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:
hamed
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<?php
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declare(strict_types=1);
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namespace DoctrineMigrations;
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use Doctrine\DBAL\Schema\Schema;
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use Doctrine\Migrations\AbstractMigration;
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/**
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* Auto-generated Migration: Please modify to your needs!
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*/
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final class Version20260622163152 extends AbstractMigration
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{
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public function getDescription(): string
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{
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return '';
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}
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public function up(Schema $schema): void
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{
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// this up() migration is auto-generated, please modify it to your needs
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$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');
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$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");
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}
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public function down(Schema $schema): void
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{
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// this down() migration is auto-generated, please modify it to your needs
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$this->addSql('DROP TABLE entity_insurance_pricing');
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}
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}
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<?php
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declare(strict_types=1);
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namespace DoctrineMigrations;
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use Doctrine\DBAL\Schema\Schema;
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use Doctrine\Migrations\AbstractMigration;
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/**
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* Auto-generated Migration: Please modify to your needs!
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*/
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final class Version20260622171538 extends AbstractMigration
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{
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public function getDescription(): string
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{
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return '';
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}
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public function up(Schema $schema): void
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{
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// this up() migration is auto-generated, please modify it to your needs
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$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');
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}
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public function down(Schema $schema): void
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{
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// this down() migration is auto-generated, please modify it to your needs
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$this->addSql('DROP TABLE tenant_insurances');
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}
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}
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@@ -0,0 +1,33 @@
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<?php
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declare(strict_types=1);
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namespace DoctrineMigrations;
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use Doctrine\DBAL\Schema\Schema;
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use Doctrine\Migrations\AbstractMigration;
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/**
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* Auto-generated Migration: Please modify to your needs!
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*/
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final class Version20260622173707 extends AbstractMigration
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{
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public function getDescription(): string
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{
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return '';
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}
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public function up(Schema $schema): void
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{
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// this up() migration is auto-generated, please modify it to your needs
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$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');
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$this->addSql('ALTER TABLE service_items ADD insurance_covered TINYINT NOT NULL, ADD insurance_price_rials INT DEFAULT NULL');
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}
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public function down(Schema $schema): void
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{
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// this down() migration is auto-generated, please modify it to your needs
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$this->addSql('DROP TABLE tenant_service_coverage');
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$this->addSql('ALTER TABLE service_items DROP insurance_covered, DROP insurance_price_rials');
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}
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}
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@@ -0,0 +1,31 @@
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<?php
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declare(strict_types=1);
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namespace DoctrineMigrations;
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use Doctrine\DBAL\Schema\Schema;
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use Doctrine\Migrations\AbstractMigration;
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/**
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* Auto-generated Migration: Please modify to your needs!
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*/
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final class Version20260622181251 extends AbstractMigration
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{
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public function getDescription(): string
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{
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return '';
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}
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public function up(Schema $schema): void
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{
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// this up() migration is auto-generated, please modify it to your needs
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$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');
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}
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public function down(Schema $schema): void
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{
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// this down() migration is auto-generated, please modify it to your needs
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$this->addSql('DROP TABLE service_tariffs');
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}
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}
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@@ -0,0 +1,35 @@
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<?php
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declare(strict_types=1);
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namespace DoctrineMigrations;
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use Doctrine\DBAL\Schema\Schema;
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use Doctrine\Migrations\AbstractMigration;
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/**
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* Auto-generated Migration: Please modify to your needs!
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*/
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final class Version20260622184409 extends AbstractMigration
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{
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public function getDescription(): string
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{
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return '';
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}
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public function up(Schema $schema): void
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{
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// this up() migration is auto-generated, please modify it to your needs
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$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');
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$this->addSql('CREATE TABLE invoices (id INT AUTO_INCREMENT NOT NULL, uuid VARCHAR(36) NOT NULL, entity_type VARCHAR(10) NOT NULL, entity_id INT NOT NULL, patient_session_id INT DEFAULT NULL, patient_record_id INT DEFAULT NULL, base_insurance_id INT DEFAULT NULL, supplementary_insurance_id INT DEFAULT NULL, total_rials INT NOT NULL, base_insurance_rials INT NOT NULL, supplementary_rials INT NOT NULL, patient_rials INT NOT NULL, status VARCHAR(15) NOT NULL, issued_at INT NOT NULL, created_at INT NOT NULL, updated_at INT NOT NULL, UNIQUE INDEX UNIQ_6A2F2F95D17F50A6 (uuid), INDEX idx_invoice_tenant (entity_type, entity_id), INDEX idx_invoice_session (patient_session_id), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
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$this->addSql('ALTER TABLE invoice_items ADD CONSTRAINT FK_DCC4B9F82989F1FD FOREIGN KEY (invoice_id) REFERENCES invoices (id) ON DELETE CASCADE');
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}
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public function down(Schema $schema): void
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{
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// this down() migration is auto-generated, please modify it to your needs
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$this->addSql('ALTER TABLE invoice_items DROP FOREIGN KEY FK_DCC4B9F82989F1FD');
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$this->addSql('DROP TABLE invoice_items');
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$this->addSql('DROP TABLE invoices');
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}
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}
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@@ -0,0 +1,35 @@
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<?php
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declare(strict_types=1);
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namespace DoctrineMigrations;
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use Doctrine\DBAL\Schema\Schema;
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use Doctrine\Migrations\AbstractMigration;
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/**
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* Auto-generated Migration: Please modify to your needs!
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*/
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final class Version20260622185948 extends AbstractMigration
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{
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public function getDescription(): string
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{
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return '';
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}
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public function up(Schema $schema): void
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{
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// this up() migration is auto-generated, please modify it to your needs
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$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');
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$this->addSql('CREATE TABLE claims (id INT AUTO_INCREMENT NOT NULL, uuid VARCHAR(36) NOT NULL, entity_type VARCHAR(10) NOT NULL, entity_id INT NOT NULL, insurance_id INT NOT NULL, insurance_kind VARCHAR(15) NOT NULL, total_claimed_rials INT NOT NULL, total_approved_rials INT DEFAULT NULL, total_paid_rials INT DEFAULT NULL, status VARCHAR(15) NOT NULL, reject_reason LONGTEXT DEFAULT NULL, submitted_at INT DEFAULT NULL, settled_at INT DEFAULT NULL, created_at INT NOT NULL, updated_at INT NOT NULL, UNIQUE INDEX UNIQ_BEA313BED17F50A6 (uuid), INDEX idx_claim_tenant (entity_type, entity_id), INDEX idx_claim_insurance_status (insurance_id, status), PRIMARY KEY (id)) DEFAULT CHARACTER SET utf8mb4');
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$this->addSql('ALTER TABLE claim_items ADD CONSTRAINT FK_DD53020B7096A49F FOREIGN KEY (claim_id) REFERENCES claims (id) ON DELETE CASCADE');
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}
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public function down(Schema $schema): void
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{
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// this down() migration is auto-generated, please modify it to your needs
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$this->addSql('ALTER TABLE claim_items DROP FOREIGN KEY FK_DD53020B7096A49F');
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$this->addSql('DROP TABLE claim_items');
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$this->addSql('DROP TABLE claims');
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}
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}
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