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feat(claims): enrich claims with insurance details and item specifics

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hamed
2026-06-24 04:48:11 +03:30
parent 27840da78d
commit c189daa860
8 changed files with 188 additions and 11 deletions
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assets/admin/pages/ClaimsPage.tsx
+44 -1
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@@ -3,7 +3,7 @@ import { useQuery, useMutation, useQueryClient } from '@tanstack/react-query';
import { CheckIcon, XMarkIcon, PaperAirplaneIcon, BanknotesIcon } from '@heroicons/react/24/outline';
import { toast } from 'sonner';
import { api } from '../lib/api';
import { formatRial, formatNumber } from '../lib/utils';
import { formatRial, formatNumber, formatDate } from '../lib/utils';
import PageHeader from '../components/ui/PageHeader';
import Modal from '../components/ui/Modal';
import SearchableSelect from '../components/ui/SearchableSelect';
@@ -13,6 +13,11 @@ interface ClaimItem {
invoice_item_id: number;
claimed_rials: number;
approved_rials: number | null;
title: string | null;
is_visit: boolean;
quantity: number;
total_rials: number | null;
visit_date: number | null;
}
interface Claim {
@@ -167,6 +172,44 @@ export default function ClaimsPage() {
)}
</div>
</div>
{c.items.length > 0 && (
<div style={{ marginTop: 12, borderTop: '1px solid var(--border)', paddingTop: 10, overflowX: 'auto' }}>
<table style={{ width: '100%', borderCollapse: 'collapse', fontSize: 12.5 }}>
<thead>
<tr style={{ color: 'var(--text-3)', textAlign: 'right' }}>
<th style={{ fontWeight: 600, padding: '4px 8px' }}>شرح</th>
<th style={{ fontWeight: 600, padding: '4px 8px' }}>تاریخ مراجعه</th>
<th style={{ fontWeight: 600, padding: '4px 8px', textAlign: 'center' }}>تعداد</th>
<th style={{ fontWeight: 600, padding: '4px 8px', textAlign: 'left' }}>مبلغ کل</th>
<th style={{ fontWeight: 600, padding: '4px 8px', textAlign: 'left' }}>سهم بیمه (ادعا)</th>
<th style={{ fontWeight: 600, padding: '4px 8px', textAlign: 'left' }}>تأییدشده</th>
</tr>
</thead>
<tbody>
{c.items.map((it, idx) => (
<tr key={idx} style={{ borderTop: '1px solid var(--border)' }}>
<td style={{ padding: '7px 8px' }}>
<span className={`badge ${it.is_visit ? 'blue' : 'gray'}`} style={{ fontSize: 9.5, marginInlineEnd: 6 }}>
{it.is_visit ? 'ویزیت' : 'خدمت'}
</span>
<span style={{ fontWeight: 500 }}>{it.title ?? '—'}</span>
</td>
<td style={{ padding: '7px 8px', color: 'var(--text-3)' }} dir="ltr">
{it.visit_date ? formatDate(it.visit_date) : '—'}
</td>
<td style={{ padding: '7px 8px', textAlign: 'center' }}>{formatNumber(it.quantity)}</td>
<td style={{ padding: '7px 8px', textAlign: 'left' }} dir="ltr">{it.total_rials != null ? formatRial(it.total_rials) : '—'}</td>
<td style={{ padding: '7px 8px', textAlign: 'left', fontWeight: 600 }} dir="ltr">{formatRial(it.claimed_rials)}</td>
<td style={{ padding: '7px 8px', textAlign: 'left', color: 'var(--text-3)' }} dir="ltr">
{it.approved_rials != null ? formatRial(it.approved_rials) : '—'}
</td>
</tr>
))}
</tbody>
</table>
</div>
)}
</div>
);
})}
docs/api/billing.md
+29 -1
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@@ -111,7 +111,35 @@
هر مطالبه در پاسخ علاوه بر `insurance_id`، فیلد `insurance_name` (نام بیمه، یا `null` اگر بیمه حذف شده باشد) را نیز دارد. در `POST` و `transition` و `GET` یکسان است.
## GET /api/v1/billing/claims?status=
لیست مطالبات tenant. فیلتر اختیاری `status` (`pending|submitted|approved|rejected|paid`). هر آیتم شامل `insurance_name` است.
لیست مطالبات tenant. فیلتر اختیاری `status` (`pending|submitted|approved|rejected|paid`). هر مطالبه شامل `insurance_name` و آرایه‌ی `items` با جزئیات هر ردیف است.
هر عضو `items` علاوه بر `invoice_item_id`، `claimed_rials`، `approved_rials`، این فیلدهای نمایشی را دارد (برای جدول صفحه‌ی مطالبات):
| فیلد | نوع | توضیح |
|------|-----|-------|
| `title` | string \| null | شرح ردیف؛ «ویزیت» یا نام خدمت |
| `is_visit` | bool | `true` اگر ردیف ویزیت باشد (`service_item_id` تهی) |
| `quantity` | int | تعداد |
| `total_rials` | int \| null | مبلغ کل آن ردیف (قیمت کامل، قبل از بیمه) |
| `visit_date` | int \| null | تاریخ ثبت مراجعه (Unix؛ نمایش شمسی) |
```json
{
"success": true,
"data": { "data": [
{
"uuid": "…", "insurance_id": 3, "insurance_name": "تأمین اجتماعی", "insurance_kind": "base",
"total_claimed_rials": 240000, "status": "pending",
"items": [
{ "invoice_item_id": 12, "title": "ویزیت", "is_visit": true, "quantity": 1, "total_rials": 300000, "claimed_rials": 240000, "approved_rials": null, "visit_date": 1718000000 },
{ "invoice_item_id": 13, "title": "سرم ۵۰۰cc", "is_visit": false, "quantity": 2, "total_rials": 170000, "claimed_rials": 0, "approved_rials": null, "visit_date": 1718000000 }
]
}
] }
}
```
> این فیلدها با یک کوئری گروهی (`InvoiceItemRepository::detailsForIds` + `PatientSessionRepository::datesForIds`) پر می‌شوند تا N+1 رخ ندهد. همان enrichment روی پاسخ `POST /claims` و `POST /claims/{uuid}/{action}` هم اعمال می‌شود.
## POST /api/v1/billing/claims/{uuid}/{action}
انتقال وضعیت. `action` ∈ `submit|approve|reject|pay`.
src/Billing/Controller/BillingController.php
+44 -7
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@@ -5,6 +5,7 @@ namespace App\Billing\Controller;
use App\Auth\Entity\User;
use App\Billing\Entity\Claim;
use App\Billing\Repository\ClaimRepository;
use App\Billing\Repository\InvoiceItemRepository;
use App\Billing\Repository\InvoiceRepository;
use App\Billing\Service\ClaimService;
use App\Billing\Service\InvoiceService;
@@ -28,6 +29,7 @@ class BillingController extends BaseController
public function __construct(
private readonly InvoiceService $invoiceService,
private readonly InvoiceRepository $invoiceRepo,
private readonly InvoiceItemRepository $invoiceItemRepo,
private readonly ClaimService $claimService,
private readonly ClaimRepository $claimRepo,
private readonly PatientSessionRepository $sessionRepo,
@@ -36,11 +38,46 @@ class BillingController extends BaseController
private readonly InsuranceRepository $insuranceRepo,
) {}
private function claimArray(Claim $claim): array
/**
* مطالبات را با نام بیمه و جزئیات هر آیتم (نوع/نام، تاریخ مراجعه، تعداد) غنی می‌کند.
* @param Claim[] $claims
*/
private function enrichClaims(array $claims): array
{
$data = $claim->toArray();
$data['insurance_name'] = $this->insuranceRepo->find($claim->getInsuranceId())?->getName();
return $data;
// جمع‌آوری همه‌ی invoice_item_idها در یک رفت‌وآمد
$invoiceItemIds = [];
foreach ($claims as $claim) {
foreach ($claim->getItems() as $ci) {
$invoiceItemIds[] = $ci->getInvoiceItemId();
}
}
$itemDetails = $this->invoiceItemRepo->detailsForIds(array_values(array_unique($invoiceItemIds)));
$sessionIds = [];
foreach ($itemDetails as $d) {
if ($d['patient_session_id'] !== null) {
$sessionIds[] = $d['patient_session_id'];
}
}
$sessionDates = $this->sessionRepo->datesForIds(array_values(array_unique($sessionIds)));
return array_map(function (Claim $claim) use ($itemDetails, $sessionDates) {
$data = $claim->toArray();
$data['insurance_name'] = $this->insuranceRepo->find($claim->getInsuranceId())?->getName();
$data['items'] = array_map(function (array $item) use ($itemDetails, $sessionDates) {
$detail = $itemDetails[$item['invoice_item_id']] ?? null;
$sessionId = $detail['patient_session_id'] ?? null;
$item['title'] = $detail['title'] ?? null;
$item['is_visit'] = $detail !== null && $detail['service_item_id'] === null;
$item['quantity'] = $detail['quantity'] ?? 1;
$item['total_rials'] = $detail['total_rials'] ?? null;
$item['visit_date'] = $sessionId !== null ? ($sessionDates[$sessionId] ?? null) : null;
return $item;
}, $data['items']);
return $data;
}, $claims);
}
#[Route('/api/v1/billing/invoices', methods: ['POST'])]
@@ -116,7 +153,7 @@ class BillingController extends BaseController
$claims = $this->claimService->createFromInvoice($invoice);
return $this->success(['data' => array_map(fn(Claim $c) => $this->claimArray($c), $claims)], 201);
return $this->success(['data' => $this->enrichClaims($claims)], 201);
}
#[Route('/api/v1/billing/claims', methods: ['GET'])]
@@ -130,7 +167,7 @@ class BillingController extends BaseController
$status = $request->query->get('status') ?: null;
$claims = $this->claimRepo->findByTenant($entityType, $entityId, $status);
return $this->success(['data' => array_map(fn(Claim $c) => $this->claimArray($c), $claims)]);
return $this->success(['data' => $this->enrichClaims($claims)]);
}
#[Route('/api/v1/billing/claims/{uuid}/{action}', methods: ['POST'], requirements: ['action' => 'submit|approve|reject|pay'])]
@@ -160,7 +197,7 @@ class BillingController extends BaseController
'reason' => trim($data['reason'] ?? ''),
]);
return $this->success(['data' => $this->claimArray($claim)]);
return $this->success(['data' => $this->enrichClaims([$claim])[0]]);
}
#[Route('/api/v1/billing/reports/insurance-debt', methods: ['GET'])]
src/Billing/Repository/InvoiceItemRepository.php
+34
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@@ -20,4 +20,38 @@ class InvoiceItemRepository extends ServiceEntityRepository
$this->getEntityManager()->flush();
}
}
/**
* جزئیات چند آیتم صورتحساب برای نمایش در مطالبات — کلیددار بر اساس id آیتم.
* @param int[] $ids
* @return array<int, array{title: string, service_item_id: int|null, quantity: int, total_rials: int, patient_session_id: int|null}>
*/
public function detailsForIds(array $ids): array
{
if ($ids === []) {
return [];
}
$rows = $this->createQueryBuilder('ii')
->select('ii.id AS id', 'ii.title AS title', 'ii.serviceItemId AS service_item_id',
'ii.quantity AS quantity', 'ii.totalRials AS total_rials',
'inv.patientSessionId AS patient_session_id')
->join('ii.invoice', 'inv')
->where('ii.id IN (:ids)')
->setParameter('ids', $ids)
->getQuery()
->getArrayResult();
$out = [];
foreach ($rows as $r) {
$out[(int) $r['id']] = [
'title' => $r['title'],
'service_item_id' => $r['service_item_id'] !== null ? (int) $r['service_item_id'] : null,
'quantity' => (int) $r['quantity'],
'total_rials' => (int) $r['total_rials'],
'patient_session_id' => $r['patient_session_id'] !== null ? (int) $r['patient_session_id'] : null,
];
}
return $out;
}
}
src/Billing/Service/InvoiceService.php
+3 -2
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@@ -52,14 +52,15 @@ class InvoiceService
// خدمات
foreach ($session->getServices() as $sessionService) {
$item = $sessionService->getServiceItem();
$qty = max(1, $sessionService->getQuantity());
$unitPrice = $this->tariffService->resolvePrice($item);
$total = new Money($unitPrice);
$total = new Money($unitPrice * $qty);
$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()));
$invoice->addItem(new InvoiceItem($invoice, $item->getName(), $unitPrice, $qty, $breakdown, $item->getId()));
}
$invoice->recalculateTotals();
src/Patient/Entity/PatientSession.php
+8
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@@ -82,6 +82,14 @@ class PatientSession
public function getInsuranceBaseId(): ?int { return $this->insuranceBaseId; }
public function getInsuranceSupplementaryId(): ?int { return $this->insuranceSupplementaryId; }
public function getServices(): Collection { return $this->services; }
public function addService(SessionService $service): self
{
if (!$this->services->contains($service)) {
$this->services->add($service);
}
return $this;
}
public function getVisitPriceRials(): int { return $this->visitPriceRials; }
public function getBaseInsuranceDiscountPercent(): float { return (float) $this->baseInsuranceDiscountPercent; }
public function getSupplementaryDiscountPercent(): float { return (float) $this->supplementaryDiscountPercent; }
src/Patient/Repository/PatientSessionRepository.php
+25
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@@ -64,4 +64,29 @@ class PatientSessionRepository extends ServiceEntityRepository
$this->getEntityManager()->persist($session);
$this->getEntityManager()->flush();
}
/**
* تاریخ ثبت چند مراجعه — کلیددار بر اساس id جلسه.
* @param int[] $ids
* @return array<int, int> sessionId => createdAt
*/
public function datesForIds(array $ids): array
{
if ($ids === []) {
return [];
}
$rows = $this->createQueryBuilder('s')
->select('s.id AS id', 's.createdAt AS created_at')
->where('s.id IN (:ids)')
->setParameter('ids', $ids)
->getQuery()
->getArrayResult();
$out = [];
foreach ($rows as $r) {
$out[(int) $r['id']] = (int) $r['created_at'];
}
return $out;
}
}
src/Patient/Service/PatientService.php
+1
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@@ -173,6 +173,7 @@ class PatientService
$qty = max(1, (int) ($svc['quantity'] ?? 1));
$ss = new SessionService($session, $item, $staff, $qty);
$this->sessionServiceRepo->save($ss);
$session->addService($ss);
}
return $session;