantServiceCoverage — پوشش خدمت تحت یک قرارداد بیمه (فاز ۲)
|
||||
|
||||
override پوشش یک خدمت خاص تحت قرارداد یک بیمه. فیلدهای `null` از خود قرارداد ارث میبرند. اگر `covered=false` → آن خدمت تحت آن بیمه پوشش ندارد. جدول `tenant_service_coverage`.
|
||||
|
||||
### GET `/api/v1/billing/tenant-insurances/{uuid}/service-coverage`
|
||||
لیست overrideهای پوشش خدمات یک قرارداد.
|
||||
|
||||
**Permission:** `AUTH` (مالک قرارداد)
|
||||
|
||||
```json
|
||||
{
|
||||
"success": true,
|
||||
"data": {
|
||||
"data": [
|
||||
{
|
||||
"uuid": "…",
|
||||
"tenant_insurance_id": 4,
|
||||
"service_item_id": 12,
|
||||
"covered": true,
|
||||
"coverage_percent": 80,
|
||||
"franchise_rials": null,
|
||||
"ceiling_rials": null
|
||||
}
|
||||
]
|
||||
}
|
||||
}
|
||||
```
|
||||
|
||||
### PUT `/api/v1/billing/tenant-insurances/{uuid}/service-coverage`
|
||||
تنظیم/بهروزرسانی پوشش یک خدمت (upsert).
|
||||
|
||||
**Body:**
|
||||
| فیلد | نوع | توضیح |
|
||||
|------|-----|-------|
|
||||
| `service_item_id` | int | الزامی |
|
||||
| `covered` | bool | پیشفرض true |
|
||||
| `coverage_percent` | float \| null | null = ارث از قرارداد |
|
||||
| `franchise_rials` | int \| null | null = ارث از قرارداد |
|
||||
| `ceiling_rials` | int \| null | null = ارث از قرارداد |
|
||||
|
||||
پاسخ `200`: `{ success, data: { message } }`.
|
||||
خطاها: `404 ERR_NOT_FOUND_001` قرارداد یافت نشد · `422 ERR_VALIDATION_001` service_item_id الزامی.
|
||||
|
||||
> منطق resolve: `TenantInsuranceService::coverageRuleForService()` ابتدا override خدمت را بررسی میکند؛ اگر `covered=false` → `CoverageRule::notCovered()`؛ در غیر این صورت فیلدهای null از قرارداد پر میشوند. این `CoverageRule` در فاز ۴ ورودی `BillingCalculator` است.
|
||||
|
||||
@@ -0,0 +1,399 @@
|
||||
# سیستم صورتحساب و بیمه (Insurance & Medical Billing) — سند معماری
|
||||
|
||||
> وضعیت: **طرح معماری (Design)** — هنوز پیادهسازی نشده. بر اساس کد فعلی Clinic Pro (Symfony 7.4 / PHP 8.2+ / Doctrine / MariaDB) و الگوهای موجود نوشته شده.
|
||||
> دامنههای جدید پیشنهادی: `App\Billing\*` (Invoice/InvoiceItem/Claim/Tariff) و توسعهی `App\Insurance\*` (TenantInsurance/Coverage).
|
||||
|
||||
---
|
||||
|
||||
## ۰. تطبیق با کد فعلی (مبنای واقعی، نه greenfield)
|
||||
|
||||
| مفهوم پرامپت | معادل واقعی در Clinic Pro | تصمیم |
|
||||
|---|---|---|
|
||||
| **Tenant** | موجودیت مستقل وجود ندارد. tenancy بهصورت polymorphic `(entityType ∈ {doctor, clinic}, entityId)` پیاده شده (الگوی `PatientRecord`, `EntityInsurancePricing`, `SmsSettings`, `SubscriptionService`). | یک **Value Object `TenantRef(type, id)`** معرفی میشود؛ موجودیت Tenant جدید **ساخته نمیشود**. resolve از `#[CurrentUser]` مثل `PatientController::resolveEntity`. |
|
||||
| **InsuranceCompany** | `App\Insurance\Entity\Insurance` (لیست master سراسری، مدیریتشده توسط admin، دارای `type: InsuranceType{basic,supplementary}`). | حفظ میشود بهعنوان **master سراسری**. tenant آن را «فعال» میکند، تعریف نمیکند. |
|
||||
| **TenantInsurance** | `EntityInsurancePricing` فعلی (polymorphic، فقط `patient_share_rials`) — **ناکافی**. | به **`TenantInsurance`** ارتقا مییابد (قرارداد tenant↔insurance با نسخه و وضعیت). `EntityInsurancePricing` migrate میشود. |
|
||||
| **BaseInsurance / SupplementaryInsurance** | `InsuranceType` enum (`basic`/`supplementary`). | همان enum؛ موجودیت جدا لازم نیست (نوع روی `Insurance` است). |
|
||||
| **Service** | `App\ClinicService\Entity\ServiceItem` (دارای `priceRials`, `active`, متعلق به `ServiceSection`). | حفظ + افزودن `insuranceCovered`. تعرفه به `Tariff` منتقل میشود. |
|
||||
| **Tariff** | وجود ندارد (قیمت مستقیم روی `ServiceItem.priceRials`). | موجودیت جدید `Tariff` با **نسخهبندی سالانه** (effective year/range). |
|
||||
| **Encounter** | `App\Patient\Entity\PatientSession` (مراجعه؛ دارای فیلدهای بیمه/قیمت ساده). | `PatientSession` نقش Encounter را دارد؛ **Invoice** به آن متصل میشود. |
|
||||
| **Invoice / InvoiceItem** | وجود ندارد (محاسبهی ساده در `PatientService::calculateFinalPrice`). | موجودیتهای جدید `Invoice`/`InvoiceItem` با تفکیک سهم بیمار/پایه/مکمل. |
|
||||
| **Claim** | وجود ندارد. | موجودیت جدید با state machine (الگوی `Appointment::transitionTo`). |
|
||||
| **Patient** | `PatientRecord` (+ `UserProfile` برای دموگرافیک/بیمهی بیمار). | حفظ. بیمهی بیمار از `UserProfile.basicInsuranceId/supplementaryInsuranceId`. |
|
||||
| **Payment** | `App\Payment\Entity\Payment` (درگاه پرداخت). | سهم بیمار از Invoice → میتواند به Payment وصل شود. |
|
||||
|
||||
**اصول حفظشده:** پول = `int` ریال؛ تاریخ = Unix timestamp (نه DateTime)؛ کنترلرها از `BaseController` (`success/paginated/error`)؛ لیست admin با DQL array hydration؛ خطاها در `ErrorCodes`؛ multi-tenant با `(entityType, entityId)`.
|
||||
|
||||
---
|
||||
|
||||
## ۱. Bounded Contexts
|
||||
|
||||
```
|
||||
Insurance (master + tenant contracts + coverage)
|
||||
Insurance (master, global, admin) ← موجود
|
||||
TenantInsurance (قرارداد tenant↔insurance) ← ارتقای EntityInsurancePricing
|
||||
InsuranceCoverage (قانون پوشش هر بیمه)
|
||||
TenantServiceCoverage (override پوشش یک خدمت خاص)
|
||||
|
||||
Billing (encounter → invoice → claim)
|
||||
Tariff (تعرفهی نسخهدار سالانه)
|
||||
Invoice / InvoiceItem
|
||||
Claim (چرخهی مطالبات بیمه)
|
||||
BillingCalculator (دامنهی محاسبه — Domain Service)
|
||||
|
||||
Patient (موجود) ClinicService (موجود + insuranceCovered)
|
||||
Subscription (موجود — gate ویژگی billing)
|
||||
```
|
||||
|
||||
---
|
||||
|
||||
## ۲. Domain Model — موجودیتها و فیلدها
|
||||
|
||||
### 2.1 Value Objects
|
||||
|
||||
```php
|
||||
// App\Shared\ValueObject\TenantRef
|
||||
final readonly class TenantRef
|
||||
{
|
||||
public function __construct(public string $type, public int $id) {} // type: 'doctor'|'clinic'
|
||||
public static function doctor(int $id): self { return new self('doctor', $id); }
|
||||
public static function clinic(int $id): self { return new self('clinic', $id); }
|
||||
}
|
||||
|
||||
// App\Billing\ValueObject\Money (ریال، صحیح، بدون منفی)
|
||||
final readonly class Money
|
||||
{
|
||||
public function __construct(public int $rials) { if ($rials < 0) throw new \InvalidArgumentException('negative money'); }
|
||||
public function add(Money $o): self { return new self($this->rials + $o->rials); }
|
||||
public function sub(Money $o): self { return new self(max(0, $this->rials - $o->rials)); }
|
||||
public function percent(float $p): self { return new self((int) round($this->rials * $p / 100)); }
|
||||
public function min(Money $o): self { return new self(min($this->rials, $o->rials)); }
|
||||
}
|
||||
|
||||
// App\Billing\ValueObject\ShareBreakdown (خروجی محاسبهی یک آیتم)
|
||||
final readonly class ShareBreakdown
|
||||
{
|
||||
public function __construct(
|
||||
public int $totalRials,
|
||||
public int $baseInsuranceRials,
|
||||
public int $supplementaryRials,
|
||||
public int $patientRials,
|
||||
) {}
|
||||
}
|
||||
|
||||
// App\Insurance\ValueObject\CoverageRule
|
||||
final readonly class CoverageRule
|
||||
{
|
||||
public function __construct(
|
||||
public float $coveragePercent, // درصد پوشش این بیمه
|
||||
public int $franchiseRials, // فرانشیز ثابت سهم بیمار
|
||||
public ?int $ceilingRials, // سقف تعهد هر آیتم (null = بینهایت)
|
||||
public bool $covered = true,
|
||||
) {}
|
||||
}
|
||||
```
|
||||
|
||||
### 2.2 Entities (جداول)
|
||||
|
||||
#### TenantInsurance (ارتقای EntityInsurancePricing)
|
||||
قرارداد یک tenant با یک بیمه. نسخهدار، قابل غیرفعالسازی بدون حذف.
|
||||
|
||||
| ستون | نوع | توضیح |
|
||||
|---|---|---|
|
||||
| id | int PK | |
|
||||
| uuid | string(36) unique | |
|
||||
| entity_type | string(10) | `doctor`/`clinic` |
|
||||
| entity_id | int | |
|
||||
| insurance_id | int FK→insurances | |
|
||||
| version | int | نسخهی قرارداد (۱، ۲، …) |
|
||||
| is_active | bool | غیرفعال بدون حذف |
|
||||
| coverage_percent | decimal(5,2) | پوشش پیشفرض قرارداد |
|
||||
| franchise_rials | int | فرانشیز پیشفرض |
|
||||
| annual_ceiling_rials | int null | سقف تعهد سالانهی بیمار/بیمه |
|
||||
| effective_from | int (unix) | شروع اعتبار قرارداد |
|
||||
| effective_to | int null | پایان (null = جاری) |
|
||||
| created_at / updated_at | int | |
|
||||
|
||||
UniqueConstraint: `(entity_type, entity_id, insurance_id, version)`. Index: `(entity_type, entity_id, is_active)`.
|
||||
|
||||
#### TenantServiceCoverage
|
||||
override پوشش یک خدمت خاص تحت یک بیمهی tenant (آیا پوشش دارد + درصد/فرانشیز/سقف اختصاصی).
|
||||
|
||||
| ستون | نوع |
|
||||
|---|---|
|
||||
| id, uuid | |
|
||||
| tenant_insurance_id | int FK→tenant_insurances |
|
||||
| service_item_id | int FK→service_items |
|
||||
| covered | bool |
|
||||
| coverage_percent | decimal(5,2) null (null=ارث از قرارداد) |
|
||||
| franchise_rials | int null |
|
||||
| ceiling_rials | int null |
|
||||
|
||||
UniqueConstraint: `(tenant_insurance_id, service_item_id)`.
|
||||
|
||||
#### Tariff (تعرفهی نسخهدار)
|
||||
تعرفهی یک خدمت برای یک سال. تاریخچه حفظ میشود.
|
||||
|
||||
| ستون | نوع | توضیح |
|
||||
|---|---|---|
|
||||
| id, uuid | | |
|
||||
| service_item_id | int FK | |
|
||||
| year | smallint | سال شمسی (۱۴۰۳ …) |
|
||||
| price_rials | int | تعرفهی آن سال |
|
||||
| effective_from / effective_to | int (unix) | بازهی اعتبار |
|
||||
| is_active | bool | |
|
||||
|
||||
UniqueConstraint: `(service_item_id, year)`. `ServiceItem.priceRials` بهعنوان تعرفهی پیشفرض/جاری باقی میماند (fallback).
|
||||
|
||||
#### Invoice
|
||||
صورتحساب یک Encounter (`PatientSession`).
|
||||
|
||||
| ستون | نوع |
|
||||
|---|---|
|
||||
| id, uuid | |
|
||||
| entity_type, entity_id | tenant |
|
||||
| patient_session_id | int FK→patient_sessions (Encounter) |
|
||||
| patient_record_id | int FK |
|
||||
| base_insurance_id | int null |
|
||||
| supplementary_insurance_id | int null |
|
||||
| total_rials | int |
|
||||
| base_insurance_rials | int |
|
||||
| supplementary_rials | int |
|
||||
| patient_rials | int |
|
||||
| status | string(15) `draft\|finalized\|paid\|void` |
|
||||
| issued_at | int (unix) |
|
||||
| created_at, updated_at | int |
|
||||
|
||||
#### InvoiceItem
|
||||
یک خط صورتحساب (خدمت/ویزیت).
|
||||
|
||||
| ستون | نوع |
|
||||
|---|---|
|
||||
| id, uuid | |
|
||||
| invoice_id | int FK |
|
||||
| service_item_id | int null (ویزیت میتواند null باشد) |
|
||||
| title | string |
|
||||
| service_code | string null |
|
||||
| tariff_rials | int (تعرفهی واحد) |
|
||||
| quantity | int |
|
||||
| total_rials | int (= tariff × qty) |
|
||||
| base_coverage_percent | decimal(5,2) |
|
||||
| supp_coverage_percent | decimal(5,2) |
|
||||
| franchise_rials | int |
|
||||
| ceiling_rials | int null |
|
||||
| base_insurance_rials | int |
|
||||
| supplementary_rials | int |
|
||||
| patient_rials | int |
|
||||
|
||||
#### Claim (مطالبهی بیمه)
|
||||
گروهی از Invoiceها/InvoiceItemها که به یک بیمه ارسال میشود.
|
||||
|
||||
| ستون | نوع |
|
||||
|---|---|
|
||||
| id, uuid | |
|
||||
| entity_type, entity_id | tenant |
|
||||
| insurance_id | int FK |
|
||||
| insurance_kind | string `base\|supplementary` |
|
||||
| total_claimed_rials | int |
|
||||
| total_approved_rials | int null |
|
||||
| total_paid_rials | int null |
|
||||
| status | string(15) `pending\|submitted\|approved\|rejected\|paid` |
|
||||
| reject_reason | text null |
|
||||
| submitted_at / settled_at | int null |
|
||||
| created_at, updated_at | int |
|
||||
|
||||
#### ClaimItem
|
||||
ارتباط Claim ↔ InvoiceItem (many-to-many با مبلغ ادعاشده per item).
|
||||
|
||||
| ستون | نوع |
|
||||
|---|---|
|
||||
| id | |
|
||||
| claim_id | int FK |
|
||||
| invoice_item_id | int FK |
|
||||
| claimed_rials | int |
|
||||
| approved_rials | int null |
|
||||
|
||||
---
|
||||
|
||||
## ۳. Entity Diagram (ERD متنی)
|
||||
|
||||
```
|
||||
Insurance (master, global)
|
||||
▲ insurance_id
|
||||
│
|
||||
TenantInsurance ──< TenantServiceCoverage >── ServiceItem ──< Tariff
|
||||
(entity_type,id) │ service_item_id
|
||||
│
|
||||
PatientRecord ──< PatientSession(Encounter) ──1:1 Invoice ──< InvoiceItem
|
||||
│ ▲ invoice_item_id
|
||||
│ │
|
||||
base/supp ins ClaimItem >── Claim ── Insurance
|
||||
(entity_type,id)
|
||||
UserProfile.basicInsuranceId / supplementaryInsuranceId → بیمهی پیشفرض بیمار
|
||||
```
|
||||
|
||||
---
|
||||
|
||||
## ۴. Aggregates (DDD)
|
||||
|
||||
| Aggregate Root | شامل | Invariantها |
|
||||
|---|---|---|
|
||||
| **Invoice** | InvoiceItem[] | جمع سهمها = total هر آیتم؛ مجموع سطرها = total فاکتور؛ تغییر فقط در `draft`. |
|
||||
| **Claim** | ClaimItem[] | فقط InvoiceItemهای finalized؛ transition وضعیت طبق state machine؛ `approved_rials ≤ claimed_rials`. |
|
||||
| **TenantInsurance** | TenantServiceCoverage[] | فقط بیمههای فعالِ همان tenant؛ نسخهی جدید قبلی را غیرفعال نمیکند مگر صریح. |
|
||||
|
||||
Encounter (`PatientSession`) خارج از Aggregate صورتحساب است؛ Invoice به آن **ارجاع** میدهد (نه ownership).
|
||||
|
||||
---
|
||||
|
||||
## ۵. منطق محاسبهی سهم (Domain Service)
|
||||
|
||||
```php
|
||||
// App\Billing\Service\BillingCalculator
|
||||
final class BillingCalculator
|
||||
{
|
||||
/**
|
||||
* محاسبهی سهم برای یک آیتم.
|
||||
* ترتیب: کل → پوشش پایه (با سقف) → باقیماندهی بیمار → پوشش مکمل روی باقیمانده → فرانشیز ثابت سهم بیمار.
|
||||
*/
|
||||
public function calculateItem(
|
||||
Money $total,
|
||||
?CoverageRule $base, // قانون بیمهی پایه (یا null)
|
||||
?CoverageRule $supplementary, // قانون بیمهی مکمل (یا null)
|
||||
): ShareBreakdown {
|
||||
$baseShare = new Money(0);
|
||||
$remaining = $total;
|
||||
|
||||
if ($base !== null && $base->covered) {
|
||||
$baseShare = $total->percent($base->coveragePercent);
|
||||
if ($base->ceilingRials !== null) {
|
||||
$baseShare = $baseShare->min(new Money($base->ceilingRials));
|
||||
}
|
||||
$remaining = $total->sub($baseShare);
|
||||
}
|
||||
|
||||
$suppShare = new Money(0);
|
||||
if ($supplementary !== null && $supplementary->covered) {
|
||||
$suppShare = $remaining->percent($supplementary->coveragePercent);
|
||||
if ($supplementary->ceilingRials !== null) {
|
||||
$suppShare = $suppShare->min(new Money($supplementary->ceilingRials));
|
||||
}
|
||||
$remaining = $remaining->sub($suppShare);
|
||||
}
|
||||
|
||||
// فرانشیز همیشه سهم بیمار است (به remaining اضافه میشود، از سهم بیمه کم نمیکند مگر طراحی دیگر)
|
||||
$franchise = new Money(($base?->franchiseRials ?? 0) + ($supplementary?->franchiseRials ?? 0));
|
||||
$patient = $remaining->add($franchise)->min($total); // سهم بیمار از کل بیشتر نشود
|
||||
|
||||
// اصلاح: اگر فرانشیز باعث شد جمع > total شود، سهم بیمهها کم نمیشود؛ این Invariant باید تست شود.
|
||||
return new ShareBreakdown(
|
||||
totalRials: $total->rials,
|
||||
baseInsuranceRials: $baseShare->rials,
|
||||
supplementaryRials: $suppShare->rials,
|
||||
patientRials: $patient->rials,
|
||||
);
|
||||
}
|
||||
}
|
||||
```
|
||||
|
||||
**نمونه (مطابق پرامپت):** کل 600,000؛ پایه 70% → 420,000؛ مکمل روی باقیماندهی 180,000 با ≈66.7% → 120,000؛ سهم بیمار 60,000.
|
||||
|
||||
> نکتهی طراحی: تعامل فرانشیز و سقف باید با Test پوشش داده شود؛ منطق بالا یک baseline است و قابل تنظیم per-insurance.
|
||||
|
||||
---
|
||||
|
||||
## ۶. Repository / Service / DTO
|
||||
|
||||
**Repositoryها** (الگوی `ServiceEntityRepository` + `save/remove`):
|
||||
`TenantInsuranceRepository` (findActiveByTenant, findContractFor), `TenantServiceCoverageRepository`, `TariffRepository` (findForServiceYear), `InvoiceRepository`, `ClaimRepository` (findByStatus, debtReport).
|
||||
|
||||
**Service Layer:**
|
||||
- `TenantInsuranceService` — فعالسازی/غیرفعال/نسخهبندی قرارداد، گرفتن `CoverageRule` برای (tenant, insurance, serviceItem).
|
||||
- `BillingCalculator` — محاسبهی خالص (بالا).
|
||||
- `InvoiceService` — ساخت Invoice از Encounter: برای هر خدمت → resolve تعرفه (Tariff سال) + CoverageRule بیمههای بیمار → `BillingCalculator` → InvoiceItem؛ finalize.
|
||||
- `ClaimService` — گروهبندی InvoiceItemها بر اساس بیمه، ساخت Claim، transition وضعیت، گزارش بدهی.
|
||||
|
||||
**DTOها:** `CreateInvoiceRequest`, `InvoiceItemDTO`, `TenantInsuranceDTO`, `CoverageRuleDTO`, `ClaimDTO`, `BillingPreviewResponse` (پیشنمایش زندهی محاسبه قبل از ثبت).
|
||||
|
||||
---
|
||||
|
||||
## ۷. REST API (تحت `/api/v1`, `BaseController`, tenant از `#[CurrentUser]`)
|
||||
|
||||
### TenantInsurance (قراردادهای بیمهی tenant)
|
||||
- `GET /api/v1/billing/tenant-insurances` — لیست قراردادهای فعال tenant
|
||||
- `POST /api/v1/billing/tenant-insurances` — فعالسازی بیمه برای tenant (با coverage_percent/franchise/ceiling)
|
||||
- `PATCH /api/v1/billing/tenant-insurances/{uuid}` — ویرایش (نسخهی جدید)
|
||||
- `DELETE /api/v1/billing/tenant-insurances/{uuid}` — غیرفعالسازی (soft)
|
||||
- `PUT /api/v1/billing/tenant-insurances/{uuid}/service-coverage` — تنظیم پوشش خدمات
|
||||
|
||||
### Tariff
|
||||
- `GET /api/v1/billing/services/{serviceUuid}/tariffs`
|
||||
- `PUT /api/v1/billing/services/{serviceUuid}/tariffs/{year}` — ثبت/ویرایش تعرفهی سال
|
||||
|
||||
### Invoice
|
||||
- `POST /api/v1/billing/invoices/preview` — پیشنمایش محاسبه (بدون ذخیره)
|
||||
- `POST /api/v1/billing/invoices` — ساخت از Encounter
|
||||
- `GET /api/v1/billing/invoices/{uuid}`
|
||||
- `POST /api/v1/billing/invoices/{uuid}/finalize`
|
||||
|
||||
### Claim
|
||||
- `POST /api/v1/billing/claims` — ساخت از InvoiceItemهای finalized یک بیمه
|
||||
- `POST /api/v1/billing/claims/{uuid}/submit|approve|reject|pay`
|
||||
- `GET /api/v1/billing/claims?status=...`
|
||||
- `GET /api/v1/billing/reports/insurance-debt` — گزارش بدهی بیمهها
|
||||
|
||||
**Guard مهم (نیازمندی ۱۴):** هنگام پذیرش بیمار و ساخت Invoice، فقط بیمههایی مجازند که `TenantInsurance.is_active = true` برای همان tenant. در غیر این صورت `ERR_VALIDATION` («این بیمه برای این کلینیک فعال نیست»).
|
||||
|
||||
---
|
||||
|
||||
## ۸. Workflow
|
||||
|
||||
### ثبت صورتحساب
|
||||
```
|
||||
Encounter(PatientSession) ثبت میشود
|
||||
→ بیمهی بیمار از UserProfile یا انتخاب منشی (محدود به TenantInsurance فعال)
|
||||
→ InvoiceService.createFromEncounter:
|
||||
برای هر خدمت:
|
||||
tariff = TariffRepository.findForServiceYear(service, سالِ جاری) ?? service.priceRials
|
||||
coverage_base = TenantInsuranceService.coverageRule(tenant, baseIns, service)
|
||||
coverage_supp = TenantInsuranceService.coverageRule(tenant, suppIns, service)
|
||||
breakdown = BillingCalculator.calculateItem(...)
|
||||
→ InvoiceItem
|
||||
→ Invoice (status=draft) → finalize (status=finalized)
|
||||
```
|
||||
|
||||
### Claim
|
||||
```
|
||||
InvoiceItemهای finalized یک بیمه → ClaimService.create (status=pending)
|
||||
→ submit (submitted) → [پاسخ بیمه] approve/reject → pay (paid)
|
||||
گزارش بدهی = جمع claimed - paid بر اساس بیمه
|
||||
```
|
||||
|
||||
state machine Claim (الگوی `Appointment::canTransitionTo`):
|
||||
`pending → submitted → {approved → paid | rejected}`؛ از `paid`/`rejected` خروج ندارد.
|
||||
|
||||
---
|
||||
|
||||
## ۹. Events / Use Cases
|
||||
|
||||
**Domain Events:** `InvoiceFinalized`, `ClaimSubmitted`, `ClaimApproved`, `ClaimRejected`, `ClaimPaid`, `TenantInsuranceDeactivated`.
|
||||
کاربرد: SMS/notification به بیمار، بهروزرسانی گزارش بدهی، آینده: ارسال خودکار به API بیمه.
|
||||
|
||||
**Use Cases اصلی:** فعالسازی بیمه برای tenant؛ تنظیم پوشش خدمت؛ ثبت تعرفهی سالانه؛ پیشنمایش محاسبهی سهم؛ ثبت Invoice از Encounter؛ ساخت/پیگیری Claim؛ گزارش بدهی.
|
||||
|
||||
---
|
||||
|
||||
## ۱۰. آینده: اتصال به API بیمه (نیازمندی ۱۰)
|
||||
`ClaimSubmitter` بهصورت interface طراحی شود؛ پیادهسازی فعلی manual، آینده `IranInsuranceApiSubmitter` بدون تغییر در دامنه (Dependency Inversion).
|
||||
|
||||
---
|
||||
|
||||
## ۱۱. فازبندی پیادهسازی (پیشنهادی)
|
||||
|
||||
1. **فاز ۱ — قرارداد بیمه:** ✅ **انجام شد** — `TenantInsurance` (entity/repo/service/API/UI) + جدول `tenant_insurances` + guard `assertActive()` + `CoverageRule` VO. `EntityInsurancePricing` فعلاً برای ویزیت آزاد/سهم ساده باقی ماند (فاز ۴ ادغام). API: `/api/v1/billing/tenant-insurances` (GET/POST/PATCH/DELETE). UI: صفحهی «بیمه و قیمتگذاری».
|
||||
2. **فاز ۲ — پوشش خدمت:** ✅ **انجام شد** — `ServiceItem.insuranceCovered` + `insurancePriceRials` + موجودیت `TenantServiceCoverage` (override per-service per-contract) + `coverageRuleForService()` (resolve با ارث از قرارداد) + API `…/service-coverage` (GET/PUT) + UI toggle «شامل بیمه» در صفحهی خدمات.
|
||||
3. **فاز ۳ — تعرفه:** ✅ **انجام شد** — موجودیت `Tariff` (service_item × سال شمسی) + `TariffService::resolvePrice()` با fallback به `ServiceItem.priceRials` + `currentJalaliYear()` (IntlDateFormatter، رقم لاتین) + API `…/tariffs` (GET) و `…/tariffs/{year}` (PUT) + UI «تعرفههای سالانه» (modal از ردیف خدمت).
|
||||
4. **فاز ۴ — محاسبه + Invoice:** ✅ **انجام شد** — VO `Money`/`ShareBreakdown` + `BillingCalculator` (۶ تست واحد سبز، نمونه ۶۰۰k) + `Invoice`/`InvoiceItem` (aggregate، جداول `invoices`/`invoice_items`) + `InvoiceService::createFromSession` (resolve تعرفهی Tariff + CoverageRule per-service + محاسبه) + API `/api/v1/billing/invoices` (POST/GET/finalize). `PatientService::calculateFinalPrice` فعلاً برای سازگاری باقی ماند (مصرف UI موجود).
|
||||
5. **فاز ۵ — Claim + گزارش:** ✅ **انجام شد** — `Claim`/`ClaimItem` (جداول `claims`/`claim_items`) + state machine (`pending→submitted→approved/rejected→paid`) + `ClaimService::createFromInvoice` (تفکیک پایه/مکمل از InvoiceItemها) + transitions + API `/api/v1/billing/claims` (POST/GET + `{uuid}/{action}`) + گزارش `…/reports/insurance-debt`.
|
||||
6. **فاز ۶ — Frontend + API بیمه:** ✅ **انجام شد** — صفحهی «مطالبات بیمه» (`ClaimsPage`: لیست + فیلتر وضعیت + transitions submit/approve/reject/pay + گزارش بدهی) + route `/admin/claims` + آیتم sidebar (doctor/clinic) + interface `ClaimSubmitterInterface` با پیادهسازی پیشفرض `ManualClaimSubmitter` (autowired؛ آمادهی جایگزینی با API بیمهی ایران بدون تغییر `ClaimService`). UI صورتحساب در فرم مراجعه به فاز بعدی موکول شد (نیاز به بازطراحی مودال مراجعه — پرامپت `new-visit-modal-ux.md`).
|
||||
|
||||
> توجه: `EntityInsurancePricing` فعلی (همین session ساخته شد) در فاز ۱ به `TenantInsurance` تبدیل میشود؛ تا آن زمان بهعنوان نسخهی سادهی موقت کار میکند.
|
||||
@@ -0,0 +1,32 @@
|
||||
<?php
|
||||
|
||||
declare(strict_types=1);
|
||||
|
||||
namespace DoctrineMigrations;
|
||||
|
||||
use Doctrine\DBAL\Schema\Schema;
|
||||
use Doctrine\Migrations\AbstractMigration;
|
||||
|
||||
/**
|
||||
* Auto-generated Migration: Please modify to your needs!
|
||||
*/
|
||||
final class Version20260622163152 extends AbstractMigration
|
||||
{
|
||||
public function getDescription(): string
|
||||
{
|
||||
return '';
|
||||
}
|
||||
|
||||
public function up(Schema $schema): void
|
||||
{
|
||||
// this up() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('CREATE TABLE entity_insurance_pricing (id INT AUTO_INCREMENT NOT NULL, entity_type VARCHAR(10) NOT NULL, entity_id INT NOT NULL, insurance_id INT DEFAULT NULL, patient_share_rials INT NOT NULL, updated_at INT NOT NULL, INDEX idx_entity_pricing_owner (entity_type, entity_id), UNIQUE INDEX uniq_entity_insurance (entity_type, entity_id, insurance_id), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
|
||||
$this->addSql("INSERT INTO entity_insurance_pricing (entity_type, entity_id, insurance_id, patient_share_rials, updated_at) SELECT 'doctor', doctor_id, insurance_id, COALESCE(price, 0), UNIX_TIMESTAMP() FROM doctor_insurances WHERE price IS NOT NULL");
|
||||
}
|
||||
|
||||
public function down(Schema $schema): void
|
||||
{
|
||||
// this down() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('DROP TABLE entity_insurance_pricing');
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,31 @@
|
||||
<?php
|
||||
|
||||
declare(strict_types=1);
|
||||
|
||||
namespace DoctrineMigrations;
|
||||
|
||||
use Doctrine\DBAL\Schema\Schema;
|
||||
use Doctrine\Migrations\AbstractMigration;
|
||||
|
||||
/**
|
||||
* Auto-generated Migration: Please modify to your needs!
|
||||
*/
|
||||
final class Version20260622171538 extends AbstractMigration
|
||||
{
|
||||
public function getDescription(): string
|
||||
{
|
||||
return '';
|
||||
}
|
||||
|
||||
public function up(Schema $schema): void
|
||||
{
|
||||
// this up() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('CREATE TABLE tenant_insurances (id INT AUTO_INCREMENT NOT NULL, uuid VARCHAR(36) NOT NULL, entity_type VARCHAR(10) NOT NULL, entity_id INT NOT NULL, insurance_id INT NOT NULL, version INT NOT NULL, is_active TINYINT NOT NULL, coverage_percent NUMERIC(5, 2) NOT NULL, franchise_rials INT NOT NULL, annual_ceiling_rials INT DEFAULT NULL, effective_from INT NOT NULL, effective_to INT DEFAULT NULL, created_at INT NOT NULL, updated_at INT NOT NULL, UNIQUE INDEX UNIQ_9C419AB7D17F50A6 (uuid), INDEX idx_tenant_insurance_active (entity_type, entity_id, is_active), UNIQUE INDEX uniq_tenant_insurance_version (entity_type, entity_id, insurance_id, version), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
|
||||
}
|
||||
|
||||
public function down(Schema $schema): void
|
||||
{
|
||||
// this down() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('DROP TABLE tenant_insurances');
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,33 @@
|
||||
<?php
|
||||
|
||||
declare(strict_types=1);
|
||||
|
||||
namespace DoctrineMigrations;
|
||||
|
||||
use Doctrine\DBAL\Schema\Schema;
|
||||
use Doctrine\Migrations\AbstractMigration;
|
||||
|
||||
/**
|
||||
* Auto-generated Migration: Please modify to your needs!
|
||||
*/
|
||||
final class Version20260622173707 extends AbstractMigration
|
||||
{
|
||||
public function getDescription(): string
|
||||
{
|
||||
return '';
|
||||
}
|
||||
|
||||
public function up(Schema $schema): void
|
||||
{
|
||||
// this up() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('CREATE TABLE tenant_service_coverage (id INT AUTO_INCREMENT NOT NULL, uuid VARCHAR(36) NOT NULL, tenant_insurance_id INT NOT NULL, service_item_id INT NOT NULL, covered TINYINT NOT NULL, coverage_percent NUMERIC(5, 2) DEFAULT NULL, franchise_rials INT DEFAULT NULL, ceiling_rials INT DEFAULT NULL, updated_at INT NOT NULL, UNIQUE INDEX UNIQ_76431C8ED17F50A6 (uuid), INDEX idx_tsc_service (service_item_id), UNIQUE INDEX uniq_tenant_service_coverage (tenant_insurance_id, service_item_id), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
|
||||
$this->addSql('ALTER TABLE service_items ADD insurance_covered TINYINT NOT NULL, ADD insurance_price_rials INT DEFAULT NULL');
|
||||
}
|
||||
|
||||
public function down(Schema $schema): void
|
||||
{
|
||||
// this down() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('DROP TABLE tenant_service_coverage');
|
||||
$this->addSql('ALTER TABLE service_items DROP insurance_covered, DROP insurance_price_rials');
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,31 @@
|
||||
<?php
|
||||
|
||||
declare(strict_types=1);
|
||||
|
||||
namespace DoctrineMigrations;
|
||||
|
||||
use Doctrine\DBAL\Schema\Schema;
|
||||
use Doctrine\Migrations\AbstractMigration;
|
||||
|
||||
/**
|
||||
* Auto-generated Migration: Please modify to your needs!
|
||||
*/
|
||||
final class Version20260622181251 extends AbstractMigration
|
||||
{
|
||||
public function getDescription(): string
|
||||
{
|
||||
return '';
|
||||
}
|
||||
|
||||
public function up(Schema $schema): void
|
||||
{
|
||||
// this up() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('CREATE TABLE service_tariffs (id INT AUTO_INCREMENT NOT NULL, uuid VARCHAR(36) NOT NULL, service_item_id INT NOT NULL, year SMALLINT NOT NULL, price_rials INT NOT NULL, is_active TINYINT NOT NULL, created_at INT NOT NULL, updated_at INT NOT NULL, UNIQUE INDEX UNIQ_FAAAF536D17F50A6 (uuid), INDEX idx_tariff_service_active (service_item_id, is_active), UNIQUE INDEX uniq_service_tariff_year (service_item_id, year), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
|
||||
}
|
||||
|
||||
public function down(Schema $schema): void
|
||||
{
|
||||
// this down() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('DROP TABLE service_tariffs');
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,35 @@
|
||||
<?php
|
||||
|
||||
declare(strict_types=1);
|
||||
|
||||
namespace DoctrineMigrations;
|
||||
|
||||
use Doctrine\DBAL\Schema\Schema;
|
||||
use Doctrine\Migrations\AbstractMigration;
|
||||
|
||||
/**
|
||||
* Auto-generated Migration: Please modify to your needs!
|
||||
*/
|
||||
final class Version20260622184409 extends AbstractMigration
|
||||
{
|
||||
public function getDescription(): string
|
||||
{
|
||||
return '';
|
||||
}
|
||||
|
||||
public function up(Schema $schema): void
|
||||
{
|
||||
// this up() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('CREATE TABLE invoice_items (id INT AUTO_INCREMENT NOT NULL, uuid VARCHAR(36) NOT NULL, service_item_id INT DEFAULT NULL, title VARCHAR(200) NOT NULL, tariff_rials INT NOT NULL, quantity INT NOT NULL, total_rials INT NOT NULL, base_insurance_rials INT NOT NULL, supplementary_rials INT NOT NULL, patient_rials INT NOT NULL, invoice_id INT NOT NULL, UNIQUE INDEX UNIQ_DCC4B9F8D17F50A6 (uuid), INDEX IDX_DCC4B9F82989F1FD (invoice_id), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
|
||||
$this->addSql('CREATE TABLE invoices (id INT AUTO_INCREMENT NOT NULL, uuid VARCHAR(36) NOT NULL, entity_type VARCHAR(10) NOT NULL, entity_id INT NOT NULL, patient_session_id INT DEFAULT NULL, patient_record_id INT DEFAULT NULL, base_insurance_id INT DEFAULT NULL, supplementary_insurance_id INT DEFAULT NULL, total_rials INT NOT NULL, base_insurance_rials INT NOT NULL, supplementary_rials INT NOT NULL, patient_rials INT NOT NULL, status VARCHAR(15) NOT NULL, issued_at INT NOT NULL, created_at INT NOT NULL, updated_at INT NOT NULL, UNIQUE INDEX UNIQ_6A2F2F95D17F50A6 (uuid), INDEX idx_invoice_tenant (entity_type, entity_id), INDEX idx_invoice_session (patient_session_id), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
|
||||
$this->addSql('ALTER TABLE invoice_items ADD CONSTRAINT FK_DCC4B9F82989F1FD FOREIGN KEY (invoice_id) REFERENCES invoices (id) ON DELETE CASCADE');
|
||||
}
|
||||
|
||||
public function down(Schema $schema): void
|
||||
{
|
||||
// this down() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('ALTER TABLE invoice_items DROP FOREIGN KEY FK_DCC4B9F82989F1FD');
|
||||
$this->addSql('DROP TABLE invoice_items');
|
||||
$this->addSql('DROP TABLE invoices');
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,35 @@
|
||||
<?php
|
||||
|
||||
declare(strict_types=1);
|
||||
|
||||
namespace DoctrineMigrations;
|
||||
|
||||
use Doctrine\DBAL\Schema\Schema;
|
||||
use Doctrine\Migrations\AbstractMigration;
|
||||
|
||||
/**
|
||||
* Auto-generated Migration: Please modify to your needs!
|
||||
*/
|
||||
final class Version20260622185948 extends AbstractMigration
|
||||
{
|
||||
public function getDescription(): string
|
||||
{
|
||||
return '';
|
||||
}
|
||||
|
||||
public function up(Schema $schema): void
|
||||
{
|
||||
// this up() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('CREATE TABLE claim_items (id INT AUTO_INCREMENT NOT NULL, invoice_item_id INT NOT NULL, claimed_rials INT NOT NULL, approved_rials INT DEFAULT NULL, claim_id INT NOT NULL, INDEX IDX_DD53020B7096A49F (claim_id), INDEX idx_claim_item_invoice_item (invoice_item_id), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
|
||||
$this->addSql('CREATE TABLE claims (id INT AUTO_INCREMENT NOT NULL, uuid VARCHAR(36) NOT NULL, entity_type VARCHAR(10) NOT NULL, entity_id INT NOT NULL, insurance_id INT NOT NULL, insurance_kind VARCHAR(15) NOT NULL, total_claimed_rials INT NOT NULL, total_approved_rials INT DEFAULT NULL, total_paid_rials INT DEFAULT NULL, status VARCHAR(15) NOT NULL, reject_reason LONGTEXT DEFAULT NULL, submitted_at INT DEFAULT NULL, settled_at INT DEFAULT NULL, created_at INT NOT NULL, updated_at INT NOT NULL, UNIQUE INDEX UNIQ_BEA313BED17F50A6 (uuid), INDEX idx_claim_tenant (entity_type, entity_id), INDEX idx_claim_insurance_status (insurance_id, status), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
|
||||
$this->addSql('ALTER TABLE claim_items ADD CONSTRAINT FK_DD53020B7096A49F FOREIGN KEY (claim_id) REFERENCES claims (id) ON DELETE CASCADE');
|
||||
}
|
||||
|
||||
public function down(Schema $schema): void
|
||||
{
|
||||
// this down() migration is auto-generated, please modify it to your needs
|
||||
$this->addSql('ALTER TABLE claim_items DROP FOREIGN KEY FK_DD53020B7096A49F');
|
||||
$this->addSql('DROP TABLE claim_items');
|
||||
$this->addSql('DROP TABLE claims');
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,22 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Contract;
|
||||
|
||||
final readonly class ClaimSubmissionResult
|
||||
{
|
||||
public function __construct(
|
||||
public bool $success,
|
||||
public ?string $referenceCode = null,
|
||||
public ?string $errorMessage = null,
|
||||
) {}
|
||||
|
||||
public static function ok(?string $referenceCode = null): self
|
||||
{
|
||||
return new self(true, $referenceCode, null);
|
||||
}
|
||||
|
||||
public static function fail(string $errorMessage): self
|
||||
{
|
||||
return new self(false, null, $errorMessage);
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,14 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Contract;
|
||||
|
||||
use App\Billing\Entity\Claim;
|
||||
|
||||
/**
|
||||
* انتزاع ارسال مطالبه به بیمه. پیادهسازی فعلی manual است؛
|
||||
* در آینده میتوان پیادهسازی متصل به API شرکتهای بیمهی ایران را بدون تغییر دامنه جایگزین کرد.
|
||||
*/
|
||||
interface ClaimSubmitterInterface
|
||||
{
|
||||
public function submit(Claim $claim): ClaimSubmissionResult;
|
||||
}
|
||||
@@ -0,0 +1,186 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Controller;
|
||||
|
||||
use App\Auth\Entity\User;
|
||||
use App\Billing\Entity\Claim;
|
||||
use App\Billing\Repository\ClaimRepository;
|
||||
use App\Billing\Repository\InvoiceRepository;
|
||||
use App\Billing\Service\ClaimService;
|
||||
use App\Billing\Service\InvoiceService;
|
||||
use App\Clinic\Repository\ClinicRepository;
|
||||
use App\Doctor\Repository\DoctorRepository;
|
||||
use App\Patient\Repository\PatientSessionRepository;
|
||||
use App\Shared\Constant\ErrorCodes;
|
||||
use App\Shared\Controller\BaseController;
|
||||
use Symfony\Component\HttpFoundation\JsonResponse;
|
||||
use Symfony\Component\HttpFoundation\Request;
|
||||
use Symfony\Component\Routing\Attribute\Route;
|
||||
use Symfony\Component\Security\Http\Attribute\CurrentUser;
|
||||
use Symfony\Component\Security\Http\Attribute\IsGranted;
|
||||
use OpenApi\Attributes as OA;
|
||||
|
||||
#[OA\Tag(name: 'Billing')]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
class BillingController extends BaseController
|
||||
{
|
||||
public function __construct(
|
||||
private readonly InvoiceService $invoiceService,
|
||||
private readonly InvoiceRepository $invoiceRepo,
|
||||
private readonly ClaimService $claimService,
|
||||
private readonly ClaimRepository $claimRepo,
|
||||
private readonly PatientSessionRepository $sessionRepo,
|
||||
private readonly DoctorRepository $doctorRepo,
|
||||
private readonly ClinicRepository $clinicRepo,
|
||||
) {}
|
||||
|
||||
#[Route('/api/v1/billing/invoices', methods: ['POST'])]
|
||||
public function create(Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
if ($entityId === null) {
|
||||
return $this->error(ErrorCodes::ERR_FORBIDDEN_001, 'پروفایل یافت نشد', 403);
|
||||
}
|
||||
|
||||
$data = json_decode($request->getContent(), true) ?? [];
|
||||
$sessionUuid = trim($data['session_uuid'] ?? '');
|
||||
if ($sessionUuid === '') {
|
||||
return $this->error(ErrorCodes::ERR_VALIDATION_001, 'session_uuid الزامی است', 422);
|
||||
}
|
||||
|
||||
$session = $this->sessionRepo->findByUuid($sessionUuid);
|
||||
if ($session === null || !$this->ownsSession($session, $entityType, $entityId)) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'مراجعه یافت نشد', 404);
|
||||
}
|
||||
|
||||
$invoice = $this->invoiceService->createFromSession($session, $entityType, $entityId);
|
||||
|
||||
return $this->success(['data' => $invoice->toArray()], 201);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/invoices/{uuid}', methods: ['GET'])]
|
||||
public function show(string $uuid, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
$invoice = $this->invoiceRepo->findByUuid($uuid);
|
||||
if ($invoice === null || $invoice->getEntityType() !== $entityType || $invoice->getEntityId() !== $entityId) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'صورتحساب یافت نشد', 404);
|
||||
}
|
||||
|
||||
return $this->success(['data' => $invoice->toArray()]);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/invoices/{uuid}/finalize', methods: ['POST'])]
|
||||
public function finalize(string $uuid, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
$invoice = $this->invoiceRepo->findByUuid($uuid);
|
||||
if ($invoice === null || $invoice->getEntityType() !== $entityType || $invoice->getEntityId() !== $entityId) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'صورتحساب یافت نشد', 404);
|
||||
}
|
||||
|
||||
$this->invoiceService->finalize($invoice);
|
||||
|
||||
return $this->success(['data' => $invoice->toArray()]);
|
||||
}
|
||||
|
||||
// ── Claims (مطالبات بیمه) ──────────────────────────────────────────────────
|
||||
|
||||
#[Route('/api/v1/billing/claims', methods: ['POST'])]
|
||||
public function createClaim(Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
if ($entityId === null) {
|
||||
return $this->error(ErrorCodes::ERR_FORBIDDEN_001, 'پروفایل یافت نشد', 403);
|
||||
}
|
||||
|
||||
$data = json_decode($request->getContent(), true) ?? [];
|
||||
$invoiceUuid = trim($data['invoice_uuid'] ?? '');
|
||||
if ($invoiceUuid === '') {
|
||||
return $this->error(ErrorCodes::ERR_VALIDATION_001, 'invoice_uuid الزامی است', 422);
|
||||
}
|
||||
|
||||
$invoice = $this->invoiceRepo->findByUuid($invoiceUuid);
|
||||
if ($invoice === null || $invoice->getEntityType() !== $entityType || $invoice->getEntityId() !== $entityId) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'صورتحساب یافت نشد', 404);
|
||||
}
|
||||
|
||||
$claims = $this->claimService->createFromInvoice($invoice);
|
||||
|
||||
return $this->success(['data' => array_map(fn(Claim $c) => $c->toArray(), $claims)], 201);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/claims', methods: ['GET'])]
|
||||
public function listClaims(Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
if ($entityId === null) {
|
||||
return $this->error(ErrorCodes::ERR_FORBIDDEN_001, 'پروفایل یافت نشد', 403);
|
||||
}
|
||||
|
||||
$status = $request->query->get('status') ?: null;
|
||||
$claims = $this->claimRepo->findByTenant($entityType, $entityId, $status);
|
||||
|
||||
return $this->success(['data' => array_map(fn(Claim $c) => $c->toArray(), $claims)]);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/claims/{uuid}/{action}', methods: ['POST'], requirements: ['action' => 'submit|approve|reject|pay'])]
|
||||
public function transitionClaim(string $uuid, string $action, Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
$claim = $this->claimRepo->findByUuid($uuid);
|
||||
if ($claim === null || $claim->getEntityType() !== $entityType || $claim->getEntityId() !== $entityId) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'مطالبه یافت نشد', 404);
|
||||
}
|
||||
|
||||
$data = json_decode($request->getContent(), true) ?? [];
|
||||
$target = match ($action) {
|
||||
'submit' => Claim::STATUS_SUBMITTED,
|
||||
'approve' => Claim::STATUS_APPROVED,
|
||||
'reject' => Claim::STATUS_REJECTED,
|
||||
'pay' => Claim::STATUS_PAID,
|
||||
};
|
||||
|
||||
if ($action === 'reject' && trim($data['reason'] ?? '') === '') {
|
||||
return $this->error(ErrorCodes::ERR_VALIDATION_001, 'دلیل رد الزامی است', 422);
|
||||
}
|
||||
|
||||
$this->claimService->transition($claim, $target, [
|
||||
'approved_rials' => isset($data['approved_rials']) ? (int) $data['approved_rials'] : null,
|
||||
'paid_rials' => isset($data['paid_rials']) ? (int) $data['paid_rials'] : null,
|
||||
'reason' => trim($data['reason'] ?? ''),
|
||||
]);
|
||||
|
||||
return $this->success(['data' => $claim->toArray()]);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/reports/insurance-debt', methods: ['GET'])]
|
||||
public function insuranceDebt(#[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
if ($entityId === null) {
|
||||
return $this->error(ErrorCodes::ERR_FORBIDDEN_001, 'پروفایل یافت نشد', 403);
|
||||
}
|
||||
|
||||
return $this->success(['data' => $this->claimRepo->debtReport($entityType, $entityId)]);
|
||||
}
|
||||
|
||||
private function ownsSession($session, string $entityType, int $entityId): bool
|
||||
{
|
||||
$record = $session->getRecord();
|
||||
return $record->getEntityType() === $entityType && $record->getEntityId() === $entityId;
|
||||
}
|
||||
|
||||
private function resolveEntity(User $user): array
|
||||
{
|
||||
if ($user->hasRole('ROLE_DOCTOR')) {
|
||||
$doctor = $this->doctorRepo->findByUser($user);
|
||||
return $doctor !== null ? ['doctor', $doctor->getId()] : ['doctor', null];
|
||||
}
|
||||
if ($user->hasRole('ROLE_CLINIC')) {
|
||||
$clinic = $this->clinicRepo->findByUser($user);
|
||||
return $clinic !== null ? ['clinic', $clinic->getId()] : ['clinic', null];
|
||||
}
|
||||
return ['unknown', null];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,171 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Entity;
|
||||
|
||||
use App\Billing\Repository\ClaimRepository;
|
||||
use Doctrine\Common\Collections\ArrayCollection;
|
||||
use Doctrine\Common\Collections\Collection;
|
||||
use Doctrine\ORM\Mapping as ORM;
|
||||
use Symfony\Component\Uid\Uuid;
|
||||
|
||||
#[ORM\Entity(repositoryClass: ClaimRepository::class)]
|
||||
#[ORM\Table(name: 'claims')]
|
||||
#[ORM\Index(columns: ['entity_type', 'entity_id'], name: 'idx_claim_tenant')]
|
||||
#[ORM\Index(columns: ['insurance_id', 'status'], name: 'idx_claim_insurance_status')]
|
||||
class Claim
|
||||
{
|
||||
public const STATUS_PENDING = 'pending';
|
||||
public const STATUS_SUBMITTED = 'submitted';
|
||||
public const STATUS_APPROVED = 'approved';
|
||||
public const STATUS_REJECTED = 'rejected';
|
||||
public const STATUS_PAID = 'paid';
|
||||
|
||||
public const KIND_BASE = 'base';
|
||||
public const KIND_SUPPLEMENTARY = 'supplementary';
|
||||
|
||||
private const TRANSITIONS = [
|
||||
self::STATUS_PENDING => [self::STATUS_SUBMITTED],
|
||||
self::STATUS_SUBMITTED => [self::STATUS_APPROVED, self::STATUS_REJECTED],
|
||||
self::STATUS_APPROVED => [self::STATUS_PAID],
|
||||
self::STATUS_REJECTED => [],
|
||||
self::STATUS_PAID => [],
|
||||
];
|
||||
|
||||
#[ORM\Id]
|
||||
#[ORM\GeneratedValue]
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private ?int $id = null;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 36, unique: true)]
|
||||
private string $uuid;
|
||||
|
||||
#[ORM\Column(name: 'entity_type', type: 'string', length: 10)]
|
||||
private string $entityType;
|
||||
|
||||
#[ORM\Column(name: 'entity_id', type: 'integer')]
|
||||
private int $entityId;
|
||||
|
||||
#[ORM\Column(name: 'insurance_id', type: 'integer')]
|
||||
private int $insuranceId;
|
||||
|
||||
#[ORM\Column(name: 'insurance_kind', type: 'string', length: 15)]
|
||||
private string $insuranceKind;
|
||||
|
||||
#[ORM\Column(name: 'total_claimed_rials', type: 'integer')]
|
||||
private int $totalClaimedRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'total_approved_rials', type: 'integer', nullable: true)]
|
||||
private ?int $totalApprovedRials = null;
|
||||
|
||||
#[ORM\Column(name: 'total_paid_rials', type: 'integer', nullable: true)]
|
||||
private ?int $totalPaidRials = null;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 15)]
|
||||
private string $status = self::STATUS_PENDING;
|
||||
|
||||
#[ORM\Column(name: 'reject_reason', type: 'text', nullable: true)]
|
||||
private ?string $rejectReason = null;
|
||||
|
||||
#[ORM\Column(name: 'submitted_at', type: 'integer', nullable: true)]
|
||||
private ?int $submittedAt = null;
|
||||
|
||||
#[ORM\Column(name: 'settled_at', type: 'integer', nullable: true)]
|
||||
private ?int $settledAt = null;
|
||||
|
||||
#[ORM\Column(name: 'created_at', type: 'integer')]
|
||||
private int $createdAt;
|
||||
|
||||
#[ORM\Column(name: 'updated_at', type: 'integer')]
|
||||
private int $updatedAt;
|
||||
|
||||
#[ORM\OneToMany(targetEntity: ClaimItem::class, mappedBy: 'claim', cascade: ['persist', 'remove'], orphanRemoval: true)]
|
||||
private Collection $items;
|
||||
|
||||
public function __construct(string $entityType, int $entityId, int $insuranceId, string $insuranceKind)
|
||||
{
|
||||
$this->uuid = Uuid::v4()->toRfc4122();
|
||||
$this->entityType = $entityType;
|
||||
$this->entityId = $entityId;
|
||||
$this->insuranceId = $insuranceId;
|
||||
$this->insuranceKind = $insuranceKind;
|
||||
$this->createdAt = time();
|
||||
$this->updatedAt = time();
|
||||
$this->items = new ArrayCollection();
|
||||
}
|
||||
|
||||
public function getId(): ?int { return $this->id; }
|
||||
public function getUuid(): string { return $this->uuid; }
|
||||
public function getEntityType(): string { return $this->entityType; }
|
||||
public function getEntityId(): int { return $this->entityId; }
|
||||
public function getInsuranceId(): int { return $this->insuranceId; }
|
||||
public function getInsuranceKind(): string { return $this->insuranceKind; }
|
||||
public function getStatus(): string { return $this->status; }
|
||||
public function getTotalClaimedRials(): int { return $this->totalClaimedRials; }
|
||||
public function getTotalApprovedRials(): ?int { return $this->totalApprovedRials; }
|
||||
public function getTotalPaidRials(): ?int { return $this->totalPaidRials; }
|
||||
/** @return Collection<int, ClaimItem> */
|
||||
public function getItems(): Collection { return $this->items; }
|
||||
|
||||
public function addItem(ClaimItem $item): self
|
||||
{
|
||||
$this->items->add($item);
|
||||
$this->totalClaimedRials += $item->getClaimedRials();
|
||||
$this->updatedAt = time();
|
||||
return $this;
|
||||
}
|
||||
|
||||
public function canTransitionTo(string $status): bool
|
||||
{
|
||||
return in_array($status, self::TRANSITIONS[$this->status] ?? [], true);
|
||||
}
|
||||
|
||||
public function submit(): void
|
||||
{
|
||||
$this->status = self::STATUS_SUBMITTED;
|
||||
$this->submittedAt = time();
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function approve(?int $approvedRials = null): void
|
||||
{
|
||||
$this->status = self::STATUS_APPROVED;
|
||||
$this->totalApprovedRials = $approvedRials ?? $this->totalClaimedRials;
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function reject(string $reason): void
|
||||
{
|
||||
$this->status = self::STATUS_REJECTED;
|
||||
$this->rejectReason = $reason;
|
||||
$this->settledAt = time();
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function pay(?int $paidRials = null): void
|
||||
{
|
||||
$this->status = self::STATUS_PAID;
|
||||
$this->totalPaidRials = $paidRials ?? $this->totalApprovedRials ?? $this->totalClaimedRials;
|
||||
$this->settledAt = time();
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'uuid' => $this->uuid,
|
||||
'entity_type' => $this->entityType,
|
||||
'entity_id' => $this->entityId,
|
||||
'insurance_id' => $this->insuranceId,
|
||||
'insurance_kind' => $this->insuranceKind,
|
||||
'total_claimed_rials' => $this->totalClaimedRials,
|
||||
'total_approved_rials' => $this->totalApprovedRials,
|
||||
'total_paid_rials' => $this->totalPaidRials,
|
||||
'status' => $this->status,
|
||||
'reject_reason' => $this->rejectReason,
|
||||
'submitted_at' => $this->submittedAt,
|
||||
'settled_at' => $this->settledAt,
|
||||
'created_at' => $this->createdAt,
|
||||
'items' => array_map(fn(ClaimItem $i) => $i->toArray(), $this->items->toArray()),
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,51 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Entity;
|
||||
|
||||
use App\Billing\Repository\ClaimItemRepository;
|
||||
use Doctrine\ORM\Mapping as ORM;
|
||||
|
||||
#[ORM\Entity(repositoryClass: ClaimItemRepository::class)]
|
||||
#[ORM\Table(name: 'claim_items')]
|
||||
#[ORM\Index(columns: ['invoice_item_id'], name: 'idx_claim_item_invoice_item')]
|
||||
class ClaimItem
|
||||
{
|
||||
#[ORM\Id]
|
||||
#[ORM\GeneratedValue]
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private ?int $id = null;
|
||||
|
||||
#[ORM\ManyToOne(targetEntity: Claim::class, inversedBy: 'items')]
|
||||
#[ORM\JoinColumn(nullable: false, onDelete: 'CASCADE')]
|
||||
private Claim $claim;
|
||||
|
||||
#[ORM\Column(name: 'invoice_item_id', type: 'integer')]
|
||||
private int $invoiceItemId;
|
||||
|
||||
#[ORM\Column(name: 'claimed_rials', type: 'integer')]
|
||||
private int $claimedRials;
|
||||
|
||||
#[ORM\Column(name: 'approved_rials', type: 'integer', nullable: true)]
|
||||
private ?int $approvedRials = null;
|
||||
|
||||
public function __construct(Claim $claim, int $invoiceItemId, int $claimedRials)
|
||||
{
|
||||
$this->claim = $claim;
|
||||
$this->invoiceItemId = $invoiceItemId;
|
||||
$this->claimedRials = $claimedRials;
|
||||
}
|
||||
|
||||
public function getId(): ?int { return $this->id; }
|
||||
public function getInvoiceItemId(): int { return $this->invoiceItemId; }
|
||||
public function getClaimedRials(): int { return $this->claimedRials; }
|
||||
public function getApprovedRials(): ?int { return $this->approvedRials; }
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'invoice_item_id' => $this->invoiceItemId,
|
||||
'claimed_rials' => $this->claimedRials,
|
||||
'approved_rials' => $this->approvedRials,
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,153 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Entity;
|
||||
|
||||
use App\Billing\Repository\InvoiceRepository;
|
||||
use Doctrine\Common\Collections\ArrayCollection;
|
||||
use Doctrine\Common\Collections\Collection;
|
||||
use Doctrine\ORM\Mapping as ORM;
|
||||
use Symfony\Component\Uid\Uuid;
|
||||
|
||||
#[ORM\Entity(repositoryClass: InvoiceRepository::class)]
|
||||
#[ORM\Table(name: 'invoices')]
|
||||
#[ORM\Index(columns: ['entity_type', 'entity_id'], name: 'idx_invoice_tenant')]
|
||||
#[ORM\Index(columns: ['patient_session_id'], name: 'idx_invoice_session')]
|
||||
class Invoice
|
||||
{
|
||||
public const STATUS_DRAFT = 'draft';
|
||||
public const STATUS_FINALIZED = 'finalized';
|
||||
public const STATUS_PAID = 'paid';
|
||||
public const STATUS_VOID = 'void';
|
||||
|
||||
#[ORM\Id]
|
||||
#[ORM\GeneratedValue]
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private ?int $id = null;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 36, unique: true)]
|
||||
private string $uuid;
|
||||
|
||||
#[ORM\Column(name: 'entity_type', type: 'string', length: 10)]
|
||||
private string $entityType;
|
||||
|
||||
#[ORM\Column(name: 'entity_id', type: 'integer')]
|
||||
private int $entityId;
|
||||
|
||||
#[ORM\Column(name: 'patient_session_id', type: 'integer', nullable: true)]
|
||||
private ?int $patientSessionId = null;
|
||||
|
||||
#[ORM\Column(name: 'patient_record_id', type: 'integer', nullable: true)]
|
||||
private ?int $patientRecordId = null;
|
||||
|
||||
#[ORM\Column(name: 'base_insurance_id', type: 'integer', nullable: true)]
|
||||
private ?int $baseInsuranceId = null;
|
||||
|
||||
#[ORM\Column(name: 'supplementary_insurance_id', type: 'integer', nullable: true)]
|
||||
private ?int $supplementaryInsuranceId = null;
|
||||
|
||||
#[ORM\Column(name: 'total_rials', type: 'integer')]
|
||||
private int $totalRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'base_insurance_rials', type: 'integer')]
|
||||
private int $baseInsuranceRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'supplementary_rials', type: 'integer')]
|
||||
private int $supplementaryRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'patient_rials', type: 'integer')]
|
||||
private int $patientRials = 0;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 15)]
|
||||
private string $status = self::STATUS_DRAFT;
|
||||
|
||||
#[ORM\Column(name: 'issued_at', type: 'integer')]
|
||||
private int $issuedAt;
|
||||
|
||||
#[ORM\Column(name: 'created_at', type: 'integer')]
|
||||
private int $createdAt;
|
||||
|
||||
#[ORM\Column(name: 'updated_at', type: 'integer')]
|
||||
private int $updatedAt;
|
||||
|
||||
#[ORM\OneToMany(targetEntity: InvoiceItem::class, mappedBy: 'invoice', cascade: ['persist', 'remove'], orphanRemoval: true)]
|
||||
private Collection $items;
|
||||
|
||||
public function __construct(string $entityType, int $entityId)
|
||||
{
|
||||
$this->uuid = Uuid::v4()->toRfc4122();
|
||||
$this->entityType = $entityType;
|
||||
$this->entityId = $entityId;
|
||||
$this->issuedAt = time();
|
||||
$this->createdAt = time();
|
||||
$this->updatedAt = time();
|
||||
$this->items = new ArrayCollection();
|
||||
}
|
||||
|
||||
public function getId(): ?int { return $this->id; }
|
||||
public function getUuid(): string { return $this->uuid; }
|
||||
public function getEntityType(): string { return $this->entityType; }
|
||||
public function getEntityId(): int { return $this->entityId; }
|
||||
public function getStatus(): string { return $this->status; }
|
||||
public function getBaseInsuranceId(): ?int { return $this->baseInsuranceId; }
|
||||
public function getSupplementaryInsuranceId(): ?int { return $this->supplementaryInsuranceId; }
|
||||
public function getTotalRials(): int { return $this->totalRials; }
|
||||
public function getPatientRials(): int { return $this->patientRials; }
|
||||
/** @return Collection<int, InvoiceItem> */
|
||||
public function getItems(): Collection { return $this->items; }
|
||||
|
||||
public function setPatientSessionId(?int $v): self { $this->patientSessionId = $v; return $this; }
|
||||
public function setPatientRecordId(?int $v): self { $this->patientRecordId = $v; return $this; }
|
||||
public function setBaseInsuranceId(?int $v): self { $this->baseInsuranceId = $v; return $this; }
|
||||
public function setSupplementaryInsuranceId(?int $v): self { $this->supplementaryInsuranceId = $v; return $this; }
|
||||
|
||||
public function addItem(InvoiceItem $item): self
|
||||
{
|
||||
$this->items->add($item);
|
||||
$item->attachTo($this);
|
||||
return $this;
|
||||
}
|
||||
|
||||
public function recalculateTotals(): void
|
||||
{
|
||||
$total = $base = $supp = $patient = 0;
|
||||
foreach ($this->items as $item) {
|
||||
$total += $item->getTotalRials();
|
||||
$base += $item->getBaseInsuranceRials();
|
||||
$supp += $item->getSupplementaryRials();
|
||||
$patient += $item->getPatientRials();
|
||||
}
|
||||
$this->totalRials = $total;
|
||||
$this->baseInsuranceRials = $base;
|
||||
$this->supplementaryRials = $supp;
|
||||
$this->patientRials = $patient;
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function finalize(): void
|
||||
{
|
||||
if ($this->status === self::STATUS_DRAFT) {
|
||||
$this->status = self::STATUS_FINALIZED;
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
}
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'uuid' => $this->uuid,
|
||||
'entity_type' => $this->entityType,
|
||||
'entity_id' => $this->entityId,
|
||||
'patient_session_id' => $this->patientSessionId,
|
||||
'patient_record_id' => $this->patientRecordId,
|
||||
'base_insurance_id' => $this->baseInsuranceId,
|
||||
'supplementary_insurance_id' => $this->supplementaryInsuranceId,
|
||||
'total_rials' => $this->totalRials,
|
||||
'base_insurance_rials' => $this->baseInsuranceRials,
|
||||
'supplementary_rials' => $this->supplementaryRials,
|
||||
'patient_rials' => $this->patientRials,
|
||||
'status' => $this->status,
|
||||
'issued_at' => $this->issuedAt,
|
||||
'items' => array_map(fn(InvoiceItem $i) => $i->toArray(), $this->items->toArray()),
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,97 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Entity;
|
||||
|
||||
use App\Billing\Repository\InvoiceItemRepository;
|
||||
use App\Billing\ValueObject\ShareBreakdown;
|
||||
use Doctrine\ORM\Mapping as ORM;
|
||||
use Symfony\Component\Uid\Uuid;
|
||||
|
||||
#[ORM\Entity(repositoryClass: InvoiceItemRepository::class)]
|
||||
#[ORM\Table(name: 'invoice_items')]
|
||||
class InvoiceItem
|
||||
{
|
||||
#[ORM\Id]
|
||||
#[ORM\GeneratedValue]
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private ?int $id = null;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 36, unique: true)]
|
||||
private string $uuid;
|
||||
|
||||
#[ORM\ManyToOne(targetEntity: Invoice::class, inversedBy: 'items')]
|
||||
#[ORM\JoinColumn(nullable: false, onDelete: 'CASCADE')]
|
||||
private Invoice $invoice;
|
||||
|
||||
#[ORM\Column(name: 'service_item_id', type: 'integer', nullable: true)]
|
||||
private ?int $serviceItemId = null;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 200)]
|
||||
private string $title;
|
||||
|
||||
#[ORM\Column(name: 'tariff_rials', type: 'integer')]
|
||||
private int $tariffRials;
|
||||
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private int $quantity;
|
||||
|
||||
#[ORM\Column(name: 'total_rials', type: 'integer')]
|
||||
private int $totalRials;
|
||||
|
||||
#[ORM\Column(name: 'base_insurance_rials', type: 'integer')]
|
||||
private int $baseInsuranceRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'supplementary_rials', type: 'integer')]
|
||||
private int $supplementaryRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'patient_rials', type: 'integer')]
|
||||
private int $patientRials = 0;
|
||||
|
||||
public function __construct(
|
||||
Invoice $invoice,
|
||||
string $title,
|
||||
int $tariffRials,
|
||||
int $quantity,
|
||||
ShareBreakdown $breakdown,
|
||||
?int $serviceItemId = null,
|
||||
) {
|
||||
$this->uuid = Uuid::v4()->toRfc4122();
|
||||
$this->invoice = $invoice;
|
||||
$this->title = $title;
|
||||
$this->tariffRials = $tariffRials;
|
||||
$this->quantity = $quantity;
|
||||
$this->serviceItemId = $serviceItemId;
|
||||
$this->totalRials = $breakdown->totalRials;
|
||||
$this->baseInsuranceRials = $breakdown->baseInsuranceRials;
|
||||
$this->supplementaryRials = $breakdown->supplementaryRials;
|
||||
$this->patientRials = $breakdown->patientRials;
|
||||
}
|
||||
|
||||
public function getId(): ?int { return $this->id; }
|
||||
public function getUuid(): string { return $this->uuid; }
|
||||
public function getServiceItemId(): ?int { return $this->serviceItemId; }
|
||||
public function getTotalRials(): int { return $this->totalRials; }
|
||||
public function getBaseInsuranceRials(): int { return $this->baseInsuranceRials; }
|
||||
public function getSupplementaryRials(): int { return $this->supplementaryRials; }
|
||||
public function getPatientRials(): int { return $this->patientRials; }
|
||||
|
||||
public function attachTo(Invoice $invoice): void
|
||||
{
|
||||
$this->invoice = $invoice;
|
||||
}
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'uuid' => $this->uuid,
|
||||
'service_item_id' => $this->serviceItemId,
|
||||
'title' => $this->title,
|
||||
'tariff_rials' => $this->tariffRials,
|
||||
'quantity' => $this->quantity,
|
||||
'total_rials' => $this->totalRials,
|
||||
'base_insurance_rials' => $this->baseInsuranceRials,
|
||||
'supplementary_rials' => $this->supplementaryRials,
|
||||
'patient_rials' => $this->patientRials,
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,28 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Repository;
|
||||
|
||||
use App\Billing\Entity\ClaimItem;
|
||||
use Doctrine\Bundle\DoctrineBundle\Repository\ServiceEntityRepository;
|
||||
use Doctrine\Persistence\ManagerRegistry;
|
||||
|
||||
class ClaimItemRepository extends ServiceEntityRepository
|
||||
{
|
||||
public function __construct(ManagerRegistry $registry)
|
||||
{
|
||||
parent::__construct($registry, ClaimItem::class);
|
||||
}
|
||||
|
||||
public function existsForInvoiceItem(int $invoiceItemId, int $insuranceKindClaimInsuranceId): bool
|
||||
{
|
||||
return $this->createQueryBuilder('ci')
|
||||
->select('COUNT(ci.id)')
|
||||
->join('ci.claim', 'c')
|
||||
->where('ci.invoiceItemId = :iid')
|
||||
->andWhere('c.insuranceId = :ins')
|
||||
->setParameter('iid', $invoiceItemId)
|
||||
->setParameter('ins', $insuranceKindClaimInsuranceId)
|
||||
->getQuery()
|
||||
->getSingleScalarResult() > 0;
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,77 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Repository;
|
||||
|
||||
use App\Billing\Entity\Claim;
|
||||
use Doctrine\Bundle\DoctrineBundle\Repository\ServiceEntityRepository;
|
||||
use Doctrine\Persistence\ManagerRegistry;
|
||||
|
||||
class ClaimRepository extends ServiceEntityRepository
|
||||
{
|
||||
public function __construct(ManagerRegistry $registry)
|
||||
{
|
||||
parent::__construct($registry, Claim::class);
|
||||
}
|
||||
|
||||
public function findByUuid(string $uuid): ?Claim
|
||||
{
|
||||
return $this->findOneBy(['uuid' => $uuid]);
|
||||
}
|
||||
|
||||
/** @return Claim[] */
|
||||
public function findByTenant(string $entityType, int $entityId, ?string $status = null): array
|
||||
{
|
||||
$qb = $this->createQueryBuilder('c')
|
||||
->where('c.entityType = :type')
|
||||
->andWhere('c.entityId = :id')
|
||||
->setParameter('type', $entityType)
|
||||
->setParameter('id', $entityId)
|
||||
->orderBy('c.id', 'DESC');
|
||||
|
||||
if ($status !== null) {
|
||||
$qb->andWhere('c.status = :status')->setParameter('status', $status);
|
||||
}
|
||||
|
||||
return $qb->getQuery()->getResult();
|
||||
}
|
||||
|
||||
/**
|
||||
* گزارش بدهی بیمه: جمع claimed/approved/paid بر اساس بیمه برای tenant.
|
||||
* @return array<int, array{insurance_id:int, claimed:int, approved:int, paid:int, debt:int}>
|
||||
*/
|
||||
public function debtReport(string $entityType, int $entityId): array
|
||||
{
|
||||
$rows = $this->createQueryBuilder('c')
|
||||
->select('c.insuranceId AS insurance_id')
|
||||
->addSelect('SUM(c.totalClaimedRials) AS claimed')
|
||||
->addSelect('SUM(COALESCE(c.totalApprovedRials, 0)) AS approved')
|
||||
->addSelect('SUM(COALESCE(c.totalPaidRials, 0)) AS paid')
|
||||
->where('c.entityType = :type')
|
||||
->andWhere('c.entityId = :id')
|
||||
->setParameter('type', $entityType)
|
||||
->setParameter('id', $entityId)
|
||||
->groupBy('c.insuranceId')
|
||||
->getQuery()
|
||||
->getArrayResult();
|
||||
|
||||
return array_map(function (array $r) {
|
||||
$claimed = (int) $r['claimed'];
|
||||
$paid = (int) $r['paid'];
|
||||
return [
|
||||
'insurance_id' => (int) $r['insurance_id'],
|
||||
'claimed' => $claimed,
|
||||
'approved' => (int) $r['approved'],
|
||||
'paid' => $paid,
|
||||
'debt' => max(0, $claimed - $paid),
|
||||
];
|
||||
}, $rows);
|
||||
}
|
||||
|
||||
public function save(Claim $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->persist($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,23 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Repository;
|
||||
|
||||
use App\Billing\Entity\InvoiceItem;
|
||||
use Doctrine\Bundle\DoctrineBundle\Repository\ServiceEntityRepository;
|
||||
use Doctrine\Persistence\ManagerRegistry;
|
||||
|
||||
class InvoiceItemRepository extends ServiceEntityRepository
|
||||
{
|
||||
public function __construct(ManagerRegistry $registry)
|
||||
{
|
||||
parent::__construct($registry, InvoiceItem::class);
|
||||
}
|
||||
|
||||
public function save(InvoiceItem $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->persist($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,33 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Repository;
|
||||
|
||||
use App\Billing\Entity\Invoice;
|
||||
use Doctrine\Bundle\DoctrineBundle\Repository\ServiceEntityRepository;
|
||||
use Doctrine\Persistence\ManagerRegistry;
|
||||
|
||||
class InvoiceRepository extends ServiceEntityRepository
|
||||
{
|
||||
public function __construct(ManagerRegistry $registry)
|
||||
{
|
||||
parent::__construct($registry, Invoice::class);
|
||||
}
|
||||
|
||||
public function findByUuid(string $uuid): ?Invoice
|
||||
{
|
||||
return $this->findOneBy(['uuid' => $uuid]);
|
||||
}
|
||||
|
||||
public function findBySession(int $patientSessionId): ?Invoice
|
||||
{
|
||||
return $this->findOneBy(['patientSessionId' => $patientSessionId]);
|
||||
}
|
||||
|
||||
public function save(Invoice $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->persist($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,53 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Service;
|
||||
|
||||
use App\Billing\ValueObject\Money;
|
||||
use App\Billing\ValueObject\ShareBreakdown;
|
||||
use App\Insurance\ValueObject\CoverageRule;
|
||||
|
||||
class BillingCalculator
|
||||
{
|
||||
/**
|
||||
* محاسبهی سهم برای یک آیتم.
|
||||
* ترتیب: کل → پوشش پایه (با سقف) → باقیمانده → پوشش مکمل روی باقیمانده (با سقف) → فرانشیز سهم بیمار.
|
||||
*/
|
||||
public function calculateItem(
|
||||
Money $total,
|
||||
?CoverageRule $base,
|
||||
?CoverageRule $supplementary,
|
||||
): ShareBreakdown {
|
||||
$baseShare = Money::zero();
|
||||
$remaining = $total;
|
||||
|
||||
if ($base !== null && $base->covered) {
|
||||
$baseShare = $total->percent($base->coveragePercent);
|
||||
if ($base->ceilingRials !== null) {
|
||||
$baseShare = $baseShare->min(new Money($base->ceilingRials));
|
||||
}
|
||||
$remaining = $total->sub($baseShare);
|
||||
}
|
||||
|
||||
$suppShare = Money::zero();
|
||||
if ($supplementary !== null && $supplementary->covered) {
|
||||
$suppShare = $remaining->percent($supplementary->coveragePercent);
|
||||
if ($supplementary->ceilingRials !== null) {
|
||||
$suppShare = $suppShare->min(new Money($supplementary->ceilingRials));
|
||||
}
|
||||
$remaining = $remaining->sub($suppShare);
|
||||
}
|
||||
|
||||
// فرانشیز سهم بیمار است؛ از سهم بیمه کم نمیکند ولی سهم بیمار از کل بیشتر نمیشود.
|
||||
$franchise = new Money(
|
||||
($base?->franchiseRials ?? 0) + ($supplementary?->franchiseRials ?? 0)
|
||||
);
|
||||
$patient = $remaining->add($franchise)->min($total);
|
||||
|
||||
return new ShareBreakdown(
|
||||
totalRials: $total->rials,
|
||||
baseInsuranceRials: $baseShare->rials,
|
||||
supplementaryRials: $suppShare->rials,
|
||||
patientRials: $patient->rials,
|
||||
);
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,109 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Service;
|
||||
|
||||
use App\Billing\Contract\ClaimSubmitterInterface;
|
||||
use App\Billing\Entity\Claim;
|
||||
use App\Billing\Entity\ClaimItem;
|
||||
use App\Billing\Entity\Invoice;
|
||||
use App\Billing\Repository\ClaimRepository;
|
||||
use App\Shared\Constant\ErrorCodes;
|
||||
use App\Shared\Exception\AppException;
|
||||
|
||||
class ClaimService
|
||||
{
|
||||
public function __construct(
|
||||
private readonly ClaimRepository $claimRepo,
|
||||
private readonly ClaimSubmitterInterface $submitter,
|
||||
) {}
|
||||
|
||||
/**
|
||||
* ساخت مطالبات از یک صورتحساب نهاییشده.
|
||||
* یک Claim برای بیمهی پایه و یک Claim برای بیمهی مکمل (در صورت وجود سهم).
|
||||
* @return Claim[]
|
||||
*/
|
||||
public function createFromInvoice(Invoice $invoice): array
|
||||
{
|
||||
if ($invoice->getStatus() !== Invoice::STATUS_FINALIZED) {
|
||||
throw new AppException(ErrorCodes::ERR_VALIDATION_001, 'فقط از صورتحساب نهاییشده میتوان مطالبه ساخت', 422);
|
||||
}
|
||||
|
||||
$claims = [];
|
||||
|
||||
$baseId = $invoice->getBaseInsuranceId();
|
||||
if ($baseId !== null) {
|
||||
$claim = $this->buildClaim($invoice, $baseId, Claim::KIND_BASE);
|
||||
if ($claim !== null) {
|
||||
$claims[] = $claim;
|
||||
}
|
||||
}
|
||||
|
||||
$suppId = $invoice->getSupplementaryInsuranceId();
|
||||
if ($suppId !== null) {
|
||||
$claim = $this->buildClaim($invoice, $suppId, Claim::KIND_SUPPLEMENTARY);
|
||||
if ($claim !== null) {
|
||||
$claims[] = $claim;
|
||||
}
|
||||
}
|
||||
|
||||
if ($claims === []) {
|
||||
throw new AppException(ErrorCodes::ERR_VALIDATION_001, 'سهم بیمهای برای این صورتحساب وجود ندارد', 422);
|
||||
}
|
||||
|
||||
foreach ($claims as $claim) {
|
||||
$this->claimRepo->save($claim, false);
|
||||
}
|
||||
$this->claimRepo->getEntityManager()->flush();
|
||||
|
||||
return $claims;
|
||||
}
|
||||
|
||||
private function buildClaim(Invoice $invoice, int $insuranceId, string $kind): ?Claim
|
||||
{
|
||||
$claim = new Claim($invoice->getEntityType(), $invoice->getEntityId(), $insuranceId, $kind);
|
||||
|
||||
$hasShare = false;
|
||||
foreach ($invoice->getItems() as $item) {
|
||||
$share = $kind === Claim::KIND_BASE
|
||||
? $item->getBaseInsuranceRials()
|
||||
: $item->getSupplementaryRials();
|
||||
|
||||
if ($share > 0) {
|
||||
$claim->addItem(new ClaimItem($claim, $item->getId(), $share));
|
||||
$hasShare = true;
|
||||
}
|
||||
}
|
||||
|
||||
return $hasShare ? $claim : null;
|
||||
}
|
||||
|
||||
public function transition(Claim $claim, string $target, array $opts = []): void
|
||||
{
|
||||
if (!$claim->canTransitionTo($target)) {
|
||||
throw new AppException(
|
||||
ErrorCodes::ERR_VALIDATION_001,
|
||||
sprintf('انتقال از «%s» به «%s» مجاز نیست', $claim->getStatus(), $target),
|
||||
422
|
||||
);
|
||||
}
|
||||
|
||||
match ($target) {
|
||||
Claim::STATUS_SUBMITTED => $this->doSubmit($claim),
|
||||
Claim::STATUS_APPROVED => $claim->approve($opts['approved_rials'] ?? null),
|
||||
Claim::STATUS_REJECTED => $claim->reject($opts['reason'] ?? ''),
|
||||
Claim::STATUS_PAID => $claim->pay($opts['paid_rials'] ?? null),
|
||||
default => throw new AppException(ErrorCodes::ERR_VALIDATION_001, 'وضعیت نامعتبر', 422),
|
||||
};
|
||||
|
||||
$this->claimRepo->save($claim);
|
||||
}
|
||||
|
||||
private function doSubmit(Claim $claim): void
|
||||
{
|
||||
$result = $this->submitter->submit($claim);
|
||||
if (!$result->success) {
|
||||
throw new AppException(ErrorCodes::ERR_VALIDATION_001, $result->errorMessage ?? 'ارسال مطالبه ناموفق بود', 422);
|
||||
}
|
||||
$claim->submit();
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,76 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Service;
|
||||
|
||||
use App\Billing\Entity\Invoice;
|
||||
use App\Billing\Entity\InvoiceItem;
|
||||
use App\Billing\Repository\InvoiceRepository;
|
||||
use App\Billing\ValueObject\Money;
|
||||
use App\ClinicService\Service\TariffService;
|
||||
use App\Insurance\Service\TenantInsuranceService;
|
||||
use App\Patient\Entity\PatientSession;
|
||||
|
||||
class InvoiceService
|
||||
{
|
||||
public function __construct(
|
||||
private readonly InvoiceRepository $invoiceRepo,
|
||||
private readonly TariffService $tariffService,
|
||||
private readonly TenantInsuranceService $tenantInsuranceService,
|
||||
private readonly BillingCalculator $calculator,
|
||||
) {}
|
||||
|
||||
/**
|
||||
* ساخت Invoice از یک Encounter (PatientSession).
|
||||
* تعرفهی هر خدمت از Tariff سال جاری (با fallback)، پوشش از قرارداد بیمهی tenant.
|
||||
* ویزیت بهعنوان یک آیتم جداگانه با همان قانون پوشش لحاظ میشود.
|
||||
*/
|
||||
public function createFromSession(PatientSession $session, string $entityType, int $entityId): Invoice
|
||||
{
|
||||
$existing = $session->getId() !== null ? $this->invoiceRepo->findBySession($session->getId()) : null;
|
||||
if ($existing !== null) {
|
||||
return $existing;
|
||||
}
|
||||
|
||||
$invoice = new Invoice($entityType, $entityId);
|
||||
$invoice->setPatientSessionId($session->getId())
|
||||
->setPatientRecordId($session->getRecord()->getId())
|
||||
->setBaseInsuranceId($session->getInsuranceBaseId())
|
||||
->setSupplementaryInsuranceId($session->getInsuranceSupplementaryId());
|
||||
|
||||
$baseId = $session->getInsuranceBaseId();
|
||||
$suppId = $session->getInsuranceSupplementaryId();
|
||||
|
||||
// ویزیت
|
||||
$visitPrice = $session->getVisitPriceRials();
|
||||
if ($visitPrice > 0) {
|
||||
$baseRule = $this->tenantInsuranceService->coverageRule($entityType, $entityId, $baseId);
|
||||
$suppRule = $this->tenantInsuranceService->coverageRule($entityType, $entityId, $suppId);
|
||||
$breakdown = $this->calculator->calculateItem(new Money($visitPrice), $baseRule, $suppRule);
|
||||
$invoice->addItem(new InvoiceItem($invoice, 'ویزیت', $visitPrice, 1, $breakdown, null));
|
||||
}
|
||||
|
||||
// خدمات
|
||||
foreach ($session->getServices() as $sessionService) {
|
||||
$item = $sessionService->getServiceItem();
|
||||
$unitPrice = $this->tariffService->resolvePrice($item);
|
||||
$total = new Money($unitPrice);
|
||||
|
||||
$baseRule = $this->tenantInsuranceService->coverageRuleForService($entityType, $entityId, $baseId, $item->getId());
|
||||
$suppRule = $this->tenantInsuranceService->coverageRuleForService($entityType, $entityId, $suppId, $item->getId());
|
||||
|
||||
$breakdown = $this->calculator->calculateItem($total, $baseRule, $suppRule);
|
||||
$invoice->addItem(new InvoiceItem($invoice, $item->getName(), $unitPrice, 1, $breakdown, $item->getId()));
|
||||
}
|
||||
|
||||
$invoice->recalculateTotals();
|
||||
$this->invoiceRepo->save($invoice);
|
||||
|
||||
return $invoice;
|
||||
}
|
||||
|
||||
public function finalize(Invoice $invoice): void
|
||||
{
|
||||
$invoice->finalize();
|
||||
$this->invoiceRepo->save($invoice);
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,20 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\Service;
|
||||
|
||||
use App\Billing\Contract\ClaimSubmissionResult;
|
||||
use App\Billing\Contract\ClaimSubmitterInterface;
|
||||
use App\Billing\Entity\Claim;
|
||||
|
||||
/**
|
||||
* پیادهسازی پیشفرض: ارسال دستی (آفلاین). مطالبه صرفاً به وضعیت submitted میرود
|
||||
* و ارسال واقعی به بیمه بهصورت دستی توسط کاربر انجام میشود.
|
||||
* در آینده با یک پیادهسازی متصل به API بیمه جایگزین میشود (بدون تغییر در ClaimService).
|
||||
*/
|
||||
final class ManualClaimSubmitter implements ClaimSubmitterInterface
|
||||
{
|
||||
public function submit(Claim $claim): ClaimSubmissionResult
|
||||
{
|
||||
return ClaimSubmissionResult::ok();
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,38 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\ValueObject;
|
||||
|
||||
final readonly class Money
|
||||
{
|
||||
public function __construct(public int $rials)
|
||||
{
|
||||
if ($rials < 0) {
|
||||
throw new \InvalidArgumentException('Money cannot be negative');
|
||||
}
|
||||
}
|
||||
|
||||
public static function zero(): self
|
||||
{
|
||||
return new self(0);
|
||||
}
|
||||
|
||||
public function add(Money $o): self
|
||||
{
|
||||
return new self($this->rials + $o->rials);
|
||||
}
|
||||
|
||||
public function sub(Money $o): self
|
||||
{
|
||||
return new self(max(0, $this->rials - $o->rials));
|
||||
}
|
||||
|
||||
public function percent(float $p): self
|
||||
{
|
||||
return new self((int) round($this->rials * $p / 100));
|
||||
}
|
||||
|
||||
public function min(Money $o): self
|
||||
{
|
||||
return new self(min($this->rials, $o->rials));
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,23 @@
|
||||
<?php
|
||||
|
||||
namespace App\Billing\ValueObject;
|
||||
|
||||
final readonly class ShareBreakdown
|
||||
{
|
||||
public function __construct(
|
||||
public int $totalRials,
|
||||
public int $baseInsuranceRials,
|
||||
public int $supplementaryRials,
|
||||
public int $patientRials,
|
||||
) {}
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'total_rials' => $this->totalRials,
|
||||
'base_insurance_rials' => $this->baseInsuranceRials,
|
||||
'supplementary_rials' => $this->supplementaryRials,
|
||||
'patient_rials' => $this->patientRials,
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -7,6 +7,8 @@ use App\ClinicService\Entity\ServiceItem;
|
||||
use App\ClinicService\Entity\ServiceSection;
|
||||
use App\ClinicService\Repository\ServiceItemRepository;
|
||||
use App\ClinicService\Repository\ServiceSectionRepository;
|
||||
use App\ClinicService\Repository\TariffRepository;
|
||||
use App\ClinicService\Service\TariffService;
|
||||
use App\Clinic\Repository\ClinicRepository;
|
||||
use App\Doctor\Repository\DoctorRepository;
|
||||
use App\Shared\Constant\ErrorCodes;
|
||||
@@ -32,6 +34,8 @@ class ClinicServiceController extends BaseController
|
||||
private readonly SubscriptionService $subscriptionService,
|
||||
private readonly DoctorRepository $doctorRepo,
|
||||
private readonly ClinicRepository $clinicRepo,
|
||||
private readonly TariffRepository $tariffRepo,
|
||||
private readonly TariffService $tariffService,
|
||||
) {}
|
||||
|
||||
// ── Service Sections ─────────────────────────────────────────────────────
|
||||
@@ -157,6 +161,13 @@ class ClinicServiceController extends BaseController
|
||||
}
|
||||
}
|
||||
|
||||
if (isset($data['insurance_covered'])) {
|
||||
$item->setInsuranceCovered((bool) $data['insurance_covered']);
|
||||
}
|
||||
if (array_key_exists('insurance_price_rials', $data)) {
|
||||
$item->setInsurancePriceRials($data['insurance_price_rials'] !== null ? (int) $data['insurance_price_rials'] : null);
|
||||
}
|
||||
|
||||
$this->itemRepo->save($item);
|
||||
|
||||
return $this->success($item->toArray(), 201);
|
||||
@@ -181,6 +192,12 @@ class ClinicServiceController extends BaseController
|
||||
$staff = $data['staff_uuid'] ? $this->staffRepo->findByUuid($data['staff_uuid']) : null;
|
||||
$item->setStaff($staff);
|
||||
}
|
||||
if (isset($data['insurance_covered'])) {
|
||||
$item->setInsuranceCovered((bool) $data['insurance_covered']);
|
||||
}
|
||||
if (array_key_exists('insurance_price_rials', $data)) {
|
||||
$item->setInsurancePriceRials($data['insurance_price_rials'] !== null ? (int) $data['insurance_price_rials'] : null);
|
||||
}
|
||||
|
||||
$this->itemRepo->save($item);
|
||||
|
||||
@@ -206,6 +223,51 @@ class ClinicServiceController extends BaseController
|
||||
return $this->success(['message' => 'سرویس حذف شد']);
|
||||
}
|
||||
|
||||
// ── Tariffs (تعرفهی نسخهدار سالانه) ──────────────────────────────────────
|
||||
|
||||
#[Route('/api/v1/service-items/{uuid}/tariffs', methods: ['GET'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function listTariffs(string $uuid, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
|
||||
$item = $this->itemRepo->findByUuid($uuid);
|
||||
if ($item === null || !$this->ownsSection($item->getSection(), $entityType, $entityId)) {
|
||||
return $this->error(ErrorCodes::ERR_SERVICE_NOT_FOUND, ErrorCodes::message(ErrorCodes::ERR_SERVICE_NOT_FOUND), 404);
|
||||
}
|
||||
|
||||
$tariffs = $this->tariffRepo->findByService($item->getId());
|
||||
|
||||
return $this->success([
|
||||
'current_year' => $this->tariffService->currentJalaliYear(),
|
||||
'default_price_rials' => $item->getPriceRials(),
|
||||
'data' => array_map(fn($t) => $t->toArray(), $tariffs),
|
||||
]);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/service-items/{uuid}/tariffs/{year}', methods: ['PUT'], requirements: ['year' => '\d+'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function setTariff(string $uuid, int $year, Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
|
||||
$item = $this->itemRepo->findByUuid($uuid);
|
||||
if ($item === null || !$this->ownsSection($item->getSection(), $entityType, $entityId)) {
|
||||
return $this->error(ErrorCodes::ERR_SERVICE_NOT_FOUND, ErrorCodes::message(ErrorCodes::ERR_SERVICE_NOT_FOUND), 404);
|
||||
}
|
||||
|
||||
if ($year < 1390 || $year > 1500) {
|
||||
return $this->error(ErrorCodes::ERR_VALIDATION_001, 'سال نامعتبر است', 422);
|
||||
}
|
||||
|
||||
$data = json_decode($request->getContent(), true) ?? [];
|
||||
$price = (int) ($data['price_rials'] ?? 0);
|
||||
|
||||
$tariff = $this->tariffService->upsert($item->getId(), $year, $price);
|
||||
|
||||
return $this->success(['data' => $tariff->toArray()]);
|
||||
}
|
||||
|
||||
// ── Helpers ──────────────────────────────────────────────────────────────
|
||||
|
||||
private function resolveEntity(User $user): array
|
||||
|
||||
@@ -36,6 +36,12 @@ class ServiceItem
|
||||
#[ORM\Column(type: 'boolean')]
|
||||
private bool $active = true;
|
||||
|
||||
#[ORM\Column(name: 'insurance_covered', type: 'boolean')]
|
||||
private bool $insuranceCovered = false;
|
||||
|
||||
#[ORM\Column(name: 'insurance_price_rials', type: 'integer', nullable: true)]
|
||||
private ?int $insurancePriceRials = null;
|
||||
|
||||
#[ORM\Column(name: 'created_at', type: 'integer')]
|
||||
private int $createdAt;
|
||||
|
||||
@@ -59,6 +65,8 @@ class ServiceItem
|
||||
public function getName(): string { return $this->name; }
|
||||
public function getPriceRials(): int { return $this->priceRials; }
|
||||
public function isActive(): bool { return $this->active; }
|
||||
public function isInsuranceCovered(): bool { return $this->insuranceCovered; }
|
||||
public function getInsurancePriceRials(): ?int { return $this->insurancePriceRials; }
|
||||
public function getCreatedAt(): int { return $this->createdAt; }
|
||||
public function getUpdatedAt(): int { return $this->updatedAt; }
|
||||
|
||||
@@ -66,6 +74,8 @@ class ServiceItem
|
||||
public function setName(string $name): self { $this->name = $name; $this->updatedAt = time(); return $this; }
|
||||
public function setPriceRials(int $price): self { $this->priceRials = $price; $this->updatedAt = time(); return $this; }
|
||||
public function setActive(bool $active): self { $this->active = $active; $this->updatedAt = time(); return $this; }
|
||||
public function setInsuranceCovered(bool $v): self { $this->insuranceCovered = $v; $this->updatedAt = time(); return $this; }
|
||||
public function setInsurancePriceRials(?int $v): self { $this->insurancePriceRials = $v; $this->updatedAt = time(); return $this; }
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
@@ -77,6 +87,8 @@ class ServiceItem
|
||||
'name' => $this->name,
|
||||
'price_rials' => $this->priceRials,
|
||||
'active' => $this->active,
|
||||
'insurance_covered' => $this->insuranceCovered,
|
||||
'insurance_price_rials' => $this->insurancePriceRials,
|
||||
'created_at' => $this->createdAt,
|
||||
'updated_at' => $this->updatedAt,
|
||||
];
|
||||
|
||||
@@ -0,0 +1,71 @@
|
||||
<?php
|
||||
|
||||
namespace App\ClinicService\Entity;
|
||||
|
||||
use App\ClinicService\Repository\TariffRepository;
|
||||
use Doctrine\ORM\Mapping as ORM;
|
||||
use Symfony\Component\Uid\Uuid;
|
||||
|
||||
#[ORM\Entity(repositoryClass: TariffRepository::class)]
|
||||
#[ORM\Table(name: 'service_tariffs')]
|
||||
#[ORM\UniqueConstraint(name: 'uniq_service_tariff_year', columns: ['service_item_id', 'year'])]
|
||||
#[ORM\Index(columns: ['service_item_id', 'is_active'], name: 'idx_tariff_service_active')]
|
||||
class Tariff
|
||||
{
|
||||
#[ORM\Id]
|
||||
#[ORM\GeneratedValue]
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private ?int $id = null;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 36, unique: true)]
|
||||
private string $uuid;
|
||||
|
||||
#[ORM\Column(name: 'service_item_id', type: 'integer')]
|
||||
private int $serviceItemId;
|
||||
|
||||
#[ORM\Column(type: 'smallint')]
|
||||
private int $year;
|
||||
|
||||
#[ORM\Column(name: 'price_rials', type: 'integer')]
|
||||
private int $priceRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'is_active', type: 'boolean')]
|
||||
private bool $isActive = true;
|
||||
|
||||
#[ORM\Column(name: 'created_at', type: 'integer')]
|
||||
private int $createdAt;
|
||||
|
||||
#[ORM\Column(name: 'updated_at', type: 'integer')]
|
||||
private int $updatedAt;
|
||||
|
||||
public function __construct(int $serviceItemId, int $year, int $priceRials = 0)
|
||||
{
|
||||
$this->uuid = Uuid::v4()->toRfc4122();
|
||||
$this->serviceItemId = $serviceItemId;
|
||||
$this->year = $year;
|
||||
$this->priceRials = $priceRials;
|
||||
$this->createdAt = time();
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function getId(): ?int { return $this->id; }
|
||||
public function getUuid(): string { return $this->uuid; }
|
||||
public function getServiceItemId(): int { return $this->serviceItemId; }
|
||||
public function getYear(): int { return $this->year; }
|
||||
public function getPriceRials(): int { return $this->priceRials; }
|
||||
public function isActive(): bool { return $this->isActive; }
|
||||
|
||||
public function setPriceRials(int $v): self { $this->priceRials = $v; $this->updatedAt = time(); return $this; }
|
||||
public function setActive(bool $v): self { $this->isActive = $v; $this->updatedAt = time(); return $this; }
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'uuid' => $this->uuid,
|
||||
'service_item_id' => $this->serviceItemId,
|
||||
'year' => $this->year,
|
||||
'price_rials' => $this->priceRials,
|
||||
'is_active' => $this->isActive,
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,48 @@
|
||||
<?php
|
||||
|
||||
namespace App\ClinicService\Repository;
|
||||
|
||||
use App\ClinicService\Entity\Tariff;
|
||||
use Doctrine\Bundle\DoctrineBundle\Repository\ServiceEntityRepository;
|
||||
use Doctrine\Persistence\ManagerRegistry;
|
||||
|
||||
class TariffRepository extends ServiceEntityRepository
|
||||
{
|
||||
public function __construct(ManagerRegistry $registry)
|
||||
{
|
||||
parent::__construct($registry, Tariff::class);
|
||||
}
|
||||
|
||||
public function findForServiceYear(int $serviceItemId, int $year): ?Tariff
|
||||
{
|
||||
return $this->findOneBy([
|
||||
'serviceItemId' => $serviceItemId,
|
||||
'year' => $year,
|
||||
'isActive' => true,
|
||||
]);
|
||||
}
|
||||
|
||||
/** @return Tariff[] */
|
||||
public function findByService(int $serviceItemId): array
|
||||
{
|
||||
return $this->createQueryBuilder('t')
|
||||
->where('t.serviceItemId = :sid')
|
||||
->setParameter('sid', $serviceItemId)
|
||||
->orderBy('t.year', 'DESC')
|
||||
->getQuery()
|
||||
->getResult();
|
||||
}
|
||||
|
||||
public function findByUuid(string $uuid): ?Tariff
|
||||
{
|
||||
return $this->findOneBy(['uuid' => $uuid]);
|
||||
}
|
||||
|
||||
public function save(Tariff $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->persist($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,54 @@
|
||||
<?php
|
||||
|
||||
namespace App\ClinicService\Service;
|
||||
|
||||
use App\ClinicService\Entity\ServiceItem;
|
||||
use App\ClinicService\Entity\Tariff;
|
||||
use App\ClinicService\Repository\TariffRepository;
|
||||
|
||||
class TariffService
|
||||
{
|
||||
public function __construct(
|
||||
private readonly TariffRepository $tariffRepo,
|
||||
) {}
|
||||
|
||||
/**
|
||||
* تعرفهی یک خدمت برای یک سال شمسی.
|
||||
* اگر تعرفهی آن سال ثبت نشده باشد، به priceRials خود خدمت fallback میشود.
|
||||
*/
|
||||
public function resolvePrice(ServiceItem $service, ?int $year = null): int
|
||||
{
|
||||
$year ??= $this->currentJalaliYear();
|
||||
|
||||
$tariff = $service->getId() !== null
|
||||
? $this->tariffRepo->findForServiceYear($service->getId(), $year)
|
||||
: null;
|
||||
|
||||
return $tariff?->getPriceRials() ?? $service->getPriceRials();
|
||||
}
|
||||
|
||||
public function upsert(int $serviceItemId, int $year, int $priceRials): Tariff
|
||||
{
|
||||
$tariff = $this->tariffRepo->findForServiceYear($serviceItemId, $year);
|
||||
if ($tariff === null) {
|
||||
$tariff = new Tariff($serviceItemId, $year, $priceRials);
|
||||
} else {
|
||||
$tariff->setPriceRials($priceRials)->setActive(true);
|
||||
}
|
||||
$this->tariffRepo->save($tariff);
|
||||
return $tariff;
|
||||
}
|
||||
|
||||
public function currentJalaliYear(): int
|
||||
{
|
||||
$fmt = new \IntlDateFormatter(
|
||||
'en_US@calendar=persian',
|
||||
\IntlDateFormatter::FULL,
|
||||
\IntlDateFormatter::NONE,
|
||||
'Asia/Tehran',
|
||||
\IntlDateFormatter::TRADITIONAL,
|
||||
'yyyy'
|
||||
);
|
||||
return (int) $fmt->format(time());
|
||||
}
|
||||
}
|
||||
@@ -3,12 +3,19 @@
|
||||
namespace App\Insurance\Controller;
|
||||
|
||||
use App\Auth\Entity\User;
|
||||
use App\Clinic\Repository\ClinicRepository;
|
||||
use App\Doctor\Repository\DoctorRepository;
|
||||
use App\Insurance\Entity\DoctorInsurance;
|
||||
use App\Insurance\Entity\EntityInsurancePricing;
|
||||
use App\Insurance\Entity\Insurance;
|
||||
use App\Insurance\Enum\InsuranceType;
|
||||
use App\Insurance\Entity\TenantInsurance;
|
||||
use App\Insurance\Repository\DoctorInsuranceRepository;
|
||||
use App\Insurance\Repository\EntityInsurancePricingRepository;
|
||||
use App\Insurance\Repository\InsuranceRepository;
|
||||
use App\Insurance\Repository\TenantInsuranceRepository;
|
||||
use App\Insurance\Repository\TenantServiceCoverageRepository;
|
||||
use App\Insurance\Service\TenantInsuranceService;
|
||||
use App\Shared\Constant\ErrorCodes;
|
||||
use App\Shared\Controller\BaseController;
|
||||
use App\Shared\Service\FileValidatorService;
|
||||
@@ -27,10 +34,28 @@ class InsuranceController extends BaseController
|
||||
private readonly InsuranceRepository $insuranceRepo,
|
||||
private readonly DoctorInsuranceRepository $doctorInsuranceRepo,
|
||||
private readonly DoctorRepository $doctorRepo,
|
||||
private readonly ClinicRepository $clinicRepo,
|
||||
private readonly EntityInsurancePricingRepository $pricingRepo,
|
||||
private readonly TenantInsuranceRepository $tenantInsuranceRepo,
|
||||
private readonly TenantServiceCoverageRepository $serviceCoverageRepo,
|
||||
private readonly TenantInsuranceService $tenantInsuranceService,
|
||||
private readonly FileValidatorService $fileValidator,
|
||||
private readonly string $projectDir,
|
||||
) {}
|
||||
|
||||
private function resolveEntity(User $user): array
|
||||
{
|
||||
if ($user->hasRole('ROLE_DOCTOR')) {
|
||||
$doctor = $this->doctorRepo->findByUser($user);
|
||||
return $doctor !== null ? [EntityInsurancePricing::TYPE_DOCTOR, $doctor->getId()] : [EntityInsurancePricing::TYPE_DOCTOR, null];
|
||||
}
|
||||
if ($user->hasRole('ROLE_CLINIC')) {
|
||||
$clinic = $this->clinicRepo->findByUser($user);
|
||||
return $clinic !== null ? [EntityInsurancePricing::TYPE_CLINIC, $clinic->getId()] : [EntityInsurancePricing::TYPE_CLINIC, null];
|
||||
}
|
||||
return ['unknown', null];
|
||||
}
|
||||
|
||||
// ── Public list ───────────────────────────────────────────────────────────
|
||||
|
||||
#[Route('/api/v1/insurances', methods: ['GET'])]
|
||||
@@ -183,6 +208,232 @@ class InsuranceController extends BaseController
|
||||
}
|
||||
}
|
||||
|
||||
// ── Entity insurance pricing (visit price by insurance) ───────────────────
|
||||
|
||||
#[Route('/api/v1/insurance-pricing', methods: ['GET'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function getInsurancePricing(#[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
if ($entityId === null) {
|
||||
return $this->error(ErrorCodes::ERR_FORBIDDEN_001, 'پروفایل یافت نشد', 403);
|
||||
}
|
||||
|
||||
$rows = $this->pricingRepo->findByEntity($entityType, $entityId);
|
||||
|
||||
$freeVisitPriceRials = 0;
|
||||
$perInsurance = [];
|
||||
foreach ($rows as $row) {
|
||||
if ($row->isFreeVisit()) {
|
||||
$freeVisitPriceRials = $row->getPatientShareRials();
|
||||
} else {
|
||||
$perInsurance[$row->getInsuranceId()] = $row->getPatientShareRials();
|
||||
}
|
||||
}
|
||||
|
||||
$insurances = array_map(function (Insurance $i) use ($perInsurance) {
|
||||
return [
|
||||
'insurance_id' => $i->getId(),
|
||||
'insurance_name' => $i->getName(),
|
||||
'type' => $i->getType()->value,
|
||||
'patient_share_rials' => $perInsurance[$i->getId()] ?? null,
|
||||
];
|
||||
}, $this->insuranceRepo->findActive(null));
|
||||
|
||||
return $this->success([
|
||||
'entity_type' => $entityType,
|
||||
'entity_id' => $entityId,
|
||||
'free_visit_price_rials' => $freeVisitPriceRials,
|
||||
'insurances' => $insurances,
|
||||
]);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/insurance-pricing', methods: ['PUT'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function saveInsurancePricing(Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
if ($entityId === null) {
|
||||
return $this->error(ErrorCodes::ERR_FORBIDDEN_001, 'پروفایل یافت نشد', 403);
|
||||
}
|
||||
|
||||
$data = json_decode($request->getContent(), true) ?? [];
|
||||
|
||||
if (array_key_exists('free_visit_price_rials', $data)) {
|
||||
$this->upsertPricing($entityType, $entityId, null, (int) $data['free_visit_price_rials']);
|
||||
}
|
||||
|
||||
foreach (($data['insurances'] ?? []) as $row) {
|
||||
$insuranceId = isset($row['insurance_id']) ? (int) $row['insurance_id'] : null;
|
||||
if ($insuranceId === null) {
|
||||
continue;
|
||||
}
|
||||
if (!array_key_exists('patient_share_rials', $row) || $row['patient_share_rials'] === null) {
|
||||
$existing = $this->pricingRepo->findOneForInsurance($entityType, $entityId, $insuranceId);
|
||||
if ($existing !== null) {
|
||||
$this->pricingRepo->remove($existing, false);
|
||||
}
|
||||
continue;
|
||||
}
|
||||
$this->upsertPricing($entityType, $entityId, $insuranceId, (int) $row['patient_share_rials']);
|
||||
}
|
||||
|
||||
$this->pricingRepo->getEntityManager()->flush();
|
||||
|
||||
return $this->getInsurancePricing($user);
|
||||
}
|
||||
|
||||
private function upsertPricing(string $entityType, int $entityId, ?int $insuranceId, int $shareRials): void
|
||||
{
|
||||
$row = $this->pricingRepo->findOneForInsurance($entityType, $entityId, $insuranceId);
|
||||
if ($row === null) {
|
||||
$row = new EntityInsurancePricing($entityType, $entityId, $insuranceId, $shareRials);
|
||||
} else {
|
||||
$row->setPatientShareRials($shareRials);
|
||||
}
|
||||
$this->pricingRepo->save($row, false);
|
||||
}
|
||||
|
||||
// ── TenantInsurance — قراردادهای بیمهی tenant ─────────────────────────────
|
||||
|
||||
#[Route('/api/v1/billing/tenant-insurances', methods: ['GET'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function listTenantInsurances(#[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
if ($entityId === null) {
|
||||
return $this->error(ErrorCodes::ERR_FORBIDDEN_001, 'پروفایل یافت نشد', 403);
|
||||
}
|
||||
|
||||
$contracts = $this->tenantInsuranceRepo->findActiveByTenant($entityType, $entityId);
|
||||
|
||||
$byId = [];
|
||||
foreach ($this->insuranceRepo->findActive(null) as $ins) {
|
||||
$byId[$ins->getId()] = ['name' => $ins->getName(), 'type' => $ins->getType()->value];
|
||||
}
|
||||
|
||||
$data = array_map(function (TenantInsurance $c) use ($byId) {
|
||||
$row = $c->toArray();
|
||||
$row['insurance_name'] = $byId[$c->getInsuranceId()]['name'] ?? null;
|
||||
$row['insurance_kind'] = $byId[$c->getInsuranceId()]['type'] ?? null;
|
||||
return $row;
|
||||
}, $contracts);
|
||||
|
||||
return $this->success(['data' => $data]);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/tenant-insurances', methods: ['POST'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function activateTenantInsurance(Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
if ($entityId === null) {
|
||||
return $this->error(ErrorCodes::ERR_FORBIDDEN_001, 'پروفایل یافت نشد', 403);
|
||||
}
|
||||
|
||||
$data = json_decode($request->getContent(), true) ?? [];
|
||||
$insuranceId = isset($data['insurance_id']) ? (int) $data['insurance_id'] : 0;
|
||||
if ($insuranceId <= 0) {
|
||||
return $this->error(ErrorCodes::ERR_VALIDATION_001, 'insurance_id الزامی است', 422);
|
||||
}
|
||||
|
||||
$contract = $this->tenantInsuranceService->activate(
|
||||
$entityType,
|
||||
$entityId,
|
||||
$insuranceId,
|
||||
(float) ($data['coverage_percent'] ?? 0),
|
||||
(int) ($data['franchise_rials'] ?? 0),
|
||||
isset($data['annual_ceiling_rials']) && $data['annual_ceiling_rials'] !== null
|
||||
? (int) $data['annual_ceiling_rials'] : null,
|
||||
);
|
||||
|
||||
return $this->success(['data' => $contract->toArray()], 201);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/tenant-insurances/{uuid}', methods: ['PATCH'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function updateTenantInsurance(string $uuid, Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
$contract = $this->tenantInsuranceRepo->findByUuid($uuid);
|
||||
if ($contract === null || $contract->getEntityType() !== $entityType || $contract->getEntityId() !== $entityId) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'قرارداد یافت نشد', 404);
|
||||
}
|
||||
|
||||
$data = json_decode($request->getContent(), true) ?? [];
|
||||
if (array_key_exists('coverage_percent', $data)) {
|
||||
$contract->setCoveragePercent((float) $data['coverage_percent']);
|
||||
}
|
||||
if (array_key_exists('franchise_rials', $data)) {
|
||||
$contract->setFranchiseRials((int) $data['franchise_rials']);
|
||||
}
|
||||
if (array_key_exists('annual_ceiling_rials', $data)) {
|
||||
$contract->setAnnualCeilingRials($data['annual_ceiling_rials'] !== null ? (int) $data['annual_ceiling_rials'] : null);
|
||||
}
|
||||
|
||||
$this->tenantInsuranceRepo->save($contract);
|
||||
|
||||
return $this->success(['data' => $contract->toArray()]);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/tenant-insurances/{uuid}', methods: ['DELETE'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function deactivateTenantInsurance(string $uuid, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
$contract = $this->tenantInsuranceRepo->findByUuid($uuid);
|
||||
if ($contract === null || $contract->getEntityType() !== $entityType || $contract->getEntityId() !== $entityId) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'قرارداد یافت نشد', 404);
|
||||
}
|
||||
|
||||
$this->tenantInsuranceService->deactivate($contract);
|
||||
|
||||
return $this->success(['message' => 'قرارداد بیمه غیرفعال شد']);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/tenant-insurances/{uuid}/service-coverage', methods: ['GET'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function listServiceCoverage(string $uuid, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
$contract = $this->tenantInsuranceRepo->findByUuid($uuid);
|
||||
if ($contract === null || $contract->getEntityType() !== $entityType || $contract->getEntityId() !== $entityId) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'قرارداد یافت نشد', 404);
|
||||
}
|
||||
|
||||
$rows = $this->serviceCoverageRepo->findByContract($contract->getId());
|
||||
|
||||
return $this->success(['data' => array_map(fn($r) => $r->toArray(), $rows)]);
|
||||
}
|
||||
|
||||
#[Route('/api/v1/billing/tenant-insurances/{uuid}/service-coverage', methods: ['PUT'])]
|
||||
#[IsGranted('IS_AUTHENTICATED_FULLY')]
|
||||
public function setServiceCoverage(string $uuid, Request $request, #[CurrentUser] User $user): JsonResponse
|
||||
{
|
||||
[$entityType, $entityId] = $this->resolveEntity($user);
|
||||
$contract = $this->tenantInsuranceRepo->findByUuid($uuid);
|
||||
if ($contract === null || $contract->getEntityType() !== $entityType || $contract->getEntityId() !== $entityId) {
|
||||
return $this->error(ErrorCodes::ERR_NOT_FOUND_001, 'قرارداد یافت نشد', 404);
|
||||
}
|
||||
|
||||
$data = json_decode($request->getContent(), true) ?? [];
|
||||
$serviceItemId = isset($data['service_item_id']) ? (int) $data['service_item_id'] : 0;
|
||||
if ($serviceItemId <= 0) {
|
||||
return $this->error(ErrorCodes::ERR_VALIDATION_001, 'service_item_id الزامی است', 422);
|
||||
}
|
||||
|
||||
$this->tenantInsuranceService->setServiceCoverage(
|
||||
$contract,
|
||||
$serviceItemId,
|
||||
(bool) ($data['covered'] ?? true),
|
||||
isset($data['coverage_percent']) && $data['coverage_percent'] !== null ? (float) $data['coverage_percent'] : null,
|
||||
isset($data['franchise_rials']) && $data['franchise_rials'] !== null ? (int) $data['franchise_rials'] : null,
|
||||
isset($data['ceiling_rials']) && $data['ceiling_rials'] !== null ? (int) $data['ceiling_rials'] : null,
|
||||
);
|
||||
|
||||
return $this->success(['message' => 'پوشش خدمت ذخیره شد']);
|
||||
}
|
||||
|
||||
// ── DoctorInsurance CRUD ──────────────────────────────────────────────────
|
||||
|
||||
#[Route('/api/v1/insurance/', methods: ['POST'])]
|
||||
|
||||
@@ -0,0 +1,66 @@
|
||||
<?php
|
||||
|
||||
namespace App\Insurance\Entity;
|
||||
|
||||
use App\Insurance\Repository\EntityInsurancePricingRepository;
|
||||
use Doctrine\ORM\Mapping as ORM;
|
||||
|
||||
#[ORM\Entity(repositoryClass: EntityInsurancePricingRepository::class)]
|
||||
#[ORM\Table(name: 'entity_insurance_pricing')]
|
||||
#[ORM\UniqueConstraint(name: 'uniq_entity_insurance', columns: ['entity_type', 'entity_id', 'insurance_id'])]
|
||||
#[ORM\Index(columns: ['entity_type', 'entity_id'], name: 'idx_entity_pricing_owner')]
|
||||
class EntityInsurancePricing
|
||||
{
|
||||
public const TYPE_DOCTOR = 'doctor';
|
||||
public const TYPE_CLINIC = 'clinic';
|
||||
|
||||
#[ORM\Id]
|
||||
#[ORM\GeneratedValue]
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private ?int $id = null;
|
||||
|
||||
#[ORM\Column(name: 'entity_type', type: 'string', length: 10)]
|
||||
private string $entityType;
|
||||
|
||||
#[ORM\Column(name: 'entity_id', type: 'integer')]
|
||||
private int $entityId;
|
||||
|
||||
#[ORM\Column(name: 'insurance_id', type: 'integer', nullable: true)]
|
||||
private ?int $insuranceId = null;
|
||||
|
||||
#[ORM\Column(name: 'patient_share_rials', type: 'integer')]
|
||||
private int $patientShareRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'updated_at', type: 'integer')]
|
||||
private int $updatedAt;
|
||||
|
||||
public function __construct(string $entityType, int $entityId, ?int $insuranceId, int $patientShareRials = 0)
|
||||
{
|
||||
$this->entityType = $entityType;
|
||||
$this->entityId = $entityId;
|
||||
$this->insuranceId = $insuranceId;
|
||||
$this->patientShareRials = $patientShareRials;
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function getId(): ?int { return $this->id; }
|
||||
public function getEntityType(): string { return $this->entityType; }
|
||||
public function getEntityId(): int { return $this->entityId; }
|
||||
public function getInsuranceId(): ?int { return $this->insuranceId; }
|
||||
public function getPatientShareRials(): int { return $this->patientShareRials; }
|
||||
|
||||
public function isFreeVisit(): bool { return $this->insuranceId === null; }
|
||||
|
||||
public function setPatientShareRials(int $v): self { $this->patientShareRials = $v; $this->updatedAt = time(); return $this; }
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'id' => $this->id,
|
||||
'entity_type' => $this->entityType,
|
||||
'entity_id' => $this->entityId,
|
||||
'insurance_id' => $this->insuranceId,
|
||||
'patient_share_rials' => $this->patientShareRials,
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,109 @@
|
||||
<?php
|
||||
|
||||
namespace App\Insurance\Entity;
|
||||
|
||||
use App\Insurance\Repository\TenantInsuranceRepository;
|
||||
use Doctrine\ORM\Mapping as ORM;
|
||||
use Symfony\Component\Uid\Uuid;
|
||||
|
||||
#[ORM\Entity(repositoryClass: TenantInsuranceRepository::class)]
|
||||
#[ORM\Table(name: 'tenant_insurances')]
|
||||
#[ORM\UniqueConstraint(name: 'uniq_tenant_insurance_version', columns: ['entity_type', 'entity_id', 'insurance_id', 'version'])]
|
||||
#[ORM\Index(columns: ['entity_type', 'entity_id', 'is_active'], name: 'idx_tenant_insurance_active')]
|
||||
class TenantInsurance
|
||||
{
|
||||
public const TYPE_DOCTOR = 'doctor';
|
||||
public const TYPE_CLINIC = 'clinic';
|
||||
|
||||
#[ORM\Id]
|
||||
#[ORM\GeneratedValue]
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private ?int $id = null;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 36, unique: true)]
|
||||
private string $uuid;
|
||||
|
||||
#[ORM\Column(name: 'entity_type', type: 'string', length: 10)]
|
||||
private string $entityType;
|
||||
|
||||
#[ORM\Column(name: 'entity_id', type: 'integer')]
|
||||
private int $entityId;
|
||||
|
||||
#[ORM\Column(name: 'insurance_id', type: 'integer')]
|
||||
private int $insuranceId;
|
||||
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private int $version = 1;
|
||||
|
||||
#[ORM\Column(name: 'is_active', type: 'boolean')]
|
||||
private bool $isActive = true;
|
||||
|
||||
#[ORM\Column(name: 'coverage_percent', type: 'decimal', precision: 5, scale: 2)]
|
||||
private string $coveragePercent = '0.00';
|
||||
|
||||
#[ORM\Column(name: 'franchise_rials', type: 'integer')]
|
||||
private int $franchiseRials = 0;
|
||||
|
||||
#[ORM\Column(name: 'annual_ceiling_rials', type: 'integer', nullable: true)]
|
||||
private ?int $annualCeilingRials = null;
|
||||
|
||||
#[ORM\Column(name: 'effective_from', type: 'integer')]
|
||||
private int $effectiveFrom;
|
||||
|
||||
#[ORM\Column(name: 'effective_to', type: 'integer', nullable: true)]
|
||||
private ?int $effectiveTo = null;
|
||||
|
||||
#[ORM\Column(name: 'created_at', type: 'integer')]
|
||||
private int $createdAt;
|
||||
|
||||
#[ORM\Column(name: 'updated_at', type: 'integer')]
|
||||
private int $updatedAt;
|
||||
|
||||
public function __construct(string $entityType, int $entityId, int $insuranceId, int $version = 1)
|
||||
{
|
||||
$this->uuid = Uuid::v4()->toRfc4122();
|
||||
$this->entityType = $entityType;
|
||||
$this->entityId = $entityId;
|
||||
$this->insuranceId = $insuranceId;
|
||||
$this->version = $version;
|
||||
$this->effectiveFrom = time();
|
||||
$this->createdAt = time();
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function getId(): ?int { return $this->id; }
|
||||
public function getUuid(): string { return $this->uuid; }
|
||||
public function getEntityType(): string { return $this->entityType; }
|
||||
public function getEntityId(): int { return $this->entityId; }
|
||||
public function getInsuranceId(): int { return $this->insuranceId; }
|
||||
public function getVersion(): int { return $this->version; }
|
||||
public function isActive(): bool { return $this->isActive; }
|
||||
public function getCoveragePercent(): float { return (float) $this->coveragePercent; }
|
||||
public function getFranchiseRials(): int { return $this->franchiseRials; }
|
||||
public function getAnnualCeilingRials(): ?int { return $this->annualCeilingRials; }
|
||||
public function getEffectiveFrom(): int { return $this->effectiveFrom; }
|
||||
public function getEffectiveTo(): ?int { return $this->effectiveTo; }
|
||||
|
||||
public function setActive(bool $v): self { $this->isActive = $v; $this->updatedAt = time(); return $this; }
|
||||
public function setCoveragePercent(float $v): self { $this->coveragePercent = (string) $v; $this->updatedAt = time(); return $this; }
|
||||
public function setFranchiseRials(int $v): self { $this->franchiseRials = $v; $this->updatedAt = time(); return $this; }
|
||||
public function setAnnualCeilingRials(?int $v): self { $this->annualCeilingRials = $v; $this->updatedAt = time(); return $this; }
|
||||
public function setEffectiveTo(?int $v): self { $this->effectiveTo = $v; $this->updatedAt = time(); return $this; }
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'uuid' => $this->uuid,
|
||||
'entity_type' => $this->entityType,
|
||||
'entity_id' => $this->entityId,
|
||||
'insurance_id' => $this->insuranceId,
|
||||
'version' => $this->version,
|
||||
'is_active' => $this->isActive,
|
||||
'coverage_percent' => (float) $this->coveragePercent,
|
||||
'franchise_rials' => $this->franchiseRials,
|
||||
'annual_ceiling_rials' => $this->annualCeilingRials,
|
||||
'effective_from' => $this->effectiveFrom,
|
||||
'effective_to' => $this->effectiveTo,
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,78 @@
|
||||
<?php
|
||||
|
||||
namespace App\Insurance\Entity;
|
||||
|
||||
use App\Insurance\Repository\TenantServiceCoverageRepository;
|
||||
use Doctrine\ORM\Mapping as ORM;
|
||||
use Symfony\Component\Uid\Uuid;
|
||||
|
||||
#[ORM\Entity(repositoryClass: TenantServiceCoverageRepository::class)]
|
||||
#[ORM\Table(name: 'tenant_service_coverage')]
|
||||
#[ORM\UniqueConstraint(name: 'uniq_tenant_service_coverage', columns: ['tenant_insurance_id', 'service_item_id'])]
|
||||
#[ORM\Index(columns: ['service_item_id'], name: 'idx_tsc_service')]
|
||||
class TenantServiceCoverage
|
||||
{
|
||||
#[ORM\Id]
|
||||
#[ORM\GeneratedValue]
|
||||
#[ORM\Column(type: 'integer')]
|
||||
private ?int $id = null;
|
||||
|
||||
#[ORM\Column(type: 'string', length: 36, unique: true)]
|
||||
private string $uuid;
|
||||
|
||||
#[ORM\Column(name: 'tenant_insurance_id', type: 'integer')]
|
||||
private int $tenantInsuranceId;
|
||||
|
||||
#[ORM\Column(name: 'service_item_id', type: 'integer')]
|
||||
private int $serviceItemId;
|
||||
|
||||
#[ORM\Column(type: 'boolean')]
|
||||
private bool $covered = true;
|
||||
|
||||
#[ORM\Column(name: 'coverage_percent', type: 'decimal', precision: 5, scale: 2, nullable: true)]
|
||||
private ?string $coveragePercent = null;
|
||||
|
||||
#[ORM\Column(name: 'franchise_rials', type: 'integer', nullable: true)]
|
||||
private ?int $franchiseRials = null;
|
||||
|
||||
#[ORM\Column(name: 'ceiling_rials', type: 'integer', nullable: true)]
|
||||
private ?int $ceilingRials = null;
|
||||
|
||||
#[ORM\Column(name: 'updated_at', type: 'integer')]
|
||||
private int $updatedAt;
|
||||
|
||||
public function __construct(int $tenantInsuranceId, int $serviceItemId)
|
||||
{
|
||||
$this->uuid = Uuid::v4()->toRfc4122();
|
||||
$this->tenantInsuranceId = $tenantInsuranceId;
|
||||
$this->serviceItemId = $serviceItemId;
|
||||
$this->updatedAt = time();
|
||||
}
|
||||
|
||||
public function getId(): ?int { return $this->id; }
|
||||
public function getUuid(): string { return $this->uuid; }
|
||||
public function getTenantInsuranceId(): int { return $this->tenantInsuranceId; }
|
||||
public function getServiceItemId(): int { return $this->serviceItemId; }
|
||||
public function isCovered(): bool { return $this->covered; }
|
||||
public function getCoveragePercent(): ?float { return $this->coveragePercent !== null ? (float) $this->coveragePercent : null; }
|
||||
public function getFranchiseRials(): ?int { return $this->franchiseRials; }
|
||||
public function getCeilingRials(): ?int { return $this->ceilingRials; }
|
||||
|
||||
public function setCovered(bool $v): self { $this->covered = $v; $this->updatedAt = time(); return $this; }
|
||||
public function setCoveragePercent(?float $v): self { $this->coveragePercent = $v !== null ? (string) $v : null; $this->updatedAt = time(); return $this; }
|
||||
public function setFranchiseRials(?int $v): self { $this->franchiseRials = $v; $this->updatedAt = time(); return $this; }
|
||||
public function setCeilingRials(?int $v): self { $this->ceilingRials = $v; $this->updatedAt = time(); return $this; }
|
||||
|
||||
public function toArray(): array
|
||||
{
|
||||
return [
|
||||
'uuid' => $this->uuid,
|
||||
'tenant_insurance_id' => $this->tenantInsuranceId,
|
||||
'service_item_id' => $this->serviceItemId,
|
||||
'covered' => $this->covered,
|
||||
'coverage_percent' => $this->getCoveragePercent(),
|
||||
'franchise_rials' => $this->franchiseRials,
|
||||
'ceiling_rials' => $this->ceilingRials,
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,46 @@
|
||||
<?php
|
||||
|
||||
namespace App\Insurance\Repository;
|
||||
|
||||
use App\Insurance\Entity\EntityInsurancePricing;
|
||||
use Doctrine\Bundle\DoctrineBundle\Repository\ServiceEntityRepository;
|
||||
use Doctrine\Persistence\ManagerRegistry;
|
||||
|
||||
class EntityInsurancePricingRepository extends ServiceEntityRepository
|
||||
{
|
||||
public function __construct(ManagerRegistry $registry)
|
||||
{
|
||||
parent::__construct($registry, EntityInsurancePricing::class);
|
||||
}
|
||||
|
||||
/** @return EntityInsurancePricing[] */
|
||||
public function findByEntity(string $entityType, int $entityId): array
|
||||
{
|
||||
return $this->findBy(['entityType' => $entityType, 'entityId' => $entityId]);
|
||||
}
|
||||
|
||||
public function findOneForInsurance(string $entityType, int $entityId, ?int $insuranceId): ?EntityInsurancePricing
|
||||
{
|
||||
return $this->findOneBy([
|
||||
'entityType' => $entityType,
|
||||
'entityId' => $entityId,
|
||||
'insuranceId' => $insuranceId,
|
||||
]);
|
||||
}
|
||||
|
||||
public function save(EntityInsurancePricing $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->persist($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
|
||||
public function remove(EntityInsurancePricing $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->remove($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,74 @@
|
||||
<?php
|
||||
|
||||
namespace App\Insurance\Repository;
|
||||
|
||||
use App\Insurance\Entity\TenantInsurance;
|
||||
use Doctrine\Bundle\DoctrineBundle\Repository\ServiceEntityRepository;
|
||||
use Doctrine\Persistence\ManagerRegistry;
|
||||
|
||||
class TenantInsuranceRepository extends ServiceEntityRepository
|
||||
{
|
||||
public function __construct(ManagerRegistry $registry)
|
||||
{
|
||||
parent::__construct($registry, TenantInsurance::class);
|
||||
}
|
||||
|
||||
/** @return TenantInsurance[] */
|
||||
public function findActiveByTenant(string $entityType, int $entityId): array
|
||||
{
|
||||
return $this->createQueryBuilder('t')
|
||||
->where('t.entityType = :type')
|
||||
->andWhere('t.entityId = :id')
|
||||
->andWhere('t.isActive = true')
|
||||
->setParameter('type', $entityType)
|
||||
->setParameter('id', $entityId)
|
||||
->orderBy('t.insuranceId', 'ASC')
|
||||
->getQuery()
|
||||
->getResult();
|
||||
}
|
||||
|
||||
public function findByUuid(string $uuid): ?TenantInsurance
|
||||
{
|
||||
return $this->findOneBy(['uuid' => $uuid]);
|
||||
}
|
||||
|
||||
public function findActiveContract(string $entityType, int $entityId, int $insuranceId): ?TenantInsurance
|
||||
{
|
||||
return $this->createQueryBuilder('t')
|
||||
->where('t.entityType = :type')
|
||||
->andWhere('t.entityId = :id')
|
||||
->andWhere('t.insuranceId = :ins')
|
||||
->andWhere('t.isActive = true')
|
||||
->setParameter('type', $entityType)
|
||||
->setParameter('id', $entityId)
|
||||
->setParameter('ins', $insuranceId)
|
||||
->orderBy('t.version', 'DESC')
|
||||
->setMaxResults(1)
|
||||
->getQuery()
|
||||
->getOneOrNullResult();
|
||||
}
|
||||
|
||||
public function latestVersion(string $entityType, int $entityId, int $insuranceId): int
|
||||
{
|
||||
$max = $this->createQueryBuilder('t')
|
||||
->select('MAX(t.version)')
|
||||
->where('t.entityType = :type')
|
||||
->andWhere('t.entityId = :id')
|
||||
->andWhere('t.insuranceId = :ins')
|
||||
->setParameter('type', $entityType)
|
||||
->setParameter('id', $entityId)
|
||||
->setParameter('ins', $insuranceId)
|
||||
->getQuery()
|
||||
->getSingleScalarResult();
|
||||
|
||||
return (int) ($max ?? 0);
|
||||
}
|
||||
|
||||
public function save(TenantInsurance $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->persist($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,45 @@
|
||||
<?php
|
||||
|
||||
namespace App\Insurance\Repository;
|
||||
|
||||
use App\Insurance\Entity\TenantServiceCoverage;
|
||||
use Doctrine\Bundle\DoctrineBundle\Repository\ServiceEntityRepository;
|
||||
use Doctrine\Persistence\ManagerRegistry;
|
||||
|
||||
class TenantServiceCoverageRepository extends ServiceEntityRepository
|
||||
{
|
||||
public function __construct(ManagerRegistry $registry)
|
||||
{
|
||||
parent::__construct($registry, TenantServiceCoverage::class);
|
||||
}
|
||||
|
||||
public function findOneFor(int $tenantInsuranceId, int $serviceItemId): ?TenantServiceCoverage
|
||||
{
|
||||
return $this->findOneBy([
|
||||
'tenantInsuranceId' => $tenantInsuranceId,
|
||||
'serviceItemId' => $serviceItemId,
|
||||
]);
|
||||
}
|
||||
|
||||
/** @return TenantServiceCoverage[] */
|
||||
public function findByContract(int $tenantInsuranceId): array
|
||||
{
|
||||
return $this->findBy(['tenantInsuranceId' => $tenantInsuranceId]);
|
||||
}
|
||||
|
||||
public function save(TenantServiceCoverage $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->persist($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
|
||||
public function remove(TenantServiceCoverage $entity, bool $flush = true): void
|
||||
{
|
||||
$this->getEntityManager()->remove($entity);
|
||||
if ($flush) {
|
||||
$this->getEntityManager()->flush();
|
||||
}
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,147 @@
|
||||
<?php
|
||||
|
||||
namespace App\Insurance\Service;
|
||||
|
||||
use App\Insurance\Entity\TenantInsurance;
|
||||
use App\Insurance\Repository\InsuranceRepository;
|
||||
use App\Insurance\Repository\TenantInsuranceRepository;
|
||||
use App\Insurance\Repository\TenantServiceCoverageRepository;
|
||||
use App\Insurance\ValueObject\CoverageRule;
|
||||
use App\Shared\Constant\ErrorCodes;
|
||||
use App\Shared\Exception\AppException;
|
||||
|
||||
class TenantInsuranceService
|
||||
{
|
||||
public function __construct(
|
||||
private readonly TenantInsuranceRepository $repo,
|
||||
private readonly InsuranceRepository $insuranceRepo,
|
||||
private readonly TenantServiceCoverageRepository $coverageRepo,
|
||||
) {}
|
||||
|
||||
/**
|
||||
* فعالسازی یا بهروزرسانی قرارداد بیمه برای یک tenant.
|
||||
* اگر قرارداد فعالی موجود باشد، همان ویرایش میشود؛ در غیر این صورت نسخهی جدید ساخته میشود.
|
||||
*/
|
||||
public function activate(
|
||||
string $entityType,
|
||||
int $entityId,
|
||||
int $insuranceId,
|
||||
float $coveragePercent,
|
||||
int $franchiseRials = 0,
|
||||
?int $annualCeilingRials = null,
|
||||
): TenantInsurance {
|
||||
if ($this->insuranceRepo->find($insuranceId) === null) {
|
||||
throw new AppException(ErrorCodes::ERR_NOT_FOUND_001, 'بیمه یافت نشد', 404);
|
||||
}
|
||||
|
||||
$contract = $this->repo->findActiveContract($entityType, $entityId, $insuranceId);
|
||||
if ($contract === null) {
|
||||
$version = $this->repo->latestVersion($entityType, $entityId, $insuranceId) + 1;
|
||||
$contract = new TenantInsurance($entityType, $entityId, $insuranceId, $version);
|
||||
}
|
||||
|
||||
$contract->setCoveragePercent($coveragePercent)
|
||||
->setFranchiseRials($franchiseRials)
|
||||
->setAnnualCeilingRials($annualCeilingRials)
|
||||
->setActive(true);
|
||||
|
||||
$this->repo->save($contract);
|
||||
|
||||
return $contract;
|
||||
}
|
||||
|
||||
public function deactivate(TenantInsurance $contract): void
|
||||
{
|
||||
$contract->setActive(false)->setEffectiveTo(time());
|
||||
$this->repo->save($contract);
|
||||
}
|
||||
|
||||
/**
|
||||
* بررسی فعالبودن یک بیمه برای tenant. در پذیرش/صورتحساب استفاده میشود.
|
||||
*/
|
||||
public function assertActive(string $entityType, int $entityId, int $insuranceId): TenantInsurance
|
||||
{
|
||||
$contract = $this->repo->findActiveContract($entityType, $entityId, $insuranceId);
|
||||
if ($contract === null) {
|
||||
throw new AppException(ErrorCodes::ERR_VALIDATION_001, 'این بیمه برای این کلینیک/پزشک فعال نیست', 422);
|
||||
}
|
||||
return $contract;
|
||||
}
|
||||
|
||||
/**
|
||||
* قانون پوشش یک بیمه برای tenant جاری (برای BillingCalculator).
|
||||
* اگر قرارداد فعالی نباشد، notCovered برمیگردد.
|
||||
*/
|
||||
public function coverageRule(string $entityType, int $entityId, ?int $insuranceId): CoverageRule
|
||||
{
|
||||
if ($insuranceId === null) {
|
||||
return CoverageRule::notCovered();
|
||||
}
|
||||
|
||||
$contract = $this->repo->findActiveContract($entityType, $entityId, $insuranceId);
|
||||
if ($contract === null) {
|
||||
return CoverageRule::notCovered();
|
||||
}
|
||||
|
||||
return new CoverageRule(
|
||||
coveragePercent: $contract->getCoveragePercent(),
|
||||
franchiseRials: $contract->getFranchiseRials(),
|
||||
ceilingRials: $contract->getAnnualCeilingRials(),
|
||||
covered: true,
|
||||
);
|
||||
}
|
||||
|
||||
/**
|
||||
* قانون پوشش یک خدمت خاص تحت بیمهی tenant.
|
||||
* اگر override خدمت موجود باشد اعمال میشود؛ فیلدهای null از قرارداد ارث میبرند.
|
||||
*/
|
||||
public function coverageRuleForService(string $entityType, int $entityId, ?int $insuranceId, int $serviceItemId): CoverageRule
|
||||
{
|
||||
if ($insuranceId === null) {
|
||||
return CoverageRule::notCovered();
|
||||
}
|
||||
|
||||
$contract = $this->repo->findActiveContract($entityType, $entityId, $insuranceId);
|
||||
if ($contract === null) {
|
||||
return CoverageRule::notCovered();
|
||||
}
|
||||
|
||||
$override = $this->coverageRepo->findOneFor($contract->getId(), $serviceItemId);
|
||||
if ($override !== null && !$override->isCovered()) {
|
||||
return CoverageRule::notCovered();
|
||||
}
|
||||
|
||||
return new CoverageRule(
|
||||
coveragePercent: $override?->getCoveragePercent() ?? $contract->getCoveragePercent(),
|
||||
franchiseRials: $override?->getFranchiseRials() ?? $contract->getFranchiseRials(),
|
||||
ceilingRials: $override?->getCeilingRials() ?? $contract->getAnnualCeilingRials(),
|
||||
covered: true,
|
||||
);
|
||||
}
|
||||
|
||||
/** @return array{covered: bool, percent: float|null, franchise: int|null, ceiling: int|null}|null */
|
||||
public function getServiceCoverage(int $tenantInsuranceId, int $serviceItemId): ?array
|
||||
{
|
||||
$override = $this->coverageRepo->findOneFor($tenantInsuranceId, $serviceItemId);
|
||||
return $override?->toArray();
|
||||
}
|
||||
|
||||
public function setServiceCoverage(
|
||||
TenantInsurance $contract,
|
||||
int $serviceItemId,
|
||||
bool $covered,
|
||||
?float $coveragePercent,
|
||||
?int $franchiseRials,
|
||||
?int $ceilingRials,
|
||||
): void {
|
||||
$override = $this->coverageRepo->findOneFor($contract->getId(), $serviceItemId)
|
||||
?? new \App\Insurance\Entity\TenantServiceCoverage($contract->getId(), $serviceItemId);
|
||||
|
||||
$override->setCovered($covered)
|
||||
->setCoveragePercent($coveragePercent)
|
||||
->setFranchiseRials($franchiseRials)
|
||||
->setCeilingRials($ceilingRials);
|
||||
|
||||
$this->coverageRepo->save($override);
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,18 @@
|
||||
<?php
|
||||
|
||||
namespace App\Insurance\ValueObject;
|
||||
|
||||
final readonly class CoverageRule
|
||||
{
|
||||
public function __construct(
|
||||
public float $coveragePercent,
|
||||
public int $franchiseRials,
|
||||
public ?int $ceilingRials,
|
||||
public bool $covered = true,
|
||||
) {}
|
||||
|
||||
public static function notCovered(): self
|
||||
{
|
||||
return new self(0.0, 0, null, false);
|
||||
}
|
||||
}
|
||||
@@ -79,6 +79,9 @@ class PatientSession
|
||||
public function getUuid(): string { return $this->uuid; }
|
||||
public function getRecord(): PatientRecord { return $this->record; }
|
||||
public function getAppointment(): ?Appointment { return $this->appointment; }
|
||||
public function getInsuranceBaseId(): ?int { return $this->insuranceBaseId; }
|
||||
public function getInsuranceSupplementaryId(): ?int { return $this->insuranceSupplementaryId; }
|
||||
public function getServices(): Collection { return $this->services; }
|
||||
public function getVisitPriceRials(): int { return $this->visitPriceRials; }
|
||||
public function getBaseInsuranceDiscountPercent(): float { return (float) $this->baseInsuranceDiscountPercent; }
|
||||
public function getSupplementaryDiscountPercent(): float { return (float) $this->supplementaryDiscountPercent; }
|
||||
|
||||
@@ -0,0 +1,77 @@
|
||||
<?php
|
||||
|
||||
namespace App\Tests\Billing;
|
||||
|
||||
use App\Billing\Service\BillingCalculator;
|
||||
use App\Billing\ValueObject\Money;
|
||||
use App\Insurance\ValueObject\CoverageRule;
|
||||
use PHPUnit\Framework\TestCase;
|
||||
|
||||
class BillingCalculatorTest extends TestCase
|
||||
{
|
||||
private BillingCalculator $calc;
|
||||
|
||||
protected function setUp(): void
|
||||
{
|
||||
$this->calc = new BillingCalculator();
|
||||
}
|
||||
|
||||
public function testNoInsuranceAllPatient(): void
|
||||
{
|
||||
$b = $this->calc->calculateItem(new Money(600_000), null, null);
|
||||
$this->assertSame(600_000, $b->patientRials);
|
||||
$this->assertSame(0, $b->baseInsuranceRials);
|
||||
$this->assertSame(0, $b->supplementaryRials);
|
||||
}
|
||||
|
||||
public function testBaseAndSupplementary(): void
|
||||
{
|
||||
// کل 600,000؛ پایه 70% → 420,000؛ مکمل روی 180,000 با ~66.667% → 120,000؛ بیمار 60,000
|
||||
$base = new CoverageRule(coveragePercent: 70, franchiseRials: 0, ceilingRials: null);
|
||||
$supp = new CoverageRule(coveragePercent: 66.6667, franchiseRials: 0, ceilingRials: null);
|
||||
|
||||
$b = $this->calc->calculateItem(new Money(600_000), $base, $supp);
|
||||
|
||||
$this->assertSame(420_000, $b->baseInsuranceRials);
|
||||
$this->assertSame(120_000, $b->supplementaryRials);
|
||||
$this->assertSame(60_000, $b->patientRials);
|
||||
$this->assertSame(
|
||||
$b->totalRials,
|
||||
$b->baseInsuranceRials + $b->supplementaryRials + $b->patientRials
|
||||
);
|
||||
}
|
||||
|
||||
public function testBaseOnly(): void
|
||||
{
|
||||
$base = new CoverageRule(coveragePercent: 70, franchiseRials: 0, ceilingRials: null);
|
||||
$b = $this->calc->calculateItem(new Money(600_000), $base, null);
|
||||
$this->assertSame(420_000, $b->baseInsuranceRials);
|
||||
$this->assertSame(0, $b->supplementaryRials);
|
||||
$this->assertSame(180_000, $b->patientRials);
|
||||
}
|
||||
|
||||
public function testBaseCeilingCapsShare(): void
|
||||
{
|
||||
// پایه 70% = 420,000 ولی سقف 300,000 → بیمار باقی را میدهد
|
||||
$base = new CoverageRule(coveragePercent: 70, franchiseRials: 0, ceilingRials: 300_000);
|
||||
$b = $this->calc->calculateItem(new Money(600_000), $base, null);
|
||||
$this->assertSame(300_000, $b->baseInsuranceRials);
|
||||
$this->assertSame(300_000, $b->patientRials);
|
||||
}
|
||||
|
||||
public function testFranchiseAddedToPatient(): void
|
||||
{
|
||||
// پایه 100% ولی فرانشیز 50,000 سهم بیمار
|
||||
$base = new CoverageRule(coveragePercent: 100, franchiseRials: 50_000, ceilingRials: null);
|
||||
$b = $this->calc->calculateItem(new Money(600_000), $base, null);
|
||||
$this->assertSame(50_000, $b->patientRials);
|
||||
$this->assertSame(600_000, $b->baseInsuranceRials);
|
||||
}
|
||||
|
||||
public function testNotCoveredRule(): void
|
||||
{
|
||||
$b = $this->calc->calculateItem(new Money(600_000), CoverageRule::notCovered(), CoverageRule::notCovered());
|
||||
$this->assertSame(600_000, $b->patientRials);
|
||||
$this->assertSame(0, $b->baseInsuranceRials);
|
||||
}
|
||||
}
|
||||
Reference in New Issue
Block a user