- Updated CoverageRule and related entities to include franchise_percent instead of franchise_rials. - Modified Appointment entity to carry supplementary insurance ID alongside base insurance. - Implemented SessionBillingService to ensure finalized invoices for insured patient sessions. - Created InvoiceFinalized event to trigger claims creation upon invoice finalization. - Added BackfillMissingClaimsCommand to generate claims for finalized invoices without existing claims. - Developed tests to validate the new functionality for supplementary insurance handling in appointments and claims.
155 lines
6.2 KiB
PHP
155 lines
6.2 KiB
PHP
<?php
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namespace App\Appointment\Service;
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use App\Appointment\Entity\Appointment;
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use App\Insurance\Enum\InsuranceType;
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use App\Insurance\Enum\ServiceCategory;
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use App\Insurance\Repository\InsuranceRepository;
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use App\Insurance\Repository\TenantInsuranceRepository;
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use App\Insurance\Service\TenantServiceCategoryService;
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use App\Shared\Constant\ErrorCodes;
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use App\Shared\Exception\AppException;
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/**
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* The insurance an appointment is billed with: which service kind (outpatient/inpatient)
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* and which basic insurance. Single place so the PATCH endpoint, the confirm endpoint and
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* the session/invoice pipeline agree on the same rules.
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*/
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class AppointmentInsuranceService
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{
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public function __construct(
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private readonly TenantServiceCategoryService $serviceCategories,
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private readonly TenantInsuranceRepository $tenantInsuranceRepo,
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private readonly InsuranceRepository $insuranceRepo,
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) {}
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/**
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* موجودیتِ صاحب نوبت — کلینیک اگر نوبت در کلینیک باشد، وگرنه خودِ پزشک.
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* همان تفکیکی که PatientService برای ساخت پرونده بهکار میبرد.
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*
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* @return array{0: string, 1: int}
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*/
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public function tenantOf(Appointment $appointment): array
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{
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$clinic = $appointment->getClinic();
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return $clinic !== null
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? ['clinic', (int) $clinic->getId()]
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: ['doctor', (int) $appointment->getDoctor()->getId()];
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}
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/**
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* نوع خدمتِ مؤثر برای محاسبه: انتخابِ نوبت، وگرنه تنها نوع فعالِ tenant،
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* وگرنه سرپایی (رفتار تاریخیِ ویزیت).
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*/
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public function effectiveCategory(Appointment $appointment): ServiceCategory
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{
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if ($appointment->getInsuranceServiceCategory() !== null) {
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return $appointment->getInsuranceServiceCategory();
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}
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[$entityType, $entityId] = $this->tenantOf($appointment);
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return $this->serviceCategories->defaultCategory($entityType, $entityId) ?? ServiceCategory::Outpatient;
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}
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/**
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* انتخاب بیمهٔ نوبت را از بدنهٔ درخواست اعمال میکند. کلیدهای نیامده دستنخورده
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* میمانند؛ رشتهٔ خالی یا null یعنی پاککردن انتخاب.
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*
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* @param array<string, mixed> $data
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* @throws AppException ۴۲۲ برای نوع خدمتِ نامعتبر/غیرفعال یا بیمهٔ بدون قرارداد فعال
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*/
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public function apply(Appointment $appointment, array $data): void
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{
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[$entityType, $entityId] = $this->tenantOf($appointment);
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if (array_key_exists('insurance_service_category', $data)) {
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$appointment->setInsuranceServiceCategory(
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$this->resolveCategory($data['insurance_service_category'], $entityType, $entityId)
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);
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}
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if (array_key_exists('insurance_base_id', $data)) {
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$appointment->setInsuranceBaseId(
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$this->resolveInsuranceId($data['insurance_base_id'], $entityType, $entityId, false)
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);
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}
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if (array_key_exists('insurance_supplementary_id', $data)) {
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$appointment->setInsuranceSupplementaryId(
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$this->resolveInsuranceId($data['insurance_supplementary_id'], $entityType, $entityId, true)
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);
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}
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}
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private function resolveCategory(mixed $raw, string $entityType, int $entityId): ?ServiceCategory
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{
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if ($raw === null || $raw === '') {
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return null;
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}
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$category = ServiceCategory::tryFromValue((string) $raw);
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if ($category === null) {
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throw new AppException(
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ErrorCodes::ERR_VALIDATION_001,
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'نوع خدمت نامعتبر است: ' . implode('، ', ServiceCategory::values()),
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422,
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'insurance_service_category',
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);
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}
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if (!$this->serviceCategories->isEnabled($entityType, $entityId, $category)) {
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throw new AppException(
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ErrorCodes::ERR_VALIDATION_001,
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sprintf('«%s» در تنظیمات بیمه فعال نیست', $category->label()),
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422,
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'insurance_service_category',
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);
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}
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return $category;
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}
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/**
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* شناسهٔ بیمهٔ معتبر برای این نوبت، یا null وقتی انتخاب پاک شده است.
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* قرارداد باید فعال باشد و نوعش با جایگاهی که در آن انتخاب شده بخواند —
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* بیمهٔ تکمیلی نمیتواند جای بیمهٔ پایه بنشیند و برعکس.
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*/
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private function resolveInsuranceId(mixed $raw, string $entityType, int $entityId, bool $supplementary): ?int
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{
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$field = $supplementary ? 'insurance_supplementary_id' : 'insurance_base_id';
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if ($raw === null || $raw === '' || (int) $raw <= 0) {
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return null;
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}
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$insuranceId = (int) $raw;
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$contract = $this->tenantInsuranceRepo->findActiveContract($entityType, $entityId, $insuranceId);
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if ($contract === null) {
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throw new AppException(
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ErrorCodes::ERR_VALIDATION_001,
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'این بیمه برای این پزشک/کلینیک قرارداد فعال ندارد',
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422,
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$field,
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);
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}
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// نوعِ قرارداد بر نوع کاتالوگ اولویت دارد — همان قاعدهٔ TenantInsuranceService.
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$kind = $contract->getKind() ?? $this->insuranceRepo->find($insuranceId)?->getType()->value;
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$isSupp = $kind === InsuranceType::Supplementary->value;
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if ($isSupp !== $supplementary) {
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throw new AppException(
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ErrorCodes::ERR_VALIDATION_001,
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$supplementary ? 'اینجا فقط بیمهٔ تکمیلی قابل انتخاب است' : 'اینجا فقط بیمهٔ پایه قابل انتخاب است',
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422,
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$field,
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);
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}
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return $insuranceId;
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}
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}
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