fix(wip): insurance payment request

erpnext/healthcare/doctype/healthcare_insurance_payment_request/healthcare_insurance_payment_request_list.js

@@ -0,0 +1,12 @@
+frappe.listview_settings['Healthcare Insurance Payment Request'] = {
+ add_fields: ['status'],
+ get_indicator: function(doc) {
+ return [__(doc.status), {
+ 'Draft': 'red',
+ 'Submitted': 'blue',
+ 'Verified': 'lightblue',
+ 'Completed': 'green',
+ 'Cancelled': 'darkgrey'
+ }[doc.status], 'status,=,' + doc.status];
+ }
+};

healthcare/healthcare/doctype/healthcare_insurance_claim/healthcare_insurance_claim.json

@@ -30,8 +30,9 @@
  "qty",
  "column_break_22",
  "item_code",
- "medical_code",
  "medical_code_standard",
+ "medical_code",
+ "medical_code_description",
  "coverage_details_section",
  "mode_of_approval",
  "claim_validity_end_date",
@@ -46,10 +47,15 @@
  "amount",
  "claim_amount",
  "patient_payable",
- "insurance_claim_billing_summary_section",
+ "billing_summary_section",
  "qty_invoiced",
  "column_break_31",
- "claim_amount_invoiced"
+ "claim_amount_invoiced",
+ "insurance_payment_section",
+ "payment_approved_amount",
+ "payment_request_comments",
+ "column_break_48",
+ "paid_amount"
  ],
  "fields": [
  {
@@ -140,15 +146,15 @@
  "bold": 1,
  "fieldname": "discount",
  "fieldtype": "Percent",
- "label": "Discount",
+ "label": "Discount %",
  "no_copy": 1,
  "read_only_depends_on": "eval:doc.service_coverage || doc.status != 'Draft'"
  },
  {
  "bold": 1,
  "fieldname": "coverage",
  "fieldtype": "Percent",
- "label": "Coverage",
+ "label": "Coverage %",
  "no_copy": 1,
  "read_only_depends_on": "eval:doc.service_coverage || doc.status != 'Draft'"
  },
@@ -173,7 +179,7 @@
  "in_standard_filter": 1,
  "label": "Status",
  "no_copy": 1,
- "options": "Draft\nApproved\nCancelled\nRejected\nInvoiced\nPartially Invoiced\nSubmitted\nCompleted\nPayment Error\nPayment Rejected",
+ "options": "Draft\nApproved\nCancelled\nRejected\nInvoiced\nPartially Invoiced\nPayment Requested\nCompleted\nPayment Error\nPayment Rejected",
  "read_only": 1,
  "reqd": 1
  },
@@ -340,7 +346,7 @@
  "fieldname": "claim_amount",
  "fieldtype": "Currency",
  "in_list_view": 1,
- "label": "Coverage Amount",
+ "label": "Claim Amount",
  "no_copy": 1,
  "read_only": 1
  },
@@ -369,17 +375,53 @@
  "options": "Medical Code Standard",
  "read_only": 1
  },
+ {
+ "fetch_from": "medical_code.description",
+ "fieldname": "medical_code_description",
+ "fieldtype": "Small Text",
+ "label": "Medical Code Description"
+ },
+ {
+ "default": "0",
+ "fieldname": "payment_approved_amount",
+ "fieldtype": "Currency",
+ "label": "Payment Approved Amount",
+ "read_only": 1
+ },
+ {
+ "default": "0",
+ "fieldname": "paid_amount",
+ "fieldtype": "Currency",
+ "label": "Paid Amount",
+ "read_only": 1
+ },
+ {
+ "depends_on": "eval:doc.status != 'Rejected'",
+ "fieldname": "billing_summary_section",
+ "fieldtype": "Section Break",
+ "label": "Billing Summary"
+ },
+ {
+ "fieldname": "column_break_48",
+ "fieldtype": "Column Break"
+ },
  {
  "depends_on": "eval:doc.status != 'Rejected'",
- "fieldname": "insurance_claim_billing_summary_section",
+ "fieldname": "insurance_payment_section",
  "fieldtype": "Section Break",
- "label": "Insurance Billing Summary"
+ "label": "Insurance Payment"
+ },
+ {
+ "fieldname": "payment_request_comments",
+ "fieldtype": "Small Text",
+ "label": "Payment Request Comments",
+ "read_only": 1
  }
  ],
  "index_web_pages_for_search": 1,
  "is_submittable": 1,
  "links": [],
- "modified": "2021-07-18 17:02:32.151849",
+ "modified": "2021-08-03 18:26:07.207203",
  "modified_by": "Administrator",
  "module": "Healthcare",
  "name": "Healthcare Insurance Claim",

healthcare/healthcare/doctype/healthcare_insurance_claim/healthcare_insurance_claim.py

@@ -68,30 +68,11 @@ def on_submit(self):
 
  self.flags.silent = False
 
- # def on_update_after_submit(self):
- # qty_invoiced = sum(detail.get('invoice_qty', 0) for detail in self.insurance_claim_details)
- # claim_amount_invoiced = sum(detail.get('invoice_amount', 0) for detail in self.insurance_claim_details)
-
- # if qty_invoiced == 0:
- # status = 'Approved'
- # if qty_invoiced < self.qty:
- # status = 'Partially Invoiced'
- # else:
- # status = 'Invoiced'
-
- # self.db_set({
- # 'qty_invoiced': qty_invoiced,
- # 'claim_amount_invoiced': claim_amount_invoiced,
- # 'status': status
- # })
-
- def update_invoice_details(self, qty, amount):
+ def update_invoice_details(self, qty=0, amount=0):
  '''
  updates qty_invoiced, claim_amount_invoiced and sets status
  NOTE: on invoice cancel, qty and amount ca be negative
  '''
-
- print(self.template_dt, qty)
  qty_invoiced = self.qty_invoiced + qty
  claim_amount_invoiced = self.claim_amount_invoiced + amount
 
@@ -230,7 +211,7 @@ def make_insurance_claim(patient, policy, company, template_dt=None, template_dn
  '''
  Inserts a new Insurance Claim for the service
  If claim status is Approved, Submits the claim
- Returns claim name and status if Insurance Claim inserted
+ Returns dict with claim name and status if Insurance Claim inserted
  '''
  if not (template_dt and template_dn) and not item_code:
  return None
@@ -300,6 +281,6 @@ def create_insurance_coverage(doc):
  coverage.coverage = doc.coverage
  coverage.discount = doc.discount
  coverage.start_date = doc.posting_date or getdate()
- # coverage.end_date = doc.approval_validity_end_date # leave blank as this is dependent on policy end date
+ # coverage.end_date = doc.approval_validity_end_date # leave blank as claim.approval_validity_end_date is dependent on policy end date
 
  return coverage

healthcare/healthcare/doctype/healthcare_insurance_claim/healthcare_insurance_claim_list.js

@@ -5,13 +5,15 @@ frappe.listview_settings['Healthcare Insurance Claim'] = {
  return [__(doc.status), {
  'Draft': 'red',
  'Approved': 'blue',
- 'Invoiced': 'orange',
- 'Partially Invoiced': 'orange',
- 'Paid': 'green',
- 'Partially Paid': 'orange',
- 'Resubmitted': 'blue',
- 'Rejected': 'grey',
- 'Payment Rejected': 'grey'
+ 'Cancelled': 'grey',
+ 'Rejected': 'darkgrey',
+ 'Invoiced': 'lightblue',
+ 'Partially Invoiced': 'lightblue',
+ 'Payment Requested': 'blue',
+ 'Payment Approved': 'green',
+ 'Completed': 'green',
+ 'Payment Error': 'red',
+ 'Payment Rejected': 'darkgrey'
  }[doc.status], 'status,=,' + doc.status];
  }
-};
+};

healthcare/healthcare/doctype/healthcare_insurance_company/healthcare_insurance_company.json

@@ -15,6 +15,7 @@
  "customer",
  "column_break_3",
  "disabled",
+ "medical_code_standard",
  "image",
  "address_and_contacts_section",
  "address_html",
@@ -110,6 +111,13 @@
  {
  "fieldname": "column_break_3",
  "fieldtype": "Column Break"
+ },
+ {
+ "description": "Default Medical Code Standard for use while Insurance Claim Submission",
+ "fieldname": "medical_code_standard",
+ "fieldtype": "Link",
+ "label": "Medical Code Standard",
+ "options": "Medical Code Standard"
  }
  ],
  "image_field": "image",
@@ -127,7 +135,7 @@
  "link_fieldname": "insurance_company"
  }
  ],
- "modified": "2021-07-11 10:22:14.710654",
+ "modified": "2021-08-03 19:46:21.382244",
  "modified_by": "Administrator",
  "module": "Healthcare",
  "name": "Healthcare Insurance Company",
@@ -171,7 +179,7 @@
  }
  ],
  "restrict_to_domain": "Healthcare",
- "search_fields": "insurance_company_name,customer",
+ "search_fields": "insurance_company_name",
  "sort_field": "modified",
  "sort_order": "ASC",
  "title_field": "insurance_company_name",

healthcare/healthcare/doctype/healthcare_insurance_contract/healthcare_insurance_contract.py

@@ -10,6 +10,9 @@
 
 class HealthcareInsuranceContract(Document):
  def validate(self):
+ if self.start_date >= self.end_date:
+ frappe.throw(_('Start Date should be before End Date'))
+
  if self.is_active:
  contract = frappe.db.exists('Healthcare Insurance Contract', {
  'insurance_company': self.insurance_company,
@@ -20,19 +23,5 @@ def validate(self):
  })
 
  if contract:
- frappe.throw(_('An active contract with this insurance company already exists: {0}').format(
+ frappe.throw(_('An active contract for this insurance company already exists: {0}').format(
  get_link_to_form('Healthcare Insurance Contract', contract)), title=_('Duplicate Contract'))
-
-#TODO: remove ?
-def validate_insurance_contract(insurance_company, company=None, on_date=None):
- contract = frappe.db.exists('Healthcare Insurance Contract', {
- 'insurance_company': insurance_company,
- 'company': company,
- 'is_active': 1,
- 'docstatus': 1,
- 'start_date': ('<=', on_date or getdate()),
- 'end_date':('>=', on_date or getdate())
- })
-
- if not contract:
- frappe.throw(_('No active contracts found for Insurance Company {0} as on {1}').format(insurance_company, on_date))