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>
2026-06-23 15:05:24 +03:30
parent 5b1dfe9b40
commit 89191eee57
54 changed files with 4233 additions and 10 deletions
@@ -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);
+    }
+}