hamed
4f4bce9fe2
- Changed franchise_rials to franchise_percent in tenant_insurances and tenant_service_coverage tables. - Reset old rial values to 0/NULL as they are not convertible to percentage. feat(command): add SeedInsuranceScenarioCommand for seeding insurance data - Implemented a command to seed supplementary insurance contracts, patients, and claims for a specified doctor. - Includes functionality for purging existing scenario data and generating new entries with predefined contracts and patient scenarios.
275 lines
11 KiB
PHP
275 lines
11 KiB
PHP
<?php
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namespace App\Tests\Billing;
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use App\Auth\Entity\User;
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use App\Billing\Entity\Claim;
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use App\Billing\Entity\ClaimItem;
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use App\Billing\Entity\Invoice;
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use App\Billing\Entity\InvoiceItem;
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use App\Billing\ValueObject\ShareBreakdown;
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use App\Doctor\Entity\Doctor;
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use App\Insurance\Entity\Insurance;
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use App\Insurance\Enum\InsuranceType;
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use App\Patient\Entity\PatientRecord;
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use App\Tests\ApiTestCase;
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/**
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* GET /api/v1/billing/claims/by-patient — the claims dashboard's first level.
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*
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* A claim reaches its patient only through claim_item → invoice_item → invoice →
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* patient_record, and one invoice can carry both a base and a supplementary claim.
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* These tests pin the aggregation against double-counting the service amount.
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*/
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class ClaimsByPatientTest extends ApiTestCase
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{
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private User $owner;
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private Doctor $doctor;
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private PatientRecord $record;
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protected function setUp(): void
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{
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parent::setUp();
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$this->owner = $this->createUser(['ROLE_DOCTOR']);
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$this->doctor = new Doctor($this->owner, 'دکتر تست');
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$this->em->persist($this->doctor);
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$this->em->flush();
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$patient = $this->createUser(['ROLE_USER']);
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$this->record = new PatientRecord('doctor', $this->doctor->getId(), $patient, 'doctor', $this->doctor->getId());
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$this->em->persist($this->record);
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$this->em->flush();
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}
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/**
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* Invoice of $total split into insurance/patient shares, with its claim(s).
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*
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* @param list<int> $insuranceIds one per claim; defaults to synthetic ids when the
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* test does not care which insurance it is
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*/
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private function invoiceWithClaims(int $total, int $baseShare, int $suppShare, array $statuses = ['pending'], array $insuranceIds = []): Invoice
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{
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$patient = $total - $baseShare - $suppShare;
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$invoice = new Invoice('doctor', $this->doctor->getId());
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$invoice->setPatientRecordId((int) $this->record->getId());
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$item = new InvoiceItem($invoice, 'جراحی', $total, 1, new ShareBreakdown($total, $baseShare, $suppShare, $patient));
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$invoice->addItem($item);
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$invoice->recalculateTotals();
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$this->em->persist($invoice);
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$this->em->persist($item);
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$this->em->flush();
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foreach ($statuses as $i => $status) {
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$kind = $i === 0 ? Claim::KIND_BASE : Claim::KIND_SUPPLEMENTARY;
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$share = $i === 0 ? $baseShare : $suppShare;
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$claim = new Claim('doctor', $this->doctor->getId(), $insuranceIds[$i] ?? (1 + $i), $kind);
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$claimItem = new ClaimItem($claim, (int) $item->getId(), $share);
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$claim->addItem($claimItem);
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if ($status !== Claim::STATUS_PENDING) {
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$claim->submit();
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}
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if ($status === Claim::STATUS_PAID) {
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$claim->approve($share);
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$claim->pay($share);
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}
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$this->em->persist($claim);
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$this->em->persist($claimItem);
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}
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$this->em->flush();
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return $invoice;
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}
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public function testAggregatesOneRowPerPatientWithConsistentShares(): void
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{
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$this->invoiceWithClaims(10_000_000, 7_000_000, 0);
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$res = $this->authJson('GET', '/api/v1/billing/claims/by-patient', $this->owner);
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self::assertSame(200, $this->responseCode());
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self::assertCount(1, $res['data']);
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$row = $res['data'][0];
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self::assertSame(1, $row['claims_count']);
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self::assertSame(10_000_000, $row['total_services_rials']);
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self::assertSame(7_000_000, $row['total_insurance_rials']);
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self::assertSame(3_000_000, $row['total_patient_rials']);
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self::assertSame('pending', $row['overall_status']);
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}
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public function testServiceTotalIsNotDoubleCountedWhenAnInvoiceHasTwoClaims(): void
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{
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// پایه و مکمل روی یک صورتحساب: مبلغ خدمات باید یکبار شمرده شود.
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$this->invoiceWithClaims(10_000_000, 6_000_000, 2_000_000, ['pending', 'pending']);
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$res = $this->authJson('GET', '/api/v1/billing/claims/by-patient', $this->owner);
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$row = $res['data'][0];
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self::assertSame(2, $row['claims_count']);
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self::assertSame(10_000_000, $row['total_services_rials']);
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self::assertSame(8_000_000, $row['total_insurance_rials']);
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self::assertSame(
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$row['total_services_rials'],
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$row['total_insurance_rials'] + $row['total_patient_rials'],
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);
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}
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public function testOverallStatusIsMixedWhenClaimsDisagree(): void
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{
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$this->invoiceWithClaims(10_000_000, 6_000_000, 2_000_000, [Claim::STATUS_PAID, Claim::STATUS_PENDING]);
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$res = $this->authJson('GET', '/api/v1/billing/claims/by-patient', $this->owner);
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self::assertSame('mixed', $res['data'][0]['overall_status']);
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}
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public function testEachRowCarriesTheInsurancesItsClaimsBelongTo(): void
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{
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$iran = new Insurance('بیمه ایران تست', InsuranceType::Basic);
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$asia = new Insurance('بیمه آسیا تست', InsuranceType::Supplementary);
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$this->em->persist($iran);
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$this->em->persist($asia);
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$this->em->flush();
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$this->invoiceWithClaims(10_000_000, 6_000_000, 2_000_000, ['pending', 'pending'], [
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(int) $iran->getId(), (int) $asia->getId(),
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]);
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$res = $this->authJson('GET', '/api/v1/billing/claims/by-patient', $this->owner);
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$row = $res['data'][0];
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self::assertCount(2, $row['insurances']);
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$names = array_column($row['insurances'], 'insurance_name');
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self::assertContains('بیمه ایران تست', $names);
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self::assertContains('بیمه آسیا تست', $names);
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self::assertSame(
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['base', 'supplementary'],
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array_values(array_unique(array_column($row['insurances'], 'kind'))),
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);
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}
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public function testKindFilterKeepsOnlyThatKindOfClaim(): void
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{
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$this->invoiceWithClaims(10_000_000, 6_000_000, 2_000_000, ['pending', 'pending']);
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$supp = $this->authJson('GET', '/api/v1/billing/claims/by-patient?kind=supplementary', $this->owner);
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self::assertSame(1, $supp['data'][0]['claims_count']);
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self::assertSame(2_000_000, $supp['data'][0]['total_insurance_rials']);
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$base = $this->authJson('GET', '/api/v1/billing/claims/by-patient?kind=base', $this->owner);
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self::assertSame(6_000_000, $base['data'][0]['total_insurance_rials']);
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}
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public function testAnUnknownKindIsRejected(): void
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{
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$body = $this->authJson('GET', '/api/v1/billing/claims/by-patient?kind=bogus', $this->owner);
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self::assertSame(422, $this->responseCode());
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self::assertSame('kind', $body['errors'][0]['field']);
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}
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public function testSearchAlsoMatchesTheInsuranceName(): void
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{
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$asia = new Insurance('بیمه آسیا جستجو', InsuranceType::Supplementary);
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$this->em->persist($asia);
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$this->em->flush();
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$this->invoiceWithClaims(10_000_000, 0, 4_000_000, ['pending'], [(int) $asia->getId()]);
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$hit = $this->authJson('GET', '/api/v1/billing/claims/by-patient?search=' . urlencode('آسیا'), $this->owner);
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self::assertSame(1, $hit['meta']['totalRecords']);
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$miss = $this->authJson('GET', '/api/v1/billing/claims/by-patient?search=' . urlencode('بیمه ناموجود'), $this->owner);
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self::assertSame(0, $miss['meta']['totalRecords']);
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self::assertSame([], $miss['data']);
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}
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public function testStatusFilterNarrowsTheAggregation(): void
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{
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$this->invoiceWithClaims(10_000_000, 7_000_000, 0);
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$res = $this->authJson('GET', '/api/v1/billing/claims/by-patient?status=paid', $this->owner);
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self::assertSame(0, $res['meta']['totalRecords']);
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}
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public function testDetailListsClaimsWithCoverageAndTimeline(): void
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{
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$this->invoiceWithClaims(10_000_000, 7_000_000, 0);
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$res = $this->authJson('GET', '/api/v1/billing/claims/by-patient/' . $this->record->getUuid(), $this->owner);
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self::assertSame(200, $this->responseCode());
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$claim = $res['data']['claims'][0];
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// JSON یک float گِرد را به int تبدیل میکند؛ مقایسهی نوعمحور اینجا معنا ندارد.
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self::assertEquals(70, $claim['coverage_percent']);
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self::assertSame(7_000_000, $claim['insurance_share_rials']);
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self::assertSame(3_000_000, $claim['patient_share_rials']);
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self::assertSame(['submitted'], $claim['allowed_transitions']);
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}
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public function testDetailRefusesARecordOfAnotherTenant(): void
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{
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$otherOwner = $this->createUser(['ROLE_DOCTOR']);
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$otherDoctor = new Doctor($otherOwner, 'دکتر دیگر');
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$this->em->persist($otherDoctor);
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$this->em->flush();
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$this->authJson('GET', '/api/v1/billing/claims/by-patient/' . $this->record->getUuid(), $otherOwner);
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self::assertSame(404, $this->responseCode());
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}
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public function testSubmitStoresTheTrackingNumberAndLogsTheTransition(): void
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{
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$this->invoiceWithClaims(10_000_000, 7_000_000, 0);
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$detail = $this->authJson('GET', '/api/v1/billing/claims/by-patient/' . $this->record->getUuid(), $this->owner);
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$uuid = $detail['data']['claims'][0]['uuid'];
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$this->authJson('POST', '/api/v1/billing/claims/' . $uuid . '/submit', $this->owner, [
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'tracking_number' => 'TM-1',
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]);
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self::assertSame(200, $this->responseCode());
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$after = $this->authJson('GET', '/api/v1/billing/claims/by-patient/' . $this->record->getUuid(), $this->owner);
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$claim = $after['data']['claims'][0];
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self::assertSame('TM-1', $claim['tracking_number']);
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self::assertSame('submitted', $claim['status']);
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self::assertSame('submitted', end($claim['logs'])['to_status']);
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}
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public function testRejectWithoutAReasonIsRefused(): void
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{
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$this->invoiceWithClaims(10_000_000, 7_000_000, 0, [Claim::STATUS_SUBMITTED]);
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$detail = $this->authJson('GET', '/api/v1/billing/claims/by-patient/' . $this->record->getUuid(), $this->owner);
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$uuid = $detail['data']['claims'][0]['uuid'];
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$this->authJson('POST', '/api/v1/billing/claims/' . $uuid . '/reject', $this->owner, []);
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self::assertSame(422, $this->responseCode());
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}
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/**
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* این داشبورد با SQL خام ساخته میشود، پس TenantFilter آن را نمیبیند و تنها
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* محافظش شرط دستیِ `c.entity_type/:entity_id` در ClaimRepository است. اگر آن
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* WHERE روزی برداشته شود، هیچ چیز جز این تست خبر نمیدهد.
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*/
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public function testAnotherTenantsClaimsNeverAppearInTheDashboard(): void
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{
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$this->invoiceWithClaims(10_000_000, 7_000_000, 0);
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$strangerUser = $this->createUser(['ROLE_DOCTOR']);
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$strangerDoctor = new Doctor($strangerUser, 'دکتر بیگانه');
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$this->em->persist($strangerDoctor);
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$this->em->flush();
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$res = $this->authJson('GET', '/api/v1/billing/claims/by-patient', $strangerUser);
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self::assertSame(200, $this->responseCode());
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self::assertSame([], $res['data'], 'مطالبات پزشک دیگر نباید دیده شود');
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}
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}
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