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 +1,77 @@
+<?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);
+    }
+}