Add endpoint to check insurance coverage amount while insert/update act in health care sheet

app/Http/Controllers/HealthCareSheetController.php

@@ -699,6 +699,8 @@ class HealthCareSheetController extends Controller
             $this->calculateInsuranceAmounts($healthCareSheet);
             // Verification de la limite de couverture
             $this->verifyInsuranceCoverageAmount($nhConfig, $insurance, $healthCareSheet, $beneficiary ?? null);
+            // Mettre à jour la couverture d'assurance de l'assuré
+            $this->updateInsuranceCoverageAmount($healthCareSheet, $insurance, $beneficiary ?? null, $datetime);
 
             foreach ($request->input('prescriptions', []) as $p) {
                 $prescription = NhMedicalPrescription::create($p);
@@ -761,19 +763,20 @@ class HealthCareSheetController extends Controller
      * @throws AppException
      */
     // Verification de la limite de couverture
-    private function verifyInsuranceCoverageAmount(NhNetworksConfig $nhConfig, NhInsurance $insurance, NhHealthCareSheet $sheet, NhHavingRight $beneficiary = null)
+    private function verifyInsuranceCoverageAmount(NhNetworksConfig $nhConfig, NhInsurance $insurance, NhHealthCareSheet $sheet, NhHavingRight $beneficiary = null
+        ,                                                           $currentInsuranceAmount = 0) // Current Insurance Amount en cas de mise à jour de la feuille de soins pour ne pas prendre en compte la couverture deja affecté
     {
         $insurance_coverage_amount = isset($beneficiary) ? $beneficiary->insurance_coverage_amount : $insurance->insurance_coverage_amount;
         $insurance_amount = $sheet->insurance_amount;
 
         if (!$nhConfig->family_coverage_sharing) {
-            $total_insurance_amount = $insurance_coverage_amount + $insurance_amount;
+            $total_insurance_amount = $insurance_coverage_amount + $insurance_amount - $currentInsuranceAmount;
             if ($total_insurance_amount > $nhConfig->coverage_limit_per_insured_per_year) {
                 DB::rollBack();
                 throw new AppException("La limite de couverture a été atteinte pour cet assuré");
             }
         } else {
-            $total_insurance_amount = $insurance_amount + $insurance->insurance_coverage_amount;
+            $total_insurance_amount = $insurance_amount + $insurance->insurance_coverage_amount - $currentInsuranceAmount;
             foreach ($insurance->beneficiaries as $b) {
                 $total_insurance_amount += $b->insurance_coverage_amount;
             }
@@ -799,6 +802,20 @@ class HealthCareSheetController extends Controller
         ]);
     }
 
+    private function updateInsuranceCoverageAmount(NhHealthCareSheet $sheet, NhInsurance $insurance, NhHavingRight $beneficiary,
+                                                                     $datetime, $currentInsuranceAmount = 0): void
+    { // Current Insurance Amount en cas de mise à jour de la feuille de soins pour ne pas prendre en compte la couverture deja affecté)
+        $sheet->insurance_consumed_at = $datetime;
+        if (!empty($beneficiary)) {
+            $beneficiary->insurance_coverage_amount += ($sheet->insurance_amount - $currentInsuranceAmount);
+            $beneficiary->save();
+        } else {
+            $insurance->insurance_coverage_amount += ($sheet->insurance_amount - $currentInsuranceAmount);
+            $insurance->save();
+        }
+        $sheet->save();
+    }
+
     /**
      * @OA\Post(
      *   path="/health-care-sheets/execution",
@@ -1030,6 +1047,8 @@ class HealthCareSheetController extends Controller
             $this->calculateInsuranceAmounts($healthCareSheet);
             // Verification de la limite de couverture
             $this->verifyInsuranceCoverageAmount($nhConfig, $sheet->insurance, $healthCareSheet, $sheet->beneficiary);
+            // Mettre à jour la couverture d'assurance de l'assuré
+            $this->updateInsuranceCoverageAmount($healthCareSheet, $sheet->insurance, $sheet->beneficiary, $datetime);
 
 
             #Clone pivots
@@ -1433,24 +1452,8 @@ class HealthCareSheetController extends Controller
         try {
             DB::beginTransaction();
             if ($action == 'ACCEPT') {
-                $nhConfig = NhNetworksConfig::where('network_id', $sheet->insurance->network_id)->first();
-                if (!isset($nhConfig)) {
-                    return $this->errorResponse(trans('errors.nano_health_not_activated'));
-                }
-                // Verification de la limite de couverture
-                $this->verifyInsuranceCoverageAmount($nhConfig, $sheet->insurance, $sheet, $sheet->beneficiary);
-
                 $sheet->state = InsuranceSubscriptionState::ACCEPTED;
                 $message = trans('messages.care_sheet_accepted');
-                // Mettre à jour la couverture d'assurance de chaque assuré
-                $sheet->insurance_consumed_at = $datetime;
-                if (!empty($sheet->beneficiary)) {
-                    $sheet->beneficiary->insurance_coverage_amount += $sheet->insurance_amount;
-                    $sheet->beneficiary->save();
-                } else {
-                    $sheet->insurance->insurance_coverage_amount += $sheet->insurance_amount;
-                    $sheet->insurance->save();
-                }
             } else if ($action == 'REJECT') {
                 $sheet->state = InsuranceSubscriptionState::REJECTED;
                 $message = trans('messages.care_sheet_rejected');
@@ -1464,8 +1467,6 @@ class HealthCareSheetController extends Controller
             DB::commit();
             return $this->successResponse($message);
 
-        } catch (AppException $e) {
-            return $this->errorResponse($e->getMessage(), $e->getCode());
         } catch (Throwable $e) {
             Log::error($e->getMessage() . '\n' . $e->getTraceAsString());
             DB::rollBack();
@@ -1712,7 +1713,7 @@ class HealthCareSheetController extends Controller
         $this->validate($request, [
             'network_agent_id' => 'required|integer|exists:networks_agents,id',
             'password' => 'required|string',
-            'beneficiary_id' => 'nullable|int|exists:nh_having_rights,id',
+//            'beneficiary_id' => 'nullable|int|exists:nh_having_rights,id',
             'practitioner_lastname' => 'nullable|string',
             'practitioner_firstname' => 'nullable|string',
             'practitioner_provider_class_id' => 'nullable|integer',
@@ -1753,14 +1754,14 @@ class HealthCareSheetController extends Controller
 
         $this->agentCredentialsVerification($request->input('network_agent_id'), $request->input('password'));
 
-        $beneficiary_id = $request->input('beneficiary_id');
+//        $beneficiary_id = $request->input('beneficiary_id');
-        if (!empty($beneficiary_id)) {
+//        if (!empty($beneficiary_id)) {
-            $beneficiary = $sheet->insurance->beneficiaries()->where('nh_having_rights.id', $beneficiary_id)->first();
+//            $beneficiary = $sheet->insurance->beneficiaries()->where('nh_having_rights.id', $beneficiary_id)->first();
-            if (!isset($beneficiary)) {
+//            if (!isset($beneficiary)) {
-                return $this->errorResponse(trans('errors.beneficiary_not_found'));
+//                return $this->errorResponse(trans('errors.beneficiary_not_found'));
-            }
+//            }
-            $sheet->beneficiary_id = $beneficiary_id;
+//            $sheet->beneficiary_id = $beneficiary_id;
-        }
+//        }
 
         $nhConfig = NhNetworksConfig::where('network_id', $sheet->insurance->network_id)->first();
         if (!isset($nhConfig)) {
@@ -1801,11 +1802,11 @@ class HealthCareSheetController extends Controller
                 $sheet->accident_date = !empty($accident_date) ? $accident_date : null;
                 $sheet->pregnancy_start_at = !empty($pregnancy_start_at) ? $pregnancy_start_at : null;
                 $sheet->pregnancy_end_at = !empty($pregnancy_end_at) ? $pregnancy_end_at : null;
-                if (isset($beneficiary)) {
+//                if (isset($beneficiary)) {
-                    $sheet->patient_lastname = $beneficiary->lastname;
+//                    $sheet->patient_lastname = $beneficiary->lastname;
-                    $sheet->patient_firstname = $beneficiary->firstname;
+//                    $sheet->patient_firstname = $beneficiary->firstname;
-                    $sheet->patient_situation = 'HAVING_RIGHT';
+//                    $sheet->patient_situation = 'HAVING_RIGHT';
-                }
+//                }
 
                 foreach ($request->input('performances', []) as $p) {
                     if (!empty($p['to_delete'])) {
@@ -1844,15 +1845,8 @@ class HealthCareSheetController extends Controller
                         ]);
                     }
                 }
-
-                // Calculer les parts de l'assurance et l'assuré pour cette feuille de soins
-                $this->calculateInsuranceAmounts($sheet);
-                // Verification de la limite de couverture
-                $this->verifyInsuranceCoverageAmount($nhConfig, $sheet->insurance, $sheet, $beneficiary ?? null);
-
             }
 
-            $_prescriptions = [];
             foreach ($request->input('prescriptions', []) as $p) {
                 if (!empty($p['to_delete'])) {
                     NhMedicalPrescription::find($p['id'])->delete();
@@ -1884,7 +1878,6 @@ class HealthCareSheetController extends Controller
                 }
                 $prescription->updated_at = $datetime;
                 $prescription->save();
-                $_prescriptions[] = $prescription;
 
                 if (empty($p['id'])) {
                     NhHealthCareSheetsPrescription::create([
@@ -1936,12 +1929,13 @@ class HealthCareSheetController extends Controller
                 }
             }
 
-            if ($sheet->type == HealthCareSheetType::EXECUTION) {
+            $currentInsuranceAmount = $sheet->insurance_amount;
             // Calculer les parts de l'assurance et l'assuré pour cette feuille de soins
             $this->calculateInsuranceAmounts($sheet);
             // Verification de la limite de couverture
-                $this->verifyInsuranceCoverageAmount($nhConfig, $sheet->insurance, $sheet, $sheet->beneficiary);
+            $this->verifyInsuranceCoverageAmount($nhConfig, $sheet->insurance, $sheet, $sheet->beneficiary, $currentInsuranceAmount);
-            }
+            // Mettre à jour la couverture d'assurance de l'assuré
+            $this->updateInsuranceCoverageAmount($sheet, $sheet->insurance, $sheet->beneficiary, $datetime, $currentInsuranceAmount);
 
             $sheet->save();
 
@@ -1992,4 +1986,243 @@ class HealthCareSheetController extends Controller
             $this->formatExamAndPrescriptionAmounts($p, $sheet);
         }
     }
+
+    /**
+     * @OA\Post(
+     *   path="/health-care-sheets/check-insurance-coverage-amount",
+     *   summary="Verifier si une ligne de la feuille est applicable",
+     *   tags={"Feuilles de soins"},
+     *   security={{"api_key":{}}},
+     * @OA\RequestBody(
+     *      description="Corps de la requete",
+     *      required=true,
+     *     @OA\MediaType(
+     *                mediaType="application/json",
+     *        @OA\Schema(
+     *                  schema="check_insurance_coverage_amount",
+     *                  title = "Verifier si une ligne de la feuille est applicable",
+     *                  required={"insured_id", "network_agent_id", "password", "practitioner_lastname", "practitioner_provider_class_id"},
+     *              @OA\Property(
+     *                  property="network_id",
+     *                  description = "ID du reseau",
+     *                  type="integer",
+     *                  example= 250
+     *              ),
+     *               @OA\Property(
+     *                  property="insurance_id",
+     *                  description = "ID de l'assurance",
+     *                  type="integer",
+     *                  example= 4
+     *              ),
+     *               @OA\Property(
+     *                  property="beneficiary_id",
+     *                  description = "ID du beneficiaire , s'il s'agit d'une feuille de soins pour beneficiaire",
+     *                  type="integer",
+     *                  example= 4
+     *              ),
+     *             @OA\Property(
+     *                  property="care_condition",
+     *                  description = "Condition de prise en charge",
+     *                  type="string",
+     *                  enum={"CURRENT_AFFECTION","LONG_TERM_AFFECTION","EXONERATION"},
+     *                  example= "CURRENT_AFFECTION"
+     *              ),
+     *              @OA\Property(
+     *                  property="act_action",
+     *                  description = "Action effectuéé sur la feuille de soins",
+     *                  type="string",
+     *                  enum={"INSERT","UPDATE"},
+     *                  example= "INSERT"
+     *              ),
+     *            @OA\Property(
+     *                  property="act_type",
+     *                  description = "Type d'acte qui correspond au type de la ligne dans la feuille de soins",
+     *                  type="string",
+     *                  enum={"PRESCRIPTION","EXAM","PRESCRIPTION"},
+     *                  example= "PRESCRIPTION"
+     *              ),
+     *           @OA\Property(
+     *                  property="act_id",
+     *                  description = "Id de l'acte",
+     *                  type="integer",
+     *                  example= 10
+     *              ),
+     *         @OA\Property(property="performances",
+     *                        type="array",
+     *                        description="Listes des prestations",
+     *                          @OA\Items(ref="#/components/schemas/check_insurance_performances")
+     *              ),
+     *       @OA\Property(property="prescriptions",
+     *                        type="array",
+     *                        description="Listes des prescriptions medicales",
+     *                          @OA\Items(ref="#/components/schemas/check_insurance_prescriptions")
+     *              ),
+     *     @OA\Property(property="exams",
+     *                        type="array",
+     *                        description="Listes des examens",
+     *                          @OA\Items(ref="#/components/schemas/check_insurance_exams")
+     *              )
+     *          ),
+     *     ),
+     *    ),
+     *   @OA\Response(
+     *      response=200,
+     *      description="OK",
+     *       @OA\JsonContent(
+     *           ref="#/components/schemas/ApiResponse",
+     *            example = {
+     *                      "status" : 200,
+     *                      "response" : "Acceptable",
+     *                      "error":null
+     *                  }
+     *       )
+     *    )
+     * )
+     * @throws \App\Exceptions\AppException
+     */
+    // Ce route sera appélé à chaque insertion/modification de prestations, examens ou prescriptions dans une feuille de soins
+    public function checkInsuranceCoverageAmount(Request $request)
+    {
+        /**
+         * @OA\Schema(
+         *                  schema="check_insurance_performances",
+         *    				 @OA\Property(property="amount",
+         *                        type="number",
+         *                        example=30000,
+         *                        description="Montant de la prestation"
+         *                    ),
+         *               @OA\Property(property="home_visit_fees",
+         *                        type="number",
+         *                        example=5000,
+         *                        description="Frais de deplacement pour visiste à domicile "
+         *                    ),
+         *        )
+         *
+         * @OA\Schema(
+         *                  schema="check_insurance_prescriptions",
+         *               @OA\Property(property="quantity",
+         *                        type="int",
+         *                        example=5,
+         *                        description="Quantité"
+         *                    ),
+         *            @OA\Property(property="unit_price",
+         *                        type="number",
+         *                        example=3000,
+         *                        description="Prix unitaire"
+         *                    )
+         *        )
+         *
+         * @OA\Schema(
+         *               schema="check_insurance_exams",
+         *               @OA\Property(property="quantity",
+         *                        type="int",
+         *                        example=5,
+         *                        description="Quantité"
+         *                    ),
+         *              @OA\Property(property="unit_price",
+         *                        type="number",
+         *                        example=5000,
+         *                        description="Prix unitaire"
+         *                    )
+         *        )
+         */
+        $this->validate($request, [
+            'network_id' => 'required|exists:networks,id',
+            'insurance_id' => 'required|exists:nh_insurances,id',
+            'beneficiary_id' => 'nullable|exists:nh_having_rights,id',
+            'care_condition' => 'required|in:CURRENT_AFFECTION,LONG_TERM_AFFECTION,EXONERATION',
+            'act_action' => 'required|in:INSERT,UPDATE', // Insertion ou modification de l'acte ( Create ou modification de la feuille de soins)
+            'act_type' => 'required|in:PERFORMANCE,EXAM,PRESCRIPTION',
+            'act_id' => 'required_if:act_action,UPDATE|integer', // Requis lors de la modification de la feuille de soins (UPDATE)
+            'performances' => 'required_if:act_type,PERFORMANCE|array',
+            'performances.*.amount' => 'required_if:act_type,PERFORMANCE|numeric',
+            'performances.*.home_visit_fees' => 'nullable|numeric',
+            'prescriptions' => 'required_if:act_type,PRESCRIPTION|array',
+            'prescriptions.*.quantity' => 'required|integer|min:1',
+            'prescriptions.*.unit_price' => 'required|numeric',
+            'exams' => 'required_if:act_type,EXAM|array',
+            'exams.*.quantity' => 'required|integer|min:1',
+            'exams.*.unit_price' => 'required|numeric',
+        ]);
+
+        $beneficiary = NhHavingRight::find($request->input('beneficiary_id'));
+        $insurance = NhInsurance::find($request->input('insurance_id'));
+        $act_id = $request->input('act_id');
+        $act_action = $request->input('act_action');
+        $act_type = $request->input('act_type');
+        $performances = $request->input('performances', []);
+        $exams = $request->input('exams', []);
+        $prescriptions = $request->input('prescriptions', []);
+
+        if (sizeof($performances) > 1 || sizeof($exams) > 1 || sizeof($prescriptions) > 1) {
+            return $this->errorResponse("La verification se fait sur une seule ligne à la fois");
+        }
+
+        $nhConfig = NhNetworksConfig::where('network_id', $insurance->network_id)->first();
+        if (!isset($nhConfig)) {
+            return $this->errorResponse(trans('errors.nano_health_not_activated'));
+        }
+
+        $parts = $this->getConfigInsuranceParts($nhConfig, $request->input('care_condition'));
+
+        $insurance_amount = 0;
+        switch ($act_type) {
+            case 'PERFORMANCE':
+                foreach ($performances as $p) {
+                    $fees = !empty($p['home_visit_fees']) ? $p['home_visit_fees'] : 0;
+                    $insurance_amount += ($parts->insurer_part * ($p['amount'] + $fees));
+                }
+                $act = NhPerformance::find($act_id);
+                break;
+            case 'EXAM':
+                foreach ($exams as $e) {
+                    $insurance_amount += ($parts->insurer_part * $e['unit_price'] * $e['quantity']);
+                }
+                $act = NhExam::find($act_id);
+                break;
+            case 'PRESCRIPTION':
+                foreach ($prescriptions as $p) {
+                    $insurance_amount += ($parts->insurer_part * $p['unit_price'] * $p['quantity']);
+                }
+                $act = NhMedicalPrescription::find($act_id);
+                break;
+            default:
+                return $this->errorResponse(trans('errors.unexpected_error'));
+        }
+
+        $insurance_coverage_amount = isset($beneficiary) ? $beneficiary->insurance_coverage_amount : $insurance->insurance_coverage_amount;
+        $current_insurance_amount = 0;
+        if ($act_action == 'UPDATE') {
+            if (!isset($act)) {
+                return $this->errorResponse(trans('errors.act_not_found'));
+            }
+            // En cas de modification d'une feuille de soins , considéré le montant de couverture actuel de l'acte deja pris en compte
+            switch ($act_type) {
+                case 'PERFORMANCE':
+                    $current_insurance_amount = $act->insurance_amount;
+                    break;
+                case 'EXAM':
+                case 'PRESCRIPTION':
+                    $current_insurance_amount = $act->insurer_paid_amount;
+                    break;
+            }
+        }
+
+        if (!$nhConfig->family_coverage_sharing) {
+            $total_insurance_amount = $insurance_coverage_amount + $insurance_amount - $current_insurance_amount;
+            if ($total_insurance_amount > $nhConfig->coverage_limit_per_insured_per_year) {
+                return $this->errorResponse("La limite de couverture a été atteinte pour cet assuré");
+            }
+        } else {
+            $total_insurance_amount = $insurance_amount + $insurance->insurance_coverage_amount - $current_insurance_amount;
+            foreach ($insurance->beneficiaries as $b) {
+                $total_insurance_amount += $b->insurance_coverage_amount;
+            }
+            if ($total_insurance_amount > ($nhConfig->coverage_limit_per_insured_per_year * ($insurance->number_of_beneficiaries + 1))) {
+                return $this->errorResponse("La mutualisation familiale a été atteinte pour cet assuré");
+            }
+        }
+
+        return $this->successResponse("Can be applied");
+    }
 }

resources/lang/en/errors.php

@@ -50,5 +50,6 @@ return [
     'cannot_renew_insurance' => "Your insurance is not stopped, you cannot renew it",
     'already_insured' => "Vous avez deja souscrit à cette assurance",
     'no_sheet_accepted' => "No care sheet accepted",
-    'no_sheet_available' => "No care sheet available"
+    'no_sheet_available' => "No care sheet available",
+    "act_not_found" => "Act not found"
 ];

resources/lang/fr/errors.php

@@ -50,5 +50,6 @@ return [
     'cannot_renew_insurance' => "Votre assurance n'est pas en arrêt , vous ne pouvez pas la renouveler",
     'already_insured' => "Vous avez deja souscrit à cette assurance",
     'no_sheet_accepted' => "Aucune feuille de soins acceptée",
-    'no_sheet_available' => "Aucune feuille de soins disponible"
+    'no_sheet_available' => "Aucune feuille de soins disponible",
+    "act_not_found" => "Acte introuvable"
 ];

routes/web.php

@@ -49,6 +49,7 @@ $router->group(['prefix' => '', 'middleware' => 'auth'], function () use ($route
     $router->get('acts', 'HealthCareSheetController@getNetworkActs');
 
     $router->get('health-care-sheets', 'HealthCareSheetController@getHealthCareSheets');
+    $router->post('health-care-sheets/check-insurance-coverage-amount', 'HealthCareSheetController@checkInsuranceCoverageAmount');
     $router->put('health-care-sheets', 'HealthCareSheetController@treatHealthCareSheet');
     $router->post('health-care-sheets/performances-amount', 'HealthCareSheetController@calculateConsultationPerformancesAmount');
     $router->post('health-care-sheets/consultation', 'HealthCareSheetController@storeHealthCareSheetConsultation');