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>
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hamed
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<?php
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namespace App\Billing\Entity;
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use App\Billing\Repository\ClaimRepository;
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use Doctrine\Common\Collections\ArrayCollection;
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use Doctrine\Common\Collections\Collection;
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use Doctrine\ORM\Mapping as ORM;
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use Symfony\Component\Uid\Uuid;
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#[ORM\Entity(repositoryClass: ClaimRepository::class)]
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#[ORM\Table(name: 'claims')]
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#[ORM\Index(columns: ['entity_type', 'entity_id'], name: 'idx_claim_tenant')]
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#[ORM\Index(columns: ['insurance_id', 'status'], name: 'idx_claim_insurance_status')]
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class Claim
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{
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public const STATUS_PENDING = 'pending';
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public const STATUS_SUBMITTED = 'submitted';
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public const STATUS_APPROVED = 'approved';
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public const STATUS_REJECTED = 'rejected';
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public const STATUS_PAID = 'paid';
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public const KIND_BASE = 'base';
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public const KIND_SUPPLEMENTARY = 'supplementary';
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private const TRANSITIONS = [
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self::STATUS_PENDING => [self::STATUS_SUBMITTED],
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self::STATUS_SUBMITTED => [self::STATUS_APPROVED, self::STATUS_REJECTED],
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self::STATUS_APPROVED => [self::STATUS_PAID],
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self::STATUS_REJECTED => [],
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self::STATUS_PAID => [],
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];
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#[ORM\Id]
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#[ORM\GeneratedValue]
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#[ORM\Column(type: 'integer')]
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private ?int $id = null;
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#[ORM\Column(type: 'string', length: 36, unique: true)]
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private string $uuid;
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#[ORM\Column(name: 'entity_type', type: 'string', length: 10)]
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private string $entityType;
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#[ORM\Column(name: 'entity_id', type: 'integer')]
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private int $entityId;
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#[ORM\Column(name: 'insurance_id', type: 'integer')]
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private int $insuranceId;
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#[ORM\Column(name: 'insurance_kind', type: 'string', length: 15)]
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private string $insuranceKind;
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#[ORM\Column(name: 'total_claimed_rials', type: 'integer')]
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private int $totalClaimedRials = 0;
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#[ORM\Column(name: 'total_approved_rials', type: 'integer', nullable: true)]
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private ?int $totalApprovedRials = null;
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#[ORM\Column(name: 'total_paid_rials', type: 'integer', nullable: true)]
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private ?int $totalPaidRials = null;
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#[ORM\Column(type: 'string', length: 15)]
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private string $status = self::STATUS_PENDING;
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#[ORM\Column(name: 'reject_reason', type: 'text', nullable: true)]
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private ?string $rejectReason = null;
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#[ORM\Column(name: 'submitted_at', type: 'integer', nullable: true)]
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private ?int $submittedAt = null;
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#[ORM\Column(name: 'settled_at', type: 'integer', nullable: true)]
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private ?int $settledAt = null;
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#[ORM\Column(name: 'created_at', type: 'integer')]
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private int $createdAt;
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#[ORM\Column(name: 'updated_at', type: 'integer')]
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private int $updatedAt;
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#[ORM\OneToMany(targetEntity: ClaimItem::class, mappedBy: 'claim', cascade: ['persist', 'remove'], orphanRemoval: true)]
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private Collection $items;
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public function __construct(string $entityType, int $entityId, int $insuranceId, string $insuranceKind)
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{
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$this->uuid = Uuid::v4()->toRfc4122();
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$this->entityType = $entityType;
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$this->entityId = $entityId;
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$this->insuranceId = $insuranceId;
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$this->insuranceKind = $insuranceKind;
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$this->createdAt = time();
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$this->updatedAt = time();
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$this->items = new ArrayCollection();
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}
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public function getId(): ?int { return $this->id; }
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public function getUuid(): string { return $this->uuid; }
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public function getEntityType(): string { return $this->entityType; }
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public function getEntityId(): int { return $this->entityId; }
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public function getInsuranceId(): int { return $this->insuranceId; }
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public function getInsuranceKind(): string { return $this->insuranceKind; }
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public function getStatus(): string { return $this->status; }
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public function getTotalClaimedRials(): int { return $this->totalClaimedRials; }
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public function getTotalApprovedRials(): ?int { return $this->totalApprovedRials; }
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public function getTotalPaidRials(): ?int { return $this->totalPaidRials; }
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/** @return Collection<int, ClaimItem> */
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public function getItems(): Collection { return $this->items; }
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public function addItem(ClaimItem $item): self
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{
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$this->items->add($item);
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$this->totalClaimedRials += $item->getClaimedRials();
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$this->updatedAt = time();
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return $this;
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}
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public function canTransitionTo(string $status): bool
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{
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return in_array($status, self::TRANSITIONS[$this->status] ?? [], true);
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}
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public function submit(): void
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{
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$this->status = self::STATUS_SUBMITTED;
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$this->submittedAt = time();
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$this->updatedAt = time();
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}
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public function approve(?int $approvedRials = null): void
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{
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$this->status = self::STATUS_APPROVED;
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$this->totalApprovedRials = $approvedRials ?? $this->totalClaimedRials;
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$this->updatedAt = time();
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}
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public function reject(string $reason): void
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{
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$this->status = self::STATUS_REJECTED;
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$this->rejectReason = $reason;
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$this->settledAt = time();
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$this->updatedAt = time();
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}
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public function pay(?int $paidRials = null): void
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{
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$this->status = self::STATUS_PAID;
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$this->totalPaidRials = $paidRials ?? $this->totalApprovedRials ?? $this->totalClaimedRials;
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$this->settledAt = time();
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$this->updatedAt = time();
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}
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public function toArray(): array
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{
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return [
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'uuid' => $this->uuid,
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'entity_type' => $this->entityType,
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'entity_id' => $this->entityId,
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'insurance_id' => $this->insuranceId,
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'insurance_kind' => $this->insuranceKind,
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'total_claimed_rials' => $this->totalClaimedRials,
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'total_approved_rials' => $this->totalApprovedRials,
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'total_paid_rials' => $this->totalPaidRials,
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'status' => $this->status,
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'reject_reason' => $this->rejectReason,
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'submitted_at' => $this->submittedAt,
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'settled_at' => $this->settledAt,
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'created_at' => $this->createdAt,
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'items' => array_map(fn(ClaimItem $i) => $i->toArray(), $this->items->toArray()),
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];
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}
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}
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