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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namespace App\Insurance\Entity;
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use App\Insurance\Repository\EntityInsurancePricingRepository;
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use Doctrine\ORM\Mapping as ORM;
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#[ORM\Entity(repositoryClass: EntityInsurancePricingRepository::class)]
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#[ORM\Table(name: 'entity_insurance_pricing')]
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#[ORM\UniqueConstraint(name: 'uniq_entity_insurance', columns: ['entity_type', 'entity_id', 'insurance_id'])]
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#[ORM\Index(columns: ['entity_type', 'entity_id'], name: 'idx_entity_pricing_owner')]
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class EntityInsurancePricing
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{
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public const TYPE_DOCTOR = 'doctor';
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public const TYPE_CLINIC = 'clinic';
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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(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', nullable: true)]
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private ?int $insuranceId = null;
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#[ORM\Column(name: 'patient_share_rials', type: 'integer')]
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private int $patientShareRials = 0;
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#[ORM\Column(name: 'updated_at', type: 'integer')]
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private int $updatedAt;
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public function __construct(string $entityType, int $entityId, ?int $insuranceId, int $patientShareRials = 0)
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{
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$this->entityType = $entityType;
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$this->entityId = $entityId;
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$this->insuranceId = $insuranceId;
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$this->patientShareRials = $patientShareRials;
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$this->updatedAt = time();
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}
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public function getId(): ?int { return $this->id; }
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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 getPatientShareRials(): int { return $this->patientShareRials; }
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public function isFreeVisit(): bool { return $this->insuranceId === null; }
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public function setPatientShareRials(int $v): self { $this->patientShareRials = $v; $this->updatedAt = time(); return $this; }
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public function toArray(): array
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{
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return [
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'id' => $this->id,
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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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'patient_share_rials' => $this->patientShareRials,
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];
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}
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}
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<?php
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namespace App\Insurance\Entity;
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use App\Insurance\Repository\TenantInsuranceRepository;
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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: TenantInsuranceRepository::class)]
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#[ORM\Table(name: 'tenant_insurances')]
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#[ORM\UniqueConstraint(name: 'uniq_tenant_insurance_version', columns: ['entity_type', 'entity_id', 'insurance_id', 'version'])]
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#[ORM\Index(columns: ['entity_type', 'entity_id', 'is_active'], name: 'idx_tenant_insurance_active')]
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class TenantInsurance
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{
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public const TYPE_DOCTOR = 'doctor';
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public const TYPE_CLINIC = 'clinic';
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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(type: 'integer')]
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private int $version = 1;
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#[ORM\Column(name: 'is_active', type: 'boolean')]
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private bool $isActive = true;
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#[ORM\Column(name: 'coverage_percent', type: 'decimal', precision: 5, scale: 2)]
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private string $coveragePercent = '0.00';
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#[ORM\Column(name: 'franchise_rials', type: 'integer')]
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private int $franchiseRials = 0;
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#[ORM\Column(name: 'annual_ceiling_rials', type: 'integer', nullable: true)]
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private ?int $annualCeilingRials = null;
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#[ORM\Column(name: 'effective_from', type: 'integer')]
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private int $effectiveFrom;
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#[ORM\Column(name: 'effective_to', type: 'integer', nullable: true)]
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private ?int $effectiveTo = 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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public function __construct(string $entityType, int $entityId, int $insuranceId, int $version = 1)
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{
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$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->version = $version;
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$this->effectiveFrom = time();
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$this->createdAt = time();
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$this->updatedAt = time();
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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 getVersion(): int { return $this->version; }
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public function isActive(): bool { return $this->isActive; }
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public function getCoveragePercent(): float { return (float) $this->coveragePercent; }
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public function getFranchiseRials(): int { return $this->franchiseRials; }
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public function getAnnualCeilingRials(): ?int { return $this->annualCeilingRials; }
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public function getEffectiveFrom(): int { return $this->effectiveFrom; }
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public function getEffectiveTo(): ?int { return $this->effectiveTo; }
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public function setActive(bool $v): self { $this->isActive = $v; $this->updatedAt = time(); return $this; }
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public function setCoveragePercent(float $v): self { $this->coveragePercent = (string) $v; $this->updatedAt = time(); return $this; }
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public function setFranchiseRials(int $v): self { $this->franchiseRials = $v; $this->updatedAt = time(); return $this; }
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public function setAnnualCeilingRials(?int $v): self { $this->annualCeilingRials = $v; $this->updatedAt = time(); return $this; }
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public function setEffectiveTo(?int $v): self { $this->effectiveTo = $v; $this->updatedAt = time(); return $this; }
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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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'version' => $this->version,
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'is_active' => $this->isActive,
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'coverage_percent' => (float) $this->coveragePercent,
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'franchise_rials' => $this->franchiseRials,
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'annual_ceiling_rials' => $this->annualCeilingRials,
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'effective_from' => $this->effectiveFrom,
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'effective_to' => $this->effectiveTo,
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];
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}
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}
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@@ -0,0 +1,78 @@
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<?php
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namespace App\Insurance\Entity;
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use App\Insurance\Repository\TenantServiceCoverageRepository;
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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: TenantServiceCoverageRepository::class)]
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#[ORM\Table(name: 'tenant_service_coverage')]
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#[ORM\UniqueConstraint(name: 'uniq_tenant_service_coverage', columns: ['tenant_insurance_id', 'service_item_id'])]
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#[ORM\Index(columns: ['service_item_id'], name: 'idx_tsc_service')]
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class TenantServiceCoverage
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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: 'tenant_insurance_id', type: 'integer')]
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private int $tenantInsuranceId;
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#[ORM\Column(name: 'service_item_id', type: 'integer')]
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private int $serviceItemId;
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#[ORM\Column(type: 'boolean')]
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private bool $covered = true;
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#[ORM\Column(name: 'coverage_percent', type: 'decimal', precision: 5, scale: 2, nullable: true)]
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private ?string $coveragePercent = null;
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#[ORM\Column(name: 'franchise_rials', type: 'integer', nullable: true)]
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private ?int $franchiseRials = null;
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#[ORM\Column(name: 'ceiling_rials', type: 'integer', nullable: true)]
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private ?int $ceilingRials = null;
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#[ORM\Column(name: 'updated_at', type: 'integer')]
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private int $updatedAt;
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public function __construct(int $tenantInsuranceId, int $serviceItemId)
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{
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$this->uuid = Uuid::v4()->toRfc4122();
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$this->tenantInsuranceId = $tenantInsuranceId;
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$this->serviceItemId = $serviceItemId;
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$this->updatedAt = time();
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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 getTenantInsuranceId(): int { return $this->tenantInsuranceId; }
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public function getServiceItemId(): int { return $this->serviceItemId; }
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public function isCovered(): bool { return $this->covered; }
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public function getCoveragePercent(): ?float { return $this->coveragePercent !== null ? (float) $this->coveragePercent : null; }
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public function getFranchiseRials(): ?int { return $this->franchiseRials; }
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public function getCeilingRials(): ?int { return $this->ceilingRials; }
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public function setCovered(bool $v): self { $this->covered = $v; $this->updatedAt = time(); return $this; }
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public function setCoveragePercent(?float $v): self { $this->coveragePercent = $v !== null ? (string) $v : null; $this->updatedAt = time(); return $this; }
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public function setFranchiseRials(?int $v): self { $this->franchiseRials = $v; $this->updatedAt = time(); return $this; }
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public function setCeilingRials(?int $v): self { $this->ceilingRials = $v; $this->updatedAt = time(); return $this; }
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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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'tenant_insurance_id' => $this->tenantInsuranceId,
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'service_item_id' => $this->serviceItemId,
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'covered' => $this->covered,
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'coverage_percent' => $this->getCoveragePercent(),
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'franchise_rials' => $this->franchiseRials,
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'ceiling_rials' => $this->ceilingRials,
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];
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}
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}
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