diff --git a/app/Controllers/ClientController.php b/app/Controllers/ClientController.php
index 4bbf2189..d974f31c 100755
--- a/app/Controllers/ClientController.php
+++ b/app/Controllers/ClientController.php
@@ -6179,7 +6179,12 @@ class ClientController extends AdminController
// $response = $ticketServiceController->getClaimExcelErrorData(["file_id" => 41]);
// $response = $ticketServiceController->claimDumpOnBoardProcess(["file_id" => 17]);
// $response = $ticketServiceController->extractExcelData("claims_dump_form_client.xlsx");
- // $response = $ticketServiceController->tpaClaimDumpImporter(["file_id" => 48]);
+ // $response = $ticketServiceController->tpaClaimDumpImporter(["file_id" => 52]); //reliance
+ // $response = $ticketServiceController->tpaClaimDumpImporter(["file_id" => 50]); //fhpl
+ // $response = $ticketServiceController->tpaClaimDumpImporter(["file_id" => 51]); //abhi
+ // $response = $ticketServiceController->tpaClaimDumpImporter(["file_id" => 48]); //vidal
+ // $response = $ticketServiceController->tpaClaimDumpImporter(["file_id" => 53]); //icici
+ // $response = $ticketServiceController->tpaClaimDumpToTicketMasterImporters(["file_id" => 48]);
// $response = $ticketServiceController->tpaClaimDumpToTicketMasterImporters(["file_id" => 48]);
// dd($response);
diff --git a/app/Controllers/JobWorker.php b/app/Controllers/JobWorker.php
index 9cc001dd..160c6fe9 100755
--- a/app/Controllers/JobWorker.php
+++ b/app/Controllers/JobWorker.php
@@ -155,6 +155,14 @@ class JobWorker extends AdminController
'type' => 'CC', // Handler Category
'handler' => 'App\Controllers\TicketServiceController',
],
+ 'tpaClaimDumpImporter' => [
+ 'type' => 'CC', // Handler Category
+ 'handler' => 'App\Controllers\TicketServiceController',
+ ],
+ 'tpaClaimDumpToTicketMasterImporters' => [
+ 'type' => 'CC', // Handler Category
+ 'handler' => 'App\Controllers\TicketServiceController',
+ ],
'excelMultieventFileFormateValidation' => [
'type' => 'CC', // Handler Category
'handler' => 'App\Controllers\EmployeeMultiEventServiceController',
diff --git a/app/Controllers/PolicyTransactionController.php b/app/Controllers/PolicyTransactionController.php
index f0d6fc56..81eede97 100644
--- a/app/Controllers/PolicyTransactionController.php
+++ b/app/Controllers/PolicyTransactionController.php
@@ -1094,6 +1094,7 @@
private function updateInceptionPolicy($id, $data)
{
// print_r($data); die;
+ $data['updated_by'] = get_session_userid();
$old_pt_data = $this->policyTransactionModel->where('is_active', 1)->where("id", $id)->first();
$old_pt_co_share_data = $this->PTCOShareDetailsModel->where('is_active', 1)->where("id", $id)->first();
if ($this->policyTransactionModel->update($id, $data)) {
@@ -2007,6 +2008,7 @@
{
if ($id) {
$data['is_active'] = 0;
+ $data['updated_by'] = get_session_userid();
$policy_transaction_data = $this->policyTransactionModel->where('id', $id)->first();
if($policy_transaction_data['policy_type_id'] > 7 && $type == 0){
@@ -2418,6 +2420,7 @@
private function updateEndorsementTransaction($id, $data)
{
+ $data['updated_by'] = get_session_userid();
$old_endorse_data = $this->policyTransactionModel->where('id', $id)->where('is_active', 1)->first();
$update = $this->policyTransactionModel->where('id', $id)->set($data)->update();
diff --git a/app/Controllers/TicketController.php b/app/Controllers/TicketController.php
index 09021a99..05ceb883 100644
--- a/app/Controllers/TicketController.php
+++ b/app/Controllers/TicketController.php
@@ -2813,6 +2813,8 @@ class TicketController extends BaseController
{
$data['tab_name'] = "Claim Dupm Upload";
$data['page_name'] = "Claims";
+ $data['tpa_list'] = $this->TPAModel->where('is_active', 1)->findAll();
+
if($this->request->is('get')){
@@ -2877,17 +2879,25 @@ class TicketController extends BaseController
$status = 'inprogress';
$insert_data = [
'file_name' => $filename,
- 'status' => $status
+ 'status' => $status,
+ 'client_id' => !empty($this->request->getPost('client_id')) ? $this->request->getPost('client_id') : null,
+ 'client_policy_id' => !empty($this->request->getPost('client_policy_id')) ? $this->request->getPost('client_policy_id') : null,
+ 'tpa_id' => !empty($this->request->getPost('tpa_id')) ? $this->request->getPost('tpa_id') : null,
];
$file_id = $this->claimDumpFileModel->insert($insert_data);
$this->myLogger->logme("error", 'claim_dumb_file_id : {file_id}, uploaded success', ['file_id' => $file_id]);
//after file upload success than call the file formate validation in service controller
- $ticketServiceController = new TicketServiceController();
- // $response = $ticketServiceController->claimDumpExcelFileFormatValidation(["file_id" => $file_id]);
- $r = Jobs::addJob(['job_name' => 'claimDumpExcelFileFormatValidation', 'payload' => ['file_id' => $file_id]]);
+ // $ticketServiceController = new TicketServiceController();
+ if(!empty($insert_data['tpa_id'])){
+ $r = Jobs::addJob(['job_name' => 'tpaClaimDumpImporter', 'payload' => ['file_id' => $file_id]]);
+ // $response = $ticketServiceController->claimDumpExcelFileFormatValidation(["file_id" => $file_id]);
+ }else{
+ $r = Jobs::addJob(['job_name' => 'claimDumpExcelFileFormatValidation', 'payload' => ['file_id' => $file_id]]);
+ // $response = $ticketServiceController->claimDumpExcelFileFormatValidation(["file_id" => $file_id]);
+ }
return $this->respond(['status' => true, 'code' => 200, 'message' => 'File uploaded successfully. File being validated'], 200);
}
@@ -2986,8 +2996,12 @@ class TicketController extends BaseController
}
+
+ // -------- CLAIM MIS UPLOAD ----------------------------------------------------------------------------------------------
+
public function claimMisFileList()
- {
+ {
+ $data['tab_name'] = "Claim MIS Upload";
$data['page_name'] = "Cliam MIS Files";
$data['claim_mis_file_list'] = $this->claimmisFileModel
->select('claims_mis_files.*, user_profiles.first_name as user_name')
diff --git a/app/Controllers/TicketServiceController.php b/app/Controllers/TicketServiceController.php
index 5cfa99f4..14c1b19a 100644
--- a/app/Controllers/TicketServiceController.php
+++ b/app/Controllers/TicketServiceController.php
@@ -7,6 +7,9 @@ use CodeIgniter\HTTP\ResponseInterface;
use CodeIgniter\API\ResponseTrait;
use PhpOffice\PhpSpreadsheet\Cell\Coordinate;
use Kint\Kint;
+use App\Libraries\TpaClaimsImportFactory;
+use App\Libraries\TPAClaimsImportServices\FhplClaimImportService;
+use App\Libraries\TPAClaimsImportServices\BaseTpaClaimImportService;
use App\Models\ClaimDumpFileModel;
use App\Models\EmployeeModel;
@@ -15,10 +18,14 @@ use App\Models\TPAModel;
use App\Models\ClientModel;
use App\Models\TicketClaimStatusModel;
use App\Models\ClientPolicyModel;
+use App\Models\ClaimsDumpFhplModel;
use App\Helpers\ExcelSanitizeHelper;
use App\Models\TicketMasterModel;
+use PhpOffice\PhpSpreadsheet\IOFactory;
+use PhpOffice\PhpSpreadsheet\Spreadsheet;
+
class TicketServiceController extends BaseController
{
use ResponseTrait;
@@ -35,6 +42,10 @@ class TicketServiceController extends BaseController
protected $ticketClaimStatusModel;
protected $clientPolicyModel;
+ protected $medi_assist_primary_key;
+ protected $vidal_primary_key;
+ protected $icici_primary_key;
+
public function __construct()
{
@@ -50,6 +61,11 @@ class TicketServiceController extends BaseController
$this->ticketClaimStatusModel = new TicketClaimStatusModel();
$this->clientPolicyModel = new ClientPolicyModel();
+ $this->medi_assist_primary_key = getenv('MEDI_ASSIST_PRIMARY_KEY_CONSTANT');
+ $this->vidal_primary_key = getenv('VIDAL_PRIMARY_KEY_CONSTANT');
+ $this->icici_primary_key = getenv('ICICI_PRIMARY_KEY_CONSTANT');
+
+
$this->claim_dump_excel_columns = [
// Mandatory Fields
@@ -1819,5 +1835,243 @@ class TicketServiceController extends BaseController
{
}
+
+
+ // --------------------------------------------------------------------------------------------------------------------------------
+
+
+ public function tpaClaimImporter($params)
+ {
+ $file_id = $params['file_id'];
+ $tpa_claims_files_data = $this->claimDumpFileModel->where('id', $file_id)->first();
+
+
+ if($this->vidal_primary_key == $tpa_claims_files_data['tpa_id']){
+
+ }else if($this->icici_primary_key == $tpa_claims_files_data['tpa_id']){
+
+ }else{
+ $this->myLogger->logme('error', 'No TPA found to import');
+ return ['status' => false, 'message' => 'No TPA found to import'];
+ }
+ }
+
+ public function tpaClaimDumpImporter($params)
+ {
+ try {
+
+ $file_id = $params['file_id'] ?? null;
+ $file_path = WRITEPATH . 'uploads/claim_dump_excel/';
+
+ if (!$file_id) {
+ return ['status' => false, 'message' => 'File ID is missing'];
+ }
+
+ $fileData = $this->claimDumpFileModel->where('id', $file_id)->first();
+
+ if (!$fileData) {
+ return ['status' => false, 'message' => 'Invalid file ID. No file data found'];
+ }
+
+ $file_full_path = $file_path . $fileData['file_name'];
+
+ if (!is_file($file_full_path)) {
+ return ['status' => false, 'message' => 'Claim dump file not found'];
+ }
+
+ $handler = TpaClaimsImportFactory::make($fileData['tpa_id'] ?? 0);
+ $result = $handler->runTpaClaimDumpInsert($file_full_path, $file_id);
+
+ // ---------- Prepare update data ----------
+ $data = [];
+
+ if (!empty($result['status']) && $result['status'] === true) {
+ $data['status'] = 'success';
+ $data['reason'] = null;
+ } else {
+ $data['status'] = 'failed';
+
+ $errorMessage = $result['message'] ?? 'Unknown import error';
+
+ $reason = [
+ 'error_summary' => array_count_values([5]),
+ 'error_data' => $errorMessage
+ ];
+
+ $data['reason'] = json_encode($reason, JSON_UNESCAPED_UNICODE);
+ }
+
+ // dd($data);
+ // ---------- Update DB ----------
+ $sql = "UPDATE claim_dump_files SET status = ?, reason = ? WHERE id = ?";
+
+ $updated = db_connect()->query(
+ $sql,
+ [
+ $data['status'] ?? null,
+ $data['reason'] ?? null,
+ $file_id
+ ]
+ );
+
+ if (!$updated) {
+ $this->myLogger->logme('error', 'Claim dump file update failed for file_id: ' . $file_id);
+ }
+
+ dd(db_connect()->getLastQuery()->getQuery());
+
+ if(!empty($result['status']) && $result['status'] === true){
+ $r = Jobs::addJob(['job_name' => 'tpaClaimDumpToTicketMasterImporters', 'payload' => ['file_id' => $file_id]]);
+ }
+
+ return $result;
+
+ } catch (\Throwable $th) {
+
+ $this->myLogger->logme(
+ "error",
+ 'TPA_CLAIM_IMPORTER_JOB : ' .
+ $th->getMessage() . ' | Line: ' . $th->getLine()
+ );
+
+ return [
+ 'status' => false,
+ 'message' => 'TPA Claim dump import failed',
+ 'error_data' => [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'trace' => $th->getTraceAsString()
+ ]
+ ];
+ }
+ }
+
+ public function tpaClaimDumpToTicketMasterImporters($params)
+ {
+ try {
+
+ $file_id = $params['file_id'] ?? null;
+ $fileData = $this->claimDumpFileModel->where('id', $file_id)->first();
+
+ if (!$fileData) {
+ return ['status' => false, 'message' => 'Invalid file ID No file data found to import'];
+ }
+
+ $handler = TpaClaimsImportFactory::make($fileData['tpa_id'] ?? 0);
+ $result = $handler->runTicketMasterInsert($params);
+
+ return $result;
+
+ } catch (\Throwable $th) {
+
+ $this->myLogger->logme("error", 'TICKET_MASTER_CLAIM_IMPORTER_JOB :' .($th->getMessage() . ' --- ' . $th->getLine() . '----' . $th->getTraceAsString()));
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+
+ return [
+ 'status' => false,
+ 'message' => $th->getMessage(),
+ 'error_data' => json_encode($errorData, JSON_PRETTY_PRINT)
+ ];
+ }
+ }
+
+ public function tpaClaimDumpToTicketMasterImportBatchSeperater($params)
+ {
+ try {
+
+ $file_id = $params['file_id'] ?? null;
+ $fileData = $this->claimDumpFileModel->where('id', $file_id)->first();
+
+ if (!$fileData) {
+ return ['status' => false, 'message' => 'Invalid file ID No file data found to import'];
+ }
+
+ $handler = TpaClaimsImportFactory::make($fileData['tpa_id'] ?? 0);
+ $result = $handler->runTicketMasterInsert($params);
+
+ return $result;
+
+ } catch (\Throwable $th) {
+
+ $this->myLogger->logme("error", 'TICKET_MASTER_CLAIM_IMPORTER_JOB :' .($th->getMessage() . ' --- ' . $th->getLine() . '----' . $th->getTraceAsString()));
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+
+ return [
+ 'status' => false,
+ 'message' => $th->getMessage(),
+ 'error_data' => json_encode($errorData, JSON_PRETTY_PRINT)
+ ];
+ }
+ }
+
+ public function readExcelBySheetName(string $filePath, string $sheetName): array
+ {
+ if (!file_exists($filePath)) {
+ return [];
+ }
+
+ $spreadsheet = IOFactory::load($filePath);
+
+ // Get sheet by name
+ $sheet = $spreadsheet->getSheetByName($sheetName);
+
+ if ($sheet === null) {
+ return [];
+ }
+
+ $rows = $sheet->toArray(null, true, true, true);
+
+ // Need at least header + one row
+ if (count($rows) < 2) {
+ return [];
+ }
+
+ // First row = headers
+ $headers = array_shift($rows);
+ $headers = array_map('trim', $headers);
+
+ $data = [];
+
+ foreach ($rows as $row) {
+ // Skip completely empty rows
+ if (!array_filter($row)) {
+ continue;
+ }
+
+ $item = [];
+
+ foreach ($headers as $key => $headerName) {
+ if ($headerName !== '') {
+ $item[$headerName] = $row[$key] ?? null;
+ }
+ }
+
+ $data[] = $item;
+ }
+
+ return $data;
+ }
+
}
diff --git a/app/Helpers/utility_helper.php b/app/Helpers/utility_helper.php
index 15d873eb..5295224b 100755
--- a/app/Helpers/utility_helper.php
+++ b/app/Helpers/utility_helper.php
@@ -649,7 +649,7 @@ if (!function_exists('change_date_format')) {
$date = DateTime::createFromFormat($source_format, $date_str);
if (!$date) {
// throw new Exception("Invalid date string for source format: $source_format");
- log_message('error', "❌ Date format error : Invalid date string | Params => date_str: {$date_str}, source_format: {$source_format}, output_format: {$output_format}");
+ // log_message('error', "❌ Date format error : Invalid date string | Params => date_str: {$date_str}, source_format: {$source_format}, output_format: {$output_format}");
return null;
}
return $date->format($output_format);
@@ -660,7 +660,7 @@ if (!function_exists('change_date_format')) {
$date = DateTime::createFromFormat($source_format, $date_str);
if (!$date) {
// throw new Exception("Invalid date string for source format: $source_format");
- log_message('error', "❌ Date format error : Invalid date string | Params => date_str: {$date_str}, source_format: {$source_format}, output_format: {$output_format}");
+ // log_message('error', "❌ Date format error : Invalid date string | Params => date_str: {$date_str}, source_format: {$source_format}, output_format: {$output_format}");
return null;
}
return $date->format('Y-m-d'); // MySQL default format
@@ -677,15 +677,15 @@ if (!function_exists('change_date_format')) {
// If no format matches, throw an exception
$allowed_placeholders = implode(', ', $allowed_formats);
// throw new Exception("Invalid date string format. Allowed formats: $allowed_placeholders");
- log_message(
- 'error',
- "❌ Date format error: Invalid date string. Allowed formats: {$allowed_placeholders} | Params => date_str: {$date_str}, source_format: {$source_format}, output_format: {$output_format}"
- );
+ // log_message(
+ // 'error',
+ // "❌ Date format error: Invalid date string. Allowed formats: {$allowed_placeholders} | Params => date_str: {$date_str}, source_format: {$source_format}, output_format: {$output_format}"
+ // );
return null;
}
} catch (Exception $e) {
// return "Error: " . $e->getMessage();
- log_message('error', "❌ Date format error: {$e->getMessage()} | Params => date_str: {$date_str}, source_format: {$source_format}, output_format: {$output_format}");
+ // log_message('error', "❌ Date format error: {$e->getMessage()} | Params => date_str: {$date_str}, source_format: {$source_format}, output_format: {$output_format}");
return null;
}
diff --git a/app/Libraries/TPAClaimsImportServices/AbhiClaimImportService.php b/app/Libraries/TPAClaimsImportServices/AbhiClaimImportService.php
new file mode 100644
index 00000000..1f62ea7f
--- /dev/null
+++ b/app/Libraries/TPAClaimsImportServices/AbhiClaimImportService.php
@@ -0,0 +1,466 @@
+ ["col_name" => "ABHI Claim No", "col_index" => 0], "db_column" => "abhi_claim_no"],
+ ["excel_column" => ["col_name" => "New ABHI Claim No With Extension", "col_index" => 1], "db_column" => "new_abhi_claim_no_with_extension"],
+ ["excel_column" => ["col_name" => "Unique Count", "col_index" => 2], "db_column" => "unique_count"],
+ ["excel_column" => ["col_name" => "Proposer Name", "col_index" => 3], "db_column" => "proposer_name"],
+ ["excel_column" => ["col_name" => "Patient Name", "col_index" => 4], "db_column" => "patient_name"],
+ ["excel_column" => ["col_name" => "Family ID", "col_index" => 5], "db_column" => "family_id"],
+ ["excel_column" => ["col_name" => "Member Code", "col_index" => 6], "db_column" => "member_code"],
+ ["excel_column" => ["col_name" => "Patient Age", "col_index" => 7], "db_column" => "patient_age"],
+ ["excel_column" => ["col_name" => "Relation", "col_index" => 8], "db_column" => "relation"],
+ ["excel_column" => ["col_name" => "Gender", "col_index" => 9], "db_column" => "gender"],
+ ["excel_column" => ["col_name" => "Certificate No", "col_index" => 10], "db_column" => "certificate_no"],
+ ["excel_column" => ["col_name" => "Master Policy No", "col_index" => 11], "db_column" => "master_policy_no"],
+ ["excel_column" => ["col_name" => "Policy Number", "col_index" => 12], "db_column" => "policy_number"],
+ ["excel_column" => ["col_name" => "Policy From", "col_index" => 13], "db_column" => "policy_from"],
+ ["excel_column" => ["col_name" => "Policy Upto", "col_index" => 14], "db_column" => "policy_upto"],
+ ["excel_column" => ["col_name" => "Product Name", "col_index" => 15], "db_column" => "product_name"],
+ ["excel_column" => ["col_name" => "Product Name 1", "col_index" => 16], "db_column" => "product_name_1"],
+ ["excel_column" => ["col_name" => "Sub - Product", "col_index" => 17], "db_column" => "sub_product"],
+ ["excel_column" => ["col_name" => "Policy Category", "col_index" => 18], "db_column" => "policy_category"],
+ ["excel_column" => ["col_name" => "Policy Category (Carry Forward till Q3 18-19)+(New Q4 18-19 Onward)", "col_index" => 19], "db_column" => "policy_category_cf_q3_q4"],
+ ["excel_column" => ["col_name" => "Sum Insured", "col_index" => 20], "db_column" => "sum_insured"],
+ ["excel_column" => ["col_name" => "Bonus", "col_index" => 21], "db_column" => "bonus"],
+ ["excel_column" => ["col_name" => "Intimation Date", "col_index" => 22], "db_column" => "intimation_date"],
+ ["excel_column" => ["col_name" => "Date Of Doc Rec", "col_index" => 23], "db_column" => "date_of_doc_rec"],
+ ["excel_column" => ["col_name" => "Intimation Final Month", "col_index" => 24], "db_column" => "intimation_final_month"],
+ ["excel_column" => ["col_name" => "Reported Year", "col_index" => 25], "db_column" => "reported_year"],
+ ["excel_column" => ["col_name" => "Reported Qurter", "col_index" => 26], "db_column" => "reported_quarter"],
+ ["excel_column" => ["col_name" => "Hospital Name", "col_index" => 27], "db_column" => "hospital_name"],
+ ["excel_column" => ["col_name" => "Hospital City", "col_index" => 28], "db_column" => "hospital_city"],
+ ["excel_column" => ["col_name" => "Hospital State", "col_index" => 29], "db_column" => "hospital_state"],
+ ["excel_column" => ["col_name" => "Diagnosis", "col_index" => 30], "db_column" => "diagnosis"],
+ ["excel_column" => ["col_name" => "ICD Chapter", "col_index" => 31], "db_column" => "icd_chapter"],
+ ["excel_column" => ["col_name" => "ICD Block", "col_index" => 32], "db_column" => "icd_block"],
+ ["excel_column" => ["col_name" => "ICD Level1", "col_index" => 33], "db_column" => "icd_level1"],
+ ["excel_column" => ["col_name" => "ICD Level2", "col_index" => 34], "db_column" => "icd_level2"],
+ ["excel_column" => ["col_name" => "Procedure Description", "col_index" => 35], "db_column" => "procedure_description"],
+ ["excel_column" => ["col_name" => "PCS Description", "col_index" => 36], "db_column" => "pcs_description"],
+ ["excel_column" => ["col_name" => "DOA", "col_index" => 37], "db_column" => "doa"],
+ ["excel_column" => ["col_name" => "DOD", "col_index" => 38], "db_column" => "dod"],
+ ["excel_column" => ["col_name" => "Claim Type", "col_index" => 39], "db_column" => "claim_type"],
+ ["excel_column" => ["col_name" => "Claim Category", "col_index" => 40], "db_column" => "claim_category"],
+ ["excel_column" => ["col_name" => "Disc Datails", "col_index" => 41], "db_column" => "disc_details"],
+ ["excel_column" => ["col_name" => "Disc Date", "col_index" => 42], "db_column" => "disc_date"],
+ ["excel_column" => ["col_name" => "Hospital Code", "col_index" => 43], "db_column" => "hospital_code"],
+ ["excel_column" => ["col_name" => "Claim Status", "col_index" => 44], "db_column" => "claim_status"],
+ ["excel_column" => ["col_name" => "Final ABHI Status-Current Month", "col_index" => 45], "db_column" => "final_abhi_status_current_month"],
+ ["excel_column" => ["col_name" => "Claimed Amount", "col_index" => 46], "db_column" => "claimed_amount"],
+ ["excel_column" => ["col_name" => "ABHI Amount Less Coins - Current Month", "col_index" => 47], "db_column" => "abhi_amount_less_coins_current_month"],
+ ["excel_column" => ["col_name" => "Repudiation Date", "col_index" => 48], "db_column" => "repudiation_date"],
+ ["excel_column" => ["col_name" => "Settled Date", "col_index" => 49], "db_column" => "settled_date"],
+ ["excel_column" => ["col_name" => "Settled Month", "col_index" => 50], "db_column" => "settled_month"],
+ ["excel_column" => ["col_name" => "Settled Year", "col_index" => 51], "db_column" => "settled_year"],
+ ["excel_column" => ["col_name" => "Settled Quarter", "col_index" => 52], "db_column" => "settled_quarter"],
+ ["excel_column" => ["col_name" => "Rejection Category", "col_index" => 53], "db_column" => "rejection_category"],
+ ["excel_column" => ["col_name" => "Rejection Category - Level 1", "col_index" => 54], "db_column" => "rejection_category_level_1"],
+ ["excel_column" => ["col_name" => "Rejection Category - Level 2", "col_index" => 55], "db_column" => "rejection_category_level_2"],
+ ["excel_column" => ["col_name" => "COVID tagging - Current Month", "col_index" => 56], "db_column" => "covid_tagging_current_month"],
+ ["excel_column" => ["col_name" => "EXPECTED DOA", "col_index" => 57], "db_column" => "expected_doa"],
+ ["excel_column" => ["col_name" => "EXPECTED DOD", "col_index" => 58], "db_column" => "expected_dod"],
+ ["excel_column" => ["col_name" => "AGENT/BROKER CODE", "col_index" => 59], "db_column" => "agent_broker_code"],
+ ["excel_column" => ["col_name" => "AGENT/BROKER NAME", "col_index" => 60], "db_column" => "agent_broker_name"],
+ ["excel_column" => ["col_name" => "HEALTHCARD_ID", "col_index" => 61], "db_column" => "healthcard_id"],
+ ["excel_column" => ["col_name" => "ABHI_NETWORK_NON_NETWORK", "col_index" => 62], "db_column" => "abhi_network_non_network"],
+ ["excel_column" => ["col_name" => "CORPORATE_EMPLOYEE_CODE", "col_index" => 63], "db_column" => "corporate_employee_code"],
+ ];
+
+
+ protected $ticketMasterMapping = [
+
+ // Employee / Member details
+ 'member_code' => 'emp_code',
+ 'relation' => 'relationship',
+
+ // Policy / Claim identifiers
+ 'policy_number' => 'policy_no',
+ 'abhi_claim_no' => 'claim_number',
+
+ // Dates
+ 'doa' => 'doa',
+ 'dod' => 'dod',
+ 'intimation_date' => 'date_of_intimat',
+
+ // Claim info
+ 'claim_status' => 'tpa_claim_status',
+ 'claimed_amount' => 'claim_amount',
+
+ // Hospital details
+ 'hospital_name' => 'hospital_name',
+ 'hospital_city' => 'hospital_city',
+ 'hospital_state' => 'hospital_state',
+
+ // Settlement / decision
+ 'repudiation_date' => 'denial_date',
+ 'settled_date' => 'settled_date',
+ 'rejection_category' => 'denial_reason',
+
+ // Misc
+ 'diagnosis' => 'claim_description',
+ 'healthcard_id' => 'tpa_no',
+
+ 'priority' => 1,
+ 'mode_of_intimation' => 5,
+ 'ticket_type_id' => 1,
+ ];
+
+
+ protected $statusMapping = [
+ 'Settled' => 11,
+ 'Rejected' => 8,
+ 'Cancelled' => 13,
+ ];
+
+
+ /**
+ * ABSTRACT FUNCTIONs
+ */
+ public function bulkInsertTPATable(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_abhi');
+
+ foreach ($data as $value) {
+
+ if (!$builder->insert($value)) {
+
+ // 🔍 Debug purpose
+ log_message('error', print_r($this->db->error(), true));
+ log_message('error', $this->db->getLastQuery());
+
+ return false;
+ }
+ }
+
+ return true;
+ }
+
+
+ public function importClaimMaster(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $ticketMasterModel = new TicketMasterModel();
+ $ticketMasterModel->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketIdInTPATable(): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_abhi');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketMasterRejectedReasonInTPATable($data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_abhi');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ /**
+ * MAPPING FUNCTIONs
+ */
+
+ public function mapTPAData(array $rows, $file_id): array
+ {
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $mapped = [];
+
+ foreach ($rows as $row) {
+
+ $item = [];
+
+ foreach ($this->mapping as $map) {
+ $excelColumn = $map['excel_column']['col_name'];
+ $dbColumn = $map['db_column'];
+
+ $value = $row[$excelColumn] ?? null;
+
+ if ($this->isDateValue($value)) {
+ $value = $this->normalizeDate($value);
+ }
+
+ $item[$dbColumn] = trim($value);
+ }
+
+ $params = [
+ 'doa' => $item['doa'] ?? null,
+ 'member_code' => $item['member_code'] ?? null,
+ 'claimed_amount' => $item['claimed_amount'] ?? null,
+ 'healthcard_id' => $item['healthcard_id'] ?? null
+ ];
+
+ $is_duplicate = $this->checkDuplicateTpaClaim('claims_dump_abhi', $params);
+
+ if ($is_duplicate) {
+ $item = [];
+ continue;
+ }
+
+ $item['file_id'] = $file_id ?? null;
+ $item['client_id'] = $file_data['client_id'] ?? null;
+ $item['client_policy_id'] = $file_data['client_policy_id'] ?? null;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+
+ $mapped[] = $item;
+ }
+
+ return $mapped;
+ }
+
+ public function mapClaimMasterData($file_id): array
+ {
+
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $tpaClaimDumpData = $this->getTpaClaimDumpData('claims_dump_abhi', ['file_id' => $file_id]);
+
+ if (empty($tpaClaimDumpData)) {
+ return ['status' => false, 'message' => "No data to insert in TICKET MASTER"];
+ }
+
+
+ $ClientPolicyModel = new ClientPolicyModel();
+ $client_policy_data = $ClientPolicyModel
+ ->select("
+ client_policy.*,
+ (
+ SELECT id
+ FROM client_rm
+ WHERE is_active = 1
+ AND level = 3
+ AND client_id = client_policy.client_id
+ ORDER BY id ASC
+ LIMIT 1
+ ) AS acm_id
+ ")
+ ->where('client_policy.id', $file_data['client_policy_id'])
+ ->where('client_policy.is_active', 1)
+ ->first();
+
+ try {
+
+ $mapped = [];
+ $rejecetd_reason = [];
+
+ foreach ($tpaClaimDumpData as $row) {
+
+ $params = [
+ 'doa' => change_date_format($row['doa'] ?? '') ?? null,
+ 'emp_code' => $row['member_code'] ?? null,
+ 'claim_amount' => $row['claimed_amount'] ?? null,
+ 'tpa_no' => $row['healthcard_id'] ?? null
+ ];
+
+ $isduplicate = $this->checkDublicateTicketMasterClaim($params);
+
+ if ($isduplicate) {
+ $reason = "This claim already exists in our system.";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ $item = [];
+
+ $item['client_id'] = $client_policy_data['client_id'] ?? null;
+ $item['client_policy_id'] = $client_policy_data['id'] ?? null;
+ $item['insurer_id'] = $client_policy_data['insurer_id'] ?? null;
+ $item['tpa_id'] = $client_policy_data['tpa_id'] ?? null;
+ $item['acm_id'] = $client_policy_data['acm_id'] ?? null;
+ $item['policy_no'] = $client_policy_data['policy_no'] ?? null;
+ $item['relationship'] = $this->convertRelation($row['relation'] ?? null);
+
+ $employee_data = $this->getEmployeeDetails($file_data['client_id'], $file_data['client_policy_id'], $row['member_code'], $item['relationship']);
+
+ if (!empty($employee_data)) {
+ $item['emp_id'] = $employee_data['id'] ?? null;
+ $item['emp_name'] = $employee_data['name'] ?? null;
+ $item['emp_mail'] = $employee_data['email_corporate'] ?? null;
+ $item['emp_mobile'] = $employee_data['mobile'] ?? null;
+ $item['insured_emp_id'] = $employee_data['insured_emp_id'] ?? null;
+ $item['insured_name'] = $employee_data['insured_name'] ?? null;
+ } else {
+
+ $reason = sprintf(
+ 'The policy number "%s" does not exist in our system. ' .
+ 'Details - Client ID: %s, Client Policy ID: %s, Employee Number: %s, Relationship: %s',
+ $row['insurer_policy_number'],
+ $file_data['client_id'],
+ $file_data['client_policy_id'],
+ $row['employee_number'],
+ $item['relationship']
+ );
+
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ foreach ($this->ticketMasterMapping as $tpaKey => $ticketMasterKey) {
+ $item[$ticketMasterKey] = array_key_exists($tpaKey, $row) ? $row[$tpaKey] : null;
+ }
+
+ // Meta fields
+ $item['claim_status_id'] = $statusMapping[$row['claim_status']] ?? 61;
+ $item['file_id'] = $file_id;
+ $item['claim_dump_ref_id'] = $row['id'];
+ $item['created_by'] = $file_data['created_by'] ?? null;
+ $item['claim_type'] = isset($row['mainclaim_prepost_type']) && !empty($row['mainclaim_prepost_type']) && strtolower($row['mainclaim_prepost_type']) == 'normal' ? 1 : 3;
+
+ $mapped[] = $item;
+ }
+
+ return ['status' => true, 'mapped_array' => $mapped, 'rejected_reason_array' => $rejecetd_reason];
+ } catch (\Throwable $th) {
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+
+ return ['status' => false, "message" => $errorData['message'], 'error_data' => $errorData];
+ }
+ }
+
+
+ /**
+ * HELPER FUNCTIONs
+ */
+
+ public function isDateValue($value): bool
+ {
+ if (empty($value)) {
+ return false;
+ }
+
+ // Excel numeric date
+ if (is_numeric($value) && $value > 30000) {
+ return true;
+ }
+
+ return strtotime(str_replace('/', '-', $value)) !== false;
+ }
+
+ public function normalizeDate($value): ?string
+ {
+ try {
+ if (empty($value)) {
+ return null;
+ }
+
+ // Excel numeric date
+ if (is_numeric($value)) {
+ return date(
+ 'Y-m-d',
+ \PhpOffice\PhpSpreadsheet\Shared\Date::excelToTimestamp($value)
+ );
+ }
+
+ $value = trim((string) $value);
+
+ // Replace / with - for strtotime compatibility
+ $value = str_replace('/', '-', $value);
+
+ $timestamp = strtotime($value);
+
+ if ($timestamp === false) {
+ return null;
+ }
+
+ return date('Y-m-d', $timestamp);
+
+ } catch (\Throwable $e) {
+ return null;
+ }
+ }
+
+ public function convertRelation(?string $relation): ?string
+ {
+ if (empty($relation)) {
+ return null;
+ }
+
+ $relation = strtolower($relation);
+
+ if (str_contains($relation, 'self')) {
+ return 'self';
+ }
+
+ if (str_contains($relation, 'spouse') || str_contains($relation, 'wife') || str_contains($relation, 'husband')) {
+ return 'spouse';
+ }
+
+ if (str_contains($relation, 'daughter')) {
+ return 'daughter';
+ }
+
+ if (str_contains($relation, 'son')) {
+ return 'son';
+ }
+
+ if (str_contains($relation, 'father in law') || str_contains($relation, 'father-in-law')) {
+ return 'father-in-law';
+ }
+
+ if (str_contains($relation, 'mother in law') || str_contains($relation, 'mother-in-law')) {
+ return 'mother-in-law';
+ }
+
+ if (str_contains($relation, 'father')) {
+ return 'father';
+ }
+
+ if (str_contains($relation, 'mother')) {
+ return 'mother';
+ }
+
+ return null; // unmatched case
+ }
+
+}
diff --git a/app/Libraries/TPAClaimsImportServices/BaseTpaClaimImportService.php b/app/Libraries/TPAClaimsImportServices/BaseTpaClaimImportService.php
new file mode 100644
index 00000000..33fbedc9
--- /dev/null
+++ b/app/Libraries/TPAClaimsImportServices/BaseTpaClaimImportService.php
@@ -0,0 +1,368 @@
+db = db_connect();
+ $this->claimDumpFileModel = new ClaimDumpFileModel();
+ }
+
+ /**
+ * First JOB for insert TPA wise Bulk Upload
+ */
+ public function runTpaClaimDumpInsert(string $filePath, int $fileId): array
+ {
+ $this->db->transStart();
+
+ $fileData = $this->claimDumpFileModel->where('id', $fileId)->first();
+
+ if (env('FHPL_PRIMARY_KEY_CONSTANT') == $fileData['tpa_id']) {
+ $rows = $this->readExcelBySheetName($filePath, 'Claims&Preauth');
+ } else if (env('R_CARE_PRIMARY_KEY_CONSTANT') == $fileData['tpa_id']) {
+ $rows = $this->readExcelBySheetName($filePath, 'CL');
+ // $AL = $this->readExcelBySheetName($filePath, 'AL');
+ // $rows = array_merge($CL, $AL);
+ } else {
+ $rows = $this->readExcel($filePath);
+ }
+ // dd($rows);
+
+ if (empty($rows)) {
+ return ['status' => false, 'message' => 'Excel file contains no data or wrong file upload'];
+ }
+
+ $tpaInsertData = $this->mapTPAData($rows, $fileId);
+ dd($tpaInsertData);
+
+ if (empty($tpaInsertData)) {
+ return ['status' => false, 'message' => 'These records already exist in the system.'];
+ }
+
+ if (env('FHPL_PRIMARY_KEY_CONSTANT') == $fileData['tpa_id']) {
+ $ClaimsDumpFhplModel = $this->db->table('claims_dump_fhpl');
+ $return_res = $ClaimsDumpFhplModel->insertBatch($tpaInsertData);
+ } else if (env('R_CARE_PRIMARY_KEY_CONSTANT') == $fileData['tpa_id']) {
+ $ClaimsDumpIciciModel = $this->db->table('claims_dump_reliance');
+ $return_res = $ClaimsDumpIciciModel->insertBatch($tpaInsertData);
+ } else if (env('ICICI_PRIMARY_KEY_CONSTANT') == $fileData['tpa_id']) {
+ $ClaimsDumpIciciModel = $this->db->table('claims_dump_icici');
+ $return_res = $ClaimsDumpIciciModel->insertBatch($tpaInsertData);
+ } else if (env('ABHI_PRIMARY_KEY_CONSTANT') == $fileData['tpa_id']) {
+ // $ClaimsDumpAbhiModel = $this->db->table('claims_dump_abhi');
+ // $return_res = $ClaimsDumpAbhiModel->insertBatch($tpaInsertData);
+ $return_res = $this->bulkInsertTPATable($tpaInsertData);
+ } else if (env('VIDAL_PRIMARY_KEY_CONSTANT') == $fileData['tpa_id']) {
+ $ClaimsDumpVidalModel = $this->db->table('claims_dump_vidal');
+ $return_res = $ClaimsDumpVidalModel->insertBatch($tpaInsertData);
+ } else if (env('MEDI_ASSIST_PRIMARY_KEY_CONSTANT') == $fileData['tpa_id']) {
+ $ClaimsDumpMediAssistModel = $this->db->table('claims_dump_medi_assist');
+ $return_res = $ClaimsDumpMediAssistModel->insertBatch($tpaInsertData);
+ } else{
+
+ }
+
+ // $return_res = $this->bulkInsertTPATable($tpaInsertData);
+
+ if (!$return_res) {
+ return ['status' => false, 'message' => 'TPA Import bulk insert failed'];
+ }
+
+ $this->db->transComplete();
+
+ if ($this->db->transStatus() === false) {
+
+ $error = $this->db->error();
+
+ $error_data = [
+ 'message' => $error['message'] ?: 'Unknown DB error',
+ 'code' => $error['code'] ?? null,
+ 'last_query' => (string) $this->db->getLastQuery()
+ ];
+
+ // dd($error_data);
+ // unset($error_data['last_query']);
+ return ['status' => false, 'message' => 'TPA Import transaction failed', 'error_data' => $error_data];
+ }
+
+ return ['status' => true, 'message' => 'File uploaded successfully', 'record_count' => count($tpaInsertData ?? [])];
+ }
+
+ /**
+ * Second JOB for insert Ticket Master table after insert the TPA bulk upload success
+ */
+ public function runTicketMasterInsert(array $params): array
+ {
+ $this->db->transStart();
+
+ $file_id = $params['file_id'];
+
+ $ticketMasterData = $this->mapClaimMasterData($file_id);
+
+ if (!$ticketMasterData['status']) {
+ return $ticketMasterData;
+ }
+
+ $return_res = $this->importClaimMaster($ticketMasterData['mapped_array']);
+
+ if(!$return_res){
+ return ['status' => false, 'message' => 'Ticket Master Claim bulk insert failed'];
+ }
+
+ $this->updateTicketMasterRejectedReasonInTPATable($ticketMasterData['rejected_reason_array']);
+
+ $this->db->transComplete();
+
+ if ($this->db->transStatus() === false) {
+ return ['status' => false, 'message' => 'Ticket Master Claim bulk insert failed'];
+ }
+
+
+
+ return ['status' => true, 'message' => 'Ticket Master Claim inserted successfully'];
+
+ }
+
+ /**
+ * Read Excel and return associative rows (header based)
+ */
+ protected function readExcel(string $filePath): array
+ {
+ helper('excel_util_helper');
+
+ if (!file_exists($filePath)) {
+ throw new RuntimeException("File not found: {$filePath}");
+ }
+
+ $spreadsheet = IOFactory::load($filePath);
+ $sheet = $spreadsheet->getActiveSheet();
+
+ $rows = $sheet->toArray(null, true, true, true);
+
+ // dd($rows);
+
+ if (count($rows) < 2) {
+ return [];
+ }
+
+ // First row is header
+ $headers = array_shift($rows);
+ $headers = array_map('trim', $headers);
+
+ $data = [];
+
+ foreach ($rows as $row) {
+
+ if(check_row_is_empty_or_null($row)){
+ break;
+ }
+
+ $item = [];
+ foreach ($headers as $key => $headerName) {
+ if ($headerName !== '') {
+ $item[$headerName] = $row[$key] ?? null;
+ }
+ }
+ $data[] = $item;
+ }
+
+ return $data;
+ }
+
+ /**
+ * Read Excel By Sheet name and return associative rows (header based)
+ */
+
+ protected function readExcelBySheetName(string $filePath, string $sheetName): array
+ {
+ if (!file_exists($filePath)) {
+ throw new RuntimeException("File not found: {$filePath}");
+ }
+
+ $spreadsheet = IOFactory::load($filePath);
+
+ // Get sheet by name
+ $sheet = $spreadsheet->getSheetByName($sheetName);
+
+ if ($sheet === null) {
+ throw new RuntimeException("Sheet '{$sheetName}' not found in Excel file");
+ }
+
+ $rows = $sheet->toArray(null, true, true, true);
+
+ // Need at least header + one row
+ if (count($rows) < 2) {
+ return [];
+ }
+
+ // First row = headers
+ $headers = array_shift($rows);
+ $headers = array_map('trim', $headers);
+
+ $data = [];
+
+ foreach ($rows as $row) {
+ // Skip completely empty rows
+ if (!array_filter($row)) {
+ continue;
+ }
+
+ $item = [];
+
+ foreach ($headers as $key => $headerName) {
+ if ($headerName !== '') {
+ $item[$headerName] = $row[$key] ?? null;
+ }
+ }
+
+ $data[] = $item;
+ }
+
+ return $data;
+ }
+
+
+ /**
+ * Dublicate check in the ticket_master table records
+ */
+ protected function checkDublicateTicketMasterClaim(array $param): bool
+ {
+ $ticketMaster = new TicketMasterModel();
+ $ticket_master_data = $ticketMaster
+ ->where('doa', $param['doa'])
+ ->where('tpa_no', $param['tpa_no'])
+ ->where('claim_amount', $param['claim_amount'])
+ ->where('emp_code', $param['emp_code'])
+ ->where('is_active', 1)
+ ->findAll();
+
+ if(count($ticket_master_data) > 0){
+ return true;
+ }
+
+ return false;
+ }
+
+ /**
+ * Dublicate check in the TPA specific table records
+ */
+ protected function checkDuplicateTpaClaim(string $table, array $params): bool
+ {
+ return $this->db->table($table)
+ ->where($params)
+ ->where('is_active', 1)
+ ->countAllResults() > 0;
+ }
+
+ /**
+ * Dublicate check in the TPA specific table records
+ */
+ protected function getTpaClaimDumpData(string $table, array $params): array
+ {
+ $tpaClaimDumpDataCount = $this->db
+ ->table($table)
+ ->where('is_active', 1)
+ ->where('file_id', $params['file_id'])
+ ->where('ticket_id IS NULL')
+ ->countAllResults();
+
+ $batch_size = 100;
+ $total_batch = (int) ceil($tpaClaimDumpDataCount / $batch_size);
+ $batch_no = isset($params['batch_no']) ? (int) $params['batch_no'] : null;
+ $last_emp_id = (int) ($params['last_emp_id'] ?? 0);
+
+
+ return $this->db
+ ->table($table)
+ ->where('is_active', 1)
+ ->where('file_id', $params['file_id'])
+ ->where('ticket_id IS NULL')
+ ->get()
+ ->getResultArray();
+
+ }
+
+ /**
+ * Dublicate check in the TPA specific table records
+ */
+ public function getEmployeeDetails(int $client_id, int $client_policy_id, string $emp_code, string $relation): array
+ {
+ $EmployeeModel = new EmployeeModel();
+ $employeeData = $EmployeeModel
+ ->select([
+ 'employees.id AS emp_id',
+ 'employees.email_corporate AS emp_mail',
+ 'employees.mobile AS emp_mobile',
+ 'employees.name AS emp_name',
+
+ // insured employee
+ 'insured.id AS insured_emp_id',
+ 'insured.name AS insured_name'
+ ])
+ ->join(
+ 'employee_polices',
+ 'employees.id = employee_polices.employee_id'
+ )
+ ->join(
+ 'employees AS insured',
+ "insured.emp_code = employees.emp_code
+ AND insured.client_id = employees.client_id
+ AND LOWER(insured.relationship) = " . $EmployeeModel->db->escape(strtolower($relation)),
+ 'left'
+ )
+ ->where('employees.is_active', 1)
+ ->where('employee_polices.is_active', 1)
+ ->where('employee_polices.client_policy_id', $client_policy_id)
+ ->where('employees.client_id', $client_id)
+ ->where('employees.emp_code', $emp_code)
+ ->where('LOWER(employees.relationship)', 'self')
+ ->first();
+
+
+ return $employeeData ?? [];
+ }
+
+ /**
+ * Map Excel rows to TPA table structure
+ */
+ abstract protected function mapTPAData(array $rows, $fileId): array;
+
+ /**
+ * Map DB rows to Ticket Master table structure
+ */
+ abstract protected function mapClaimMasterData($fileId): array;
+
+ /**
+ * Insert into TPA-specific table (bulk)
+ */
+ abstract protected function bulkInsertTPATable(array $data): bool;
+
+ /**
+ * Insert into Ticket-Master-specific table (bulk)
+ */
+ abstract protected function importClaimMaster(array $data): bool;
+
+ /**
+ * Update TPA table with ticket_master primary key
+ */
+ abstract protected function updateTicketIdInTPATable(): bool;
+
+ /**
+ * Update TPA table with ticket_master insert rejected reason
+ */
+ abstract protected function updateTicketMasterRejectedReasonInTPATable(array $data): bool;
+}
diff --git a/app/Libraries/TPAClaimsImportServices/FhplClaimImportService.php b/app/Libraries/TPAClaimsImportServices/FhplClaimImportService.php
new file mode 100644
index 00000000..ced6c2f3
--- /dev/null
+++ b/app/Libraries/TPAClaimsImportServices/FhplClaimImportService.php
@@ -0,0 +1,503 @@
+["col_name"=>"Requesttype","col_index"=>0],"db_column"=>"request_type"],
+ ["excel_column"=>["col_name"=>"Intimation ID","col_index"=>1],"db_column"=>"intimation_id"],
+ ["excel_column"=>["col_name"=>"Intimation Date","col_index"=>2],"db_column"=>"intimation_date"],
+ ["excel_column"=>["col_name"=>"claimid","col_index"=>3],"db_column"=>"claim_id"],
+ ["excel_column"=>["col_name"=>"slno","col_index"=>4],"db_column"=>"sl_no"],
+ ["excel_column"=>["col_name"=>"UHIDNO","col_index"=>5],"db_column"=>"uhid_no"],
+ ["excel_column"=>["col_name"=>"Membername","col_index"=>6],"db_column"=>"member_name"],
+ ["excel_column"=>["col_name"=>"Main Memuhidno","col_index"=>7],"db_column"=>"main_member_uhid_no"],
+ ["excel_column"=>["col_name"=>"Main Memname","col_index"=>8],"db_column"=>"main_member_name"],
+ ["excel_column"=>["col_name"=>"Gender","col_index"=>9],"db_column"=>"gender"],
+ ["excel_column"=>["col_name"=>"DOB","col_index"=>10],"db_column"=>"dob"],
+ ["excel_column"=>["col_name"=>"Yrs","col_index"=>11],"db_column"=>"years"],
+ ["excel_column"=>["col_name"=>"relationship","col_index"=>12],"db_column"=>"relationship"],
+ ["excel_column"=>["col_name"=>"employeeid","col_index"=>13],"db_column"=>"employee_id"],
+ ["excel_column"=>["col_name"=>"Mobile","col_index"=>14],"db_column"=>"mobile"],
+ ["excel_column"=>["col_name"=>"Email","col_index"=>15],"db_column"=>"email"],
+ ["excel_column"=>["col_name"=>"Policy No","col_index"=>16],"db_column"=>"policy_no"],
+ ["excel_column"=>["col_name"=>"Policy Start Date","col_index"=>17],"db_column"=>"policy_start_date"],
+ ["excel_column"=>["col_name"=>"Policy Commencing Date","col_index"=>18],"db_column"=>"policy_commencing_date"],
+ ["excel_column"=>["col_name"=>"Policy Expiry Date","col_index"=>19],"db_column"=>"policy_expiry_date"],
+ ["excel_column"=>["col_name"=>"Organisationname","col_index"=>20],"db_column"=>"organisation_name"],
+ ["excel_column"=>["col_name"=>"Claimreceiveddate","col_index"=>21],"db_column"=>"claim_received_date"],
+ ["excel_column"=>["col_name"=>"Admdate","col_index"=>22],"db_column"=>"admission_date"],
+ ["excel_column"=>["col_name"=>"Dis Date","col_index"=>23],"db_column"=>"discharge_date"],
+ ["excel_column"=>["col_name"=>"Diagnosis","col_index"=>24],"db_column"=>"diagnosis"],
+ ["excel_column"=>["col_name"=>"Service Type","col_index"=>25],"db_column"=>"service_type"],
+ ["excel_column"=>["col_name"=>"Service Sub Type","col_index"=>26],"db_column"=>"service_sub_type"],
+ ["excel_column"=>["col_name"=>"icdcode First Level","col_index"=>27],"db_column"=>"icd_code_first_level"],
+ ["excel_column"=>["col_name"=>"icdcode Second Level","col_index"=>28],"db_column"=>"icd_code_second_level"],
+ ["excel_column"=>["col_name"=>"icdcode Third Level","col_index"=>29],"db_column"=>"icd_code_third_level"],
+ ["excel_column"=>["col_name"=>"Claim Type","col_index"=>30],"db_column"=>"claim_type"],
+ ["excel_column"=>["col_name"=>"Providername","col_index"=>31],"db_column"=>"provider_name"],
+ ["excel_column"=>["col_name"=>"provideraddress","col_index"=>32],"db_column"=>"provider_address"],
+ ["excel_column"=>["col_name"=>"providerplace","col_index"=>33],"db_column"=>"provider_place"],
+ ["excel_column"=>["col_name"=>"providerstate","col_index"=>34],"db_column"=>"provider_state"],
+ ["excel_column"=>["col_name"=>"Provider Pincode","col_index"=>35],"db_column"=>"provider_pincode"],
+ ["excel_column"=>["col_name"=>"PROVIDERTYPE","col_index"=>36],"db_column"=>"provider_type"],
+ ["excel_column"=>["col_name"=>"Provider Identification","col_index"=>37],"db_column"=>"provider_identification"],
+ ["excel_column"=>["col_name"=>"coverageamount","col_index"=>38],"db_column"=>"coverage_amount"],
+ ["excel_column"=>["col_name"=>"claimamount","col_index"=>39],"db_column"=>"claim_amount"],
+ ["excel_column"=>["col_name"=>"billedamount","col_index"=>40],"db_column"=>"billed_amount"],
+ ["excel_column"=>["col_name"=>"Disallowed Amount","col_index"=>41],"db_column"=>"disallowed_amount"],
+ ["excel_column"=>["col_name"=>"Dis Allowence Reason1","col_index"=>42],"db_column"=>"dis_allowance_reason_1"],
+ ["excel_column"=>["col_name"=>"Dis Allowence Reason2","col_index"=>43],"db_column"=>"dis_allowance_reason_2"],
+ ["excel_column"=>["col_name"=>"settledamt","col_index"=>44],"db_column"=>"settled_amount"],
+ ["excel_column"=>["col_name"=>"Incurred Amount","col_index"=>45],"db_column"=>"incurred_amount"],
+ ["excel_column"=>["col_name"=>"Discountamount","col_index"=>46],"db_column"=>"discount_amount"],
+ ["excel_column"=>["col_name"=>"TDSAmount","col_index"=>47],"db_column"=>"tds_amount"],
+ ["excel_column"=>["col_name"=>"Net Amount Paid","col_index"=>48],"db_column"=>"net_amount_paid"],
+ ["excel_column"=>["col_name"=>"Co Payment","col_index"=>49],"db_column"=>"co_payment"],
+ ["excel_column"=>["col_name"=>"Current Claim Status","col_index"=>50],"db_column"=>"current_claim_status"],
+ ["excel_column"=>["col_name"=>"Balance Suminsured","col_index"=>51],"db_column"=>"balance_sum_insured"],
+ ["excel_column"=>["col_name"=>"Chequeno","col_index"=>52],"db_column"=>"cheque_no"],
+ ["excel_column"=>["col_name"=>"chequedate","col_index"=>53],"db_column"=>"cheque_date"],
+ ["excel_column"=>["col_name"=>"Claim Passed Date","col_index"=>54],"db_column"=>"claim_passed_date"],
+ ["excel_column"=>["col_name"=>"Settled Date","col_index"=>55],"db_column"=>"settled_date"],
+ ["excel_column"=>["col_name"=>"Pending Remarks","col_index"=>56],"db_column"=>"pending_remarks"],
+ ["excel_column"=>["col_name"=>"Ir Investigation","col_index"=>57],"db_column"=>"ir_investigation"],
+ ["excel_column"=>["col_name"=>"Date of IR","col_index"=>58],"db_column"=>"ir_date"],
+ ["excel_column"=>["col_name"=>"Date of IRretrieval Date","col_index"=>59],"db_column"=>"ir_retrieval_date"],
+ ["excel_column"=>["col_name"=>"first Reminder","col_index"=>60],"db_column"=>"first_reminder"],
+ ["excel_column"=>["col_name"=>"Second Reminder","col_index"=>61],"db_column"=>"second_reminder"],
+ ["excel_column"=>["col_name"=>"Rejection Remarks","col_index"=>62],"db_column"=>"rejection_remarks"],
+ ["excel_column"=>["col_name"=>"Payee name","col_index"=>63],"db_column"=>"payee_name"],
+ ["excel_column"=>["col_name"=>"Treatment Type","col_index"=>64],"db_column"=>"treatment_type"],
+ ["excel_column"=>["col_name"=>"roomdays","col_index"=>65],"db_column"=>"room_days"],
+ ["excel_column"=>["col_name"=>"icudays","col_index"=>66],"db_column"=>"icu_days"],
+ ["excel_column"=>["col_name"=>"totalstay","col_index"=>67],"db_column"=>"total_stay"],
+ ["excel_column"=>["col_name"=>"Room Rent Claimed","col_index"=>68],"db_column"=>"room_rent_claimed"],
+ ["excel_column"=>["col_name"=>"ICU Claimed","col_index"=>69],"db_column"=>"icu_claimed"],
+ ["excel_column"=>["col_name"=>"ICU Related","col_index"=>70],"db_column"=>"icu_related"],
+ ["excel_column"=>["col_name"=>"Nursing Claimed","col_index"=>71],"db_column"=>"nursing_claimed"],
+ ["excel_column"=>["col_name"=>"Nursing Charges","col_index"=>72],"db_column"=>"nursing_charges"],
+ ["excel_column"=>["col_name"=>"Room Rent Related","col_index"=>73],"db_column"=>"room_rent_related"],
+ ["excel_column"=>["col_name"=>"Professional Charges","col_index"=>74],"db_column"=>"professional_charges"],
+ ["excel_column"=>["col_name"=>"Drugs Medication Consumables Investigationsetc","col_index"=>75],"db_column"=>"drugs_medication_consumables"],
+ ["excel_column"=>["col_name"=>"Investigations Procedures IP","col_index"=>76],"db_column"=>"investigations_procedures_ip"],
+ ["excel_column"=>["col_name"=>"Domicillary Hospitalization","col_index"=>77],"db_column"=>"domicillary_hospitalization"],
+ ["excel_column"=>["col_name"=>"Maternity","col_index"=>78],"db_column"=>"maternity"],
+ ["excel_column"=>["col_name"=>"Day Care","col_index"=>79],"db_column"=>"day_care"],
+ ["excel_column"=>["col_name"=>"Operation Theatre","col_index"=>80],"db_column"=>"operation_theatre"],
+ ["excel_column"=>["col_name"=>"Organ Donar","col_index"=>81],"db_column"=>"organ_donor"],
+ ["excel_column"=>["col_name"=>"Ancilliary Services","col_index"=>82],"db_column"=>"ancillary_services"],
+ ["excel_column"=>["col_name"=>"Dental","col_index"=>83],"db_column"=>"dental"],
+ ["excel_column"=>["col_name"=>"Out Patient Coverage","col_index"=>84],"db_column"=>"out_patient_coverage"],
+ ["excel_column"=>["col_name"=>"Personal Accident","col_index"=>85],"db_column"=>"personal_accident"],
+ ["excel_column"=>["col_name"=>"Critical Illness","col_index"=>86],"db_column"=>"critical_illness"],
+ ["excel_column"=>["col_name"=>"Health Check Up","col_index"=>87],"db_column"=>"health_check_up"],
+ ["excel_column"=>["col_name"=>"Spectacles Contact Lenses Hearing Aid","col_index"=>88],"db_column"=>"spectacles_contact_lenses_hearing_aid"],
+ ["excel_column"=>["col_name"=>"Notes","col_index"=>89],"db_column"=>"notes"],
+ ["excel_column"=>["col_name"=>"Buffer Amount","col_index"=>90],"db_column"=>"buffer_amount"],
+ ["excel_column"=>["col_name"=>"tertiaryamount","col_index"=>91],"db_column"=>"tertiary_amount"],
+ ["excel_column"=>["col_name"=>"insurancename","col_index"=>92],"db_column"=>"insurance_name"],
+ ["excel_column"=>["col_name"=>"Roname","col_index"=>93],"db_column"=>"ro_name"],
+ ["excel_column"=>["col_name"=>"Class Of Accommodation","col_index"=>94],"db_column"=>"class_of_accommodation"],
+ ["excel_column"=>["col_name"=>"claimcreateddatetime","col_index"=>95],"db_column"=>"claim_created_datetime"],
+ ["excel_column"=>["col_name"=>"Insurer Claim ID","col_index"=>96],"db_column"=>"insurer_claim_id"],
+ ["excel_column"=>["col_name"=>"Gipsa","col_index"=>97],"db_column"=>"gipsa"],
+ ["excel_column"=>["col_name"=>"Date Of Joining","col_index"=>98],"db_column"=>"date_of_joining"],
+ ["excel_column"=>["col_name"=>"GIPSAHospital","col_index"=>99],"db_column"=>"gipsa_hospital"],
+ ["excel_column"=>["col_name"=>"Package","col_index"=>100],"db_column"=>"package"],
+ ["excel_column"=>["col_name"=>"Is NIDB","col_index"=>101],"db_column"=>"is_nidb"],
+ ["excel_column"=>["col_name"=>"NIDB Removed Date","col_index"=>102],"db_column"=>"nidb_removed_date"],
+ ["excel_column"=>["col_name"=>"Investigationdate","col_index"=>103],"db_column"=>"investigation_date"],
+ ["excel_column"=>["col_name"=>"Investigation Retrieval Date","col_index"=>104],"db_column"=>"investigation_retrieval_date"],
+ ["excel_column"=>["col_name"=>"Reopeneddate","col_index"=>105],"db_column"=>"reopened_date"],
+ ["excel_column"=>["col_name"=>"Referto Insurer Date","col_index"=>106],"db_column"=>"refer_to_insurer_date"],
+ ["excel_column"=>["col_name"=>"Receiveddatefrom Insurer","col_index"=>107],"db_column"=>"received_date_from_insurer"],
+ ["excel_column"=>["col_name"=>"Rejection Category","col_index"=>108],"db_column"=>"rejection_category"],
+ ["excel_column"=>["col_name"=>"Referto Insurer Reasons","col_index"=>109],"db_column"=>"refer_to_insurer_reasons"],
+ ["excel_column"=>["col_name"=>"Is VIP","col_index"=>110],"db_column"=>"is_vip"],
+ ["excel_column"=>["col_name"=>"Main Claim Status","col_index"=>111],"db_column"=>"main_claim_status"],
+ ["excel_column"=>["col_name"=>"Main Claimtype","col_index"=>112],"db_column"=>"main_claim_type"],
+ ["excel_column"=>["col_name"=>"icd Third Level Code","col_index"=>113],"db_column"=>"icd_third_level_code"],
+ ["excel_column"=>["col_name"=>"Benefit Plan Name","col_index"=>114],"db_column"=>"benefit_plan_name"],
+ ["excel_column"=>["col_name"=>"zone","col_index"=>115],"db_column"=>"zone"],
+ ["excel_column"=>["col_name"=>"Grade","col_index"=>116],"db_column"=>"grade"],
+ ["excel_column"=>["col_name"=>"Last Modified Date","col_index"=>117],"db_column"=>"last_modified_date"],
+ ["excel_column"=>["col_name"=>"Temp MOU","col_index"=>118],"db_column"=>"temp_mou"],
+ ];
+
+ protected $ticketMasterMapping = [
+
+ // Employee / Member details
+ 'member_code' => 'emp_code',
+ 'relation' => 'relationship',
+
+ // Policy / Claim identifiers
+ 'policy_number' => 'policy_no',
+ 'certificate_no' => 'claim_number',
+ 'abhi_claim_no' => 'tpa_claim_id',
+
+ // Dates
+ 'doa' => 'doa',
+ 'dod' => 'dod',
+ 'intimation_date' => 'date_of_intimat',
+
+ // Claim info
+ 'claim_type' => 'claim_type',
+ 'claim_status' => 'tpa_claim_status',
+ 'claimed_amount' => 'claim_amount',
+ 'abhi_amount_less_coins_current_month' => 'approved_amount',
+
+ // Hospital details
+ 'hospital_name' => 'hospital_name',
+ 'hospital_city' => 'hospital_city',
+ 'hospital_state' => 'hospital_state',
+
+ // Settlement / decision
+ 'repudiation_date' => 'denial_date',
+ 'settled_date' => 'settled_date',
+ 'rejection_category' => 'denial_reason',
+
+ // Misc
+ 'diagnosis' => 'claim_description',
+ 'healthcard_id' => 'tpa_no',
+
+ 'priority' => 1,
+ 'mode_of_intimation' => 5,
+ 'ticket_type_id' => 1,
+ ];
+
+ protected $statusMapping = [
+ 'Settled' => 11,
+ 'Rejected' => 8,
+ ];
+
+ /**
+ * ABSTRACT FUNCTIONs
+ */
+ public function bulkInsertTPATable(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $ClaimsDumpFhplModel = new ClaimsDumpFhplModel();
+ $result = $ClaimsDumpFhplModel->insertBatch($data);
+
+ return true;
+
+ }
+
+
+ public function importClaimMaster(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $ticketMasterModel = new TicketMasterModel();
+ $ticketMasterModel->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketIdInTPATable(): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_fhpl');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketMasterRejectedReasonInTPATable($data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_fhpl');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ /**
+ * MAPPING FUNCTIONs
+ */
+
+ public function mapTPAData(array $rows, $file_id): array
+ {
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $mapped = [];
+
+ foreach ($rows as $row) {
+
+ $item = [];
+
+ foreach ($this->mapping as $map) {
+ $excelColumn = $map['excel_column']['col_name'];
+ $dbColumn = $map['db_column'];
+
+ $value = $row[$excelColumn] ?? null;
+
+ if ($this->isDateValue($value)) {
+ $value = $this->normalizeDate($value);
+ }
+
+ $item[$dbColumn] = trim($value);
+ }
+
+ // $params = [
+ // 'admission_date' => change_date_format($item['admission_date'] ?? '') ?? null,
+ // 'employee_number' => $item['employee_number'] ?? null,
+ // 'claim_amount' => $item['claim_amount'] ?? null,
+ // 'primary_policy_holder_card_id' => $item['primary_policy_holder_card_id'] ?? null
+ // ];
+
+ // $is_duplicate = $this->checkDuplicateTpaClaim('claims_dump_fhpl', $params);
+
+ // if ($is_duplicate) {
+ // $item = [];
+ // continue;
+ // }
+
+ $item['file_id'] = $file_id ?? null;
+ $item['client_id'] = $file_data['client_id'] ?? null;
+ $item['client_policy_id'] = $file_data['client_policy_id'] ?? null;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+
+ $mapped[] = $item;
+ }
+
+ return $mapped;
+ }
+
+ public function mapClaimMasterData($file_id): array
+ {
+
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $tpaClaimDumpData = $this->getTpaClaimDumpData('claims_dump_fhpl', ['file_id' => $file_id]);
+
+ if (empty($tpaClaimDumpData)) {
+ return ['status' => false, 'message' => "No data to insert in TICKET MASTER"];
+ }
+
+
+ $ClientPolicyModel = new ClientPolicyModel();
+ $client_policy_data = $ClientPolicyModel
+ ->select("
+ client_policy.*,
+ (
+ SELECT id
+ FROM client_rm
+ WHERE is_active = 1
+ AND level = 3
+ AND client_id = client_policy.client_id
+ ORDER BY id ASC
+ LIMIT 1
+ ) AS acm_id
+ ")
+ ->where('client_policy.id', $file_data['client_policy_id'])
+ ->where('client_policy.is_active', 1)
+ ->first();
+
+ try {
+
+ $mapped = [];
+ $rejecetd_reason = [];
+
+ foreach ($tpaClaimDumpData as $row) {
+
+ $params = [
+ 'doa' => change_date_format($row['date_of_admission'] ?? '') ?? null,
+ 'emp_code' => $row['employee_number'] ?? null,
+ 'claim_amount' => $row['claim_amount'] ?? null,
+ 'tpa_no' => $row['primary_policy_holder_card_id'] ?? null
+ ];
+
+ $isduplicate = $this->checkDublicateTicketMasterClaim($params);
+
+ if ($isduplicate) {
+ $reason = "This claim already exists in our system.";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ $item = [];
+
+ $item['client_id'] = $client_policy_data['client_id'] ?? null;
+ $item['client_policy_id'] = $client_policy_data['id'] ?? null;
+ $item['insurer_id'] = $client_policy_data['insurer_id'] ?? null;
+ $item['tpa_id'] = $client_policy_data['tpa_id'] ?? null;
+ $item['acm_id'] = $client_policy_data['acm_id'] ?? null;
+ $item['policy_no'] = $client_policy_data['policy_no'] ?? null;
+ $item['relationship'] = $this->convertRelation($row['relation'] ?? null, $row['gender'] ?? null);
+
+ $employee_data = $this->getEmployeeDetails($file_data['client_id'], $file_data['client_policy_id'], $row['employee_number'], $item['relationship']);
+
+ if (!empty($employee_data)) {
+ $item['emp_id'] = $employee_data['id'] ?? null;
+ $item['emp_name'] = $employee_data['name'] ?? null;
+ $item['emp_mail'] = $employee_data['email_corporate'] ?? null;
+ $item['emp_mobile'] = $employee_data['mobile'] ?? null;
+ $item['insured_emp_id'] = $employee_data['insured_emp_id'] ?? null;
+ $item['insured_name'] = $employee_data['insured_name'] ?? null;
+ } else {
+
+ $reason = sprintf(
+ 'The policy number "%s" does not exist in our system. ' .
+ 'Details - Client ID: %s, Client Policy ID: %s, Employee Number: %s, Relationship: %s',
+ $row['insurer_policy_number'],
+ $file_data['client_id'],
+ $file_data['client_policy_id'],
+ $row['employee_number'],
+ $item['relationship']
+ );
+
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ foreach ($this->ticketMasterMapping as $tpaKey => $ticketMasterKey) {
+ $item[$ticketMasterKey] = array_key_exists($tpaKey, $row) ? $row[$tpaKey] : null;
+ }
+
+ // Meta fields
+ $item['claim_status_id'] = $statusMapping[$row['current_claim_status']] ?? 61;
+ $item['file_id'] = $file_id;
+ $item['claim_dump_ref_id'] = $row['id'];
+ $item['created_by'] = $file_data['created_by'] ?? null;
+ $item['claim_type'] = isset($row['mainclaim_prepost_type']) && !empty($row['mainclaim_prepost_type']) && strtolower($row['mainclaim_prepost_type']) == 'normal' ? 1 : 3;
+
+ $mapped[] = $item;
+ }
+
+ return ['status' => true, 'mapped_array' => $mapped, 'rejected_reason_array' => $rejecetd_reason];
+
+ } catch (\Throwable $th) {
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+
+ return ['status' => false, "message" => $errorData['message'], 'error_data' => $errorData];
+ }
+ }
+
+
+ /**
+ * HELPER FUNCTIONs
+ */
+
+ public function isDateValue($value): bool
+ {
+ if (empty($value)) {
+ return false;
+ }
+
+ // Excel numeric date (e.g. 44927)
+ if (is_numeric($value) && $value > 30000) {
+ return true;
+ }
+
+ // Common date formats
+ return preg_match(
+ '/^\d{1,2}[\/\-]\d{1,2}[\/\-]\d{2,4}$|^\d{4}[\/\-]\d{1,2}[\/\-]\d{1,2}$/',
+ (string) $value
+ ) === 1;
+ }
+
+
+ public function normalizeDate($value): ?string
+ {
+ try {
+ // Excel numeric date
+ if (is_numeric($value)) {
+ return date('Y-m-d', \PhpOffice\PhpSpreadsheet\Shared\Date::excelToTimestamp($value));
+ }
+
+ // String date
+ return date('Y-m-d', strtotime(str_replace('/', '-', $value)));
+ } catch (\Throwable $e) {
+ return null;
+ }
+ }
+
+
+ public function convertRelation(string $relation, string $gender): ?string
+ {
+ if (empty($relation)) {
+ return null;
+ }
+
+ $relation = strtolower($relation);
+ $gender = strtolower($gender);
+
+ if ($relation == 'self') {
+ return $relation;
+ }
+
+ if ($relation == 'spouse') {
+ return $relation;
+ }
+
+ if ($relation == 'child' && $gender == 'male') {
+ return 'son';
+ }
+
+ if ($relation == 'child' && $gender == 'female') {
+ return 'daughter';
+ }
+
+ if ($relation == 'parents' && $gender == 'male') {
+ return 'father';
+ }
+
+ if ($relation == 'parents' && $gender == 'female') {
+ return 'mother';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'male') {
+ return 'father-in-law';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'female') {
+ return 'mother-in-law';
+ }
+
+ return null;
+ }
+
+
+
+}
diff --git a/app/Libraries/TPAClaimsImportServices/IciciClaimImportService.php b/app/Libraries/TPAClaimsImportServices/IciciClaimImportService.php
new file mode 100644
index 00000000..9f1ddfe3
--- /dev/null
+++ b/app/Libraries/TPAClaimsImportServices/IciciClaimImportService.php
@@ -0,0 +1,445 @@
+ ["col_name" => "POLICY_NAME", "col_index" => 0], "db_column" => "policy_name"],
+ ["excel_column" => ["col_name" => "POLICY_NO", "col_index" => 1], "db_column" => "policy_no"],
+ ["excel_column" => ["col_name" => "UHID", "col_index" => 2], "db_column" => "uhid"],
+ ["excel_column" => ["col_name" => "INSURED_NAME", "col_index" => 3], "db_column" => "insured_name"],
+ ["excel_column" => ["col_name" => "MAIN_MEMBER_NAME", "col_index" => 4], "db_column" => "main_member_name"],
+ ["excel_column" => ["col_name" => "EMPLOYEE_MEMBER_ID", "col_index" => 5], "db_column" => "employee_member_id"],
+ ["excel_column" => ["col_name" => "GRADE", "col_index" => 6], "db_column" => "grade"],
+ ["excel_column" => ["col_name" => "RELATION", "col_index" => 7], "db_column" => "relation"],
+ ["excel_column" => ["col_name" => "AGE", "col_index" => 8], "db_column" => "age"],
+ ["excel_column" => ["col_name" => "GENDER", "col_index" => 9], "db_column" => "gender"],
+ ["excel_column" => ["col_name" => "DIAGNOSIS", "col_index" => 10], "db_column" => "diagnosis"],
+ ["excel_column" => ["col_name" => "CLAIMED_AMOUNT", "col_index" => 11], "db_column" => "claimed_amount"],
+ ["excel_column" => ["col_name" => "NET_SANCT_AMT", "col_index" => 12], "db_column" => "net_sanct_amt"],
+ ["excel_column" => ["col_name" => "COPAYMENT_AMT", "col_index" => 13], "db_column" => "copayment_amt"],
+ ["excel_column" => ["col_name" => "DISALLOWED_AMOUNT", "col_index" => 14], "db_column" => "disallowed_amount"],
+ ["excel_column" => ["col_name" => "REASON_FOR_DISALLOWANCE", "col_index" => 15], "db_column" => "reason_for_disallowance"],
+ ["excel_column" => ["col_name" => "PAYMENT_AMOUNT", "col_index" => 16], "db_column" => "payment_amount"],
+ ["excel_column" => ["col_name" => "SUM_INSURED", "col_index" => 17], "db_column" => "sum_insured"],
+ ["excel_column" => ["col_name" => "BAL_SUM_INSURED", "col_index" => 18], "db_column" => "bal_sum_insured"],
+ ["excel_column" => ["col_name" => "TYPE_OF_CLAIM", "col_index" => 19], "db_column" => "type_of_claim"],
+ ["excel_column" => ["col_name" => "Claim_r_Os_Amt", "col_index" => 20], "db_column" => "claim_r_os_amt"],
+ ["excel_column" => ["col_name" => "Updated_status", "col_index" => 21], "db_column" => "updated_status"],
+ ["excel_column" => ["col_name" => "Disease_Category", "col_index" => 22], "db_column" => "disease_category"],
+ ["excel_column" => ["col_name" => "POLICY_START_DATE", "col_index" => 23], "db_column" => "policy_start_date"],
+ ["excel_column" => ["col_name" => "POLICY_END_DATE", "col_index" => 24], "db_column" => "policy_end_date"],
+ ["excel_column" => ["col_name" => "CLAIM_NUMBER", "col_index" => 25], "db_column" => "claim_number"],
+ ["excel_column" => ["col_name" => "AL_NO", "col_index" => 26], "db_column" => "al_no"],
+ ["excel_column" => ["col_name" => "HOSPITAL_CODE", "col_index" => 27], "db_column" => "hospital_code"],
+ ["excel_column" => ["col_name" => "HOSPITAL_ID", "col_index" => 28], "db_column" => "hospital_id"],
+ ["excel_column" => ["col_name" => "HOSPITAL_NAME", "col_index" => 29], "db_column" => "hospital_name"],
+ ["excel_column" => ["col_name" => "TREATMENT_TAKEN", "col_index" => 30], "db_column" => "treatment_taken"],
+ ["excel_column" => ["col_name" => "CF_Utilised_Amounnt", "col_index" => 31], "db_column" => "cf_utilised_amount"],
+ ["excel_column" => ["col_name" => "DT_OF_DEFICIENCIES_SENT", "col_index" => 32], "db_column" => "dt_of_deficiencies_sent"],
+ ["excel_column" => ["col_name" => "DT_OF_DEFICIENCIES_RECIEVED", "col_index" => 33], "db_column" => "dt_of_deficiencies_received"],
+ ["excel_column" => ["col_name" => "PAYMENT_DATE", "col_index" => 34], "db_column" => "payment_date"],
+ ["excel_column" => ["col_name" => "PAYEE_NAME", "col_index" => 35], "db_column" => "payee_name"],
+ ["excel_column" => ["col_name" => "PAYMENT_MODE", "col_index" => 36], "db_column" => "payment_mode"],
+ ["excel_column" => ["col_name" => "CHEQUE_NUMBER", "col_index" => 37], "db_column" => "cheque_number"],
+ ["excel_column" => ["col_name" => "DOA", "col_index" => 38], "db_column" => "doa"],
+ ["excel_column" => ["col_name" => "DOD", "col_index" => 39], "db_column" => "dod"],
+ ["excel_column" => ["col_name" => "HOSPITAL_CITY", "col_index" => 40], "db_column" => "hospital_city"],
+ ["excel_column" => ["col_name" => "HOSPITAL_STATE", "col_index" => 41], "db_column" => "hospital_state"],
+ ["excel_column" => ["col_name" => "REJECTED_QUERY_REASON", "col_index" => 42], "db_column" => "rejected_query_reason"],
+ ["excel_column" => ["col_name" => "REJECTED_QUERY_DESC", "col_index" => 43], "db_column" => "rejected_query_desc"],
+ ["excel_column" => ["col_name" => "REJECTED_QUERY_CLOSED_DATE", "col_index" => 44], "db_column" => "rejected_query_closed_date"],
+ ["excel_column" => ["col_name" => "REJREOPEN_CLOSURE_DATE", "col_index" => 45], "db_column" => "rejreopen_closure_date"],
+ ["excel_column" => ["col_name" => "CLAIM_CLASSIFICATION", "col_index" => 46], "db_column" => "claim_classification"],
+ ["excel_column" => ["col_name" => "TAGGED_INWARD_NO", "col_index" => 47], "db_column" => "tagged_inward_no"],
+ ["excel_column" => ["col_name" => "INWARD_DATE", "col_index" => 48], "db_column" => "inward_date"],
+ ["excel_column" => ["col_name" => "ICD_ID_L3", "col_index" => 49], "db_column" => "icd_id_l3"],
+ ["excel_column" => ["col_name" => "Incidence_Count", "col_index" => 50], "db_column" => "incidence_count"],
+ ["excel_column" => ["col_name" => "FLEXI_OPTION", "col_index" => 51], "db_column" => "flexi_option"],
+ ["excel_column" => ["col_name" => "Base_TopUp_Option", "col_index" => 52], "db_column" => "base_topup_option"],
+ ["excel_column" => ["col_name" => "POLICY_GROUP_NAME", "col_index" => 53], "db_column" => "policy_group_name"],
+ ["excel_column" => ["col_name" => "Relation_Group", "col_index" => 54], "db_column" => "relation_group"],
+ ["excel_column" => ["col_name" => "Age_Band", "col_index" => 55], "db_column" => "age_band"],
+ ["excel_column" => ["col_name" => "Work_Location", "col_index" => 56], "db_column" => "work_location"],
+ ["excel_column" => ["col_name" => "ILTC_TAG", "col_index" => 57], "db_column" => "iltc_tag"],
+ ];
+
+ protected $ticketMasterMapping = [
+
+ // Employee / Member
+ 'employee_member_id' => 'emp_code',
+ 'relation_group' => 'relationship',
+
+ // Claim
+ 'claim_number' => 'claim_number',
+ 'claimed_amount' => 'claim_amount',
+ 'claim_status' => 'tpa_claim_status',
+
+ // Dates
+ 'doa' => 'doa',
+ 'dod' => 'dod',
+ 'payment_date' => 'settled_date',
+
+ // Hospital
+ 'hospital_name' => 'hospital_name',
+ 'hospital_city' => 'hospital_city',
+ 'hospital_state' => 'hospital_state',
+
+ 'cheque_number' => 'utr_details',
+ 'tpa_no' => 'uhid',
+ 'rejected_query_desc' => 'claim_description',
+ ];
+
+ protected $statusMapping = [
+ 'PAID' => 11,
+ 'REJECTED' => 8,
+ ];
+
+
+ /**
+ * ABSTRACT FUNCTIONs
+ */
+ public function bulkInsertTPATable(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ try {
+
+
+ $ClaimsDumpFhplModel = new ClaimsDumpFhplModel();
+ $result = $ClaimsDumpFhplModel->insertBatch($data);
+
+ return true;
+
+ } catch (\Throwable $th) {
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+ return false;
+ }
+
+ }
+
+
+ public function importClaimMaster(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $ticketMasterModel = new TicketMasterModel();
+ $ticketMasterModel->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketIdInTPATable(): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_icici');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketMasterRejectedReasonInTPATable($data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_icici');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ /**
+ * MAPPING FUNCTIONs
+ */
+
+ public function mapTPAData(array $rows, $file_id): array
+ {
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $mapped = [];
+
+ foreach ($rows as $row) {
+
+ $item = [];
+
+ foreach ($this->mapping as $map) {
+ $excelColumn = $map['excel_column']['col_name'];
+ $dbColumn = $map['db_column'];
+
+ $value = $row[$excelColumn] ?? null;
+
+ if ($this->isDateValue($value)) {
+ $value = $this->normalizeDate($value);
+ }
+
+ $item[$dbColumn] = $value;
+ }
+
+ $params = [
+ 'doa' => change_date_format($item['doa'] ?? '') ?? null,
+ 'employee_member_id' => $item['employee_member_id'] ?? null,
+ 'claimed_amount' => $item['claimed_amount'] ?? null,
+ 'uhid' => $item['uhid'] ?? null
+ ];
+
+ $is_duplicate = $this->checkDuplicateTpaClaim('claims_dump_icici', $params);
+
+ if ($is_duplicate) {
+ $item = [];
+ continue;
+ }
+
+ $item['file_id'] = $file_id ?? null;
+ $item['client_id'] = $file_data['client_id'] ?? null;
+ $item['client_policy_id'] = $file_data['client_policy_id'] ?? null;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+
+ $mapped[] = $item;
+ }
+
+ return $mapped;
+ }
+
+ public function mapClaimMasterData($file_id): array
+ {
+
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $tpaClaimDumpData = $this->getTpaClaimDumpData('claims_dump_icici', ['file_id' => $file_id]);
+
+ if (empty($tpaClaimDumpData)) {
+ return ['status' => false, 'message' => "No data to insert in TICKET MASTER"];
+ }
+
+
+ $ClientPolicyModel = new ClientPolicyModel();
+ $client_policy_data = $ClientPolicyModel
+ ->select("
+ client_policy.*,
+ (
+ SELECT id
+ FROM client_rm
+ WHERE is_active = 1
+ AND level = 3
+ AND client_id = client_policy.client_id
+ ORDER BY id ASC
+ LIMIT 1
+ ) AS acm_id
+ ")
+ ->where('client_policy.id', $file_data['client_policy_id'])
+ ->where('client_policy.is_active', 1)
+ ->first();
+
+ try {
+
+ $mapped = [];
+ $rejecetd_reason = [];
+
+ foreach ($tpaClaimDumpData as $row) {
+
+ $params = [
+ 'doa' => change_date_format($row['doa'] ?? '') ?? null,
+ 'emp_code' => $row['employee_member_id'] ?? null,
+ 'claim_amount' => $row['claim_amount'] ?? null,
+ 'tpa_no' => $row['uhid'] ?? null
+ ];
+
+ $isduplicate = $this->checkDublicateTicketMasterClaim($params);
+
+ if ($isduplicate) {
+ $reason = "This claim already exists in our system.";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ $item = [];
+
+ $item['client_id'] = $client_policy_data['client_id'] ?? null;
+ $item['client_policy_id'] = $client_policy_data['id'] ?? null;
+ $item['insurer_id'] = $client_policy_data['insurer_id'] ?? null;
+ $item['tpa_id'] = $client_policy_data['tpa_id'] ?? null;
+ $item['acm_id'] = $client_policy_data['acm_id'] ?? null;
+ $item['policy_no'] = $client_policy_data['policy_no'] ?? null;
+ $item['relationship'] = strtolower($row['relation_group'] ?? '');
+
+ $employee_data = $this->getEmployeeDetails($file_data['client_id'], $file_data['client_policy_id'], $row['employee_number'], $item['relationship']);
+
+ if (!empty($employee_data)) {
+ $item['emp_id'] = $employee_data['id'] ?? null;
+ $item['emp_name'] = $employee_data['name'] ?? null;
+ $item['emp_mail'] = $employee_data['email_corporate'] ?? null;
+ $item['emp_mobile'] = $employee_data['mobile'] ?? null;
+ $item['insured_emp_id'] = $employee_data['insured_emp_id'] ?? null;
+ $item['insured_name'] = $employee_data['insured_name'] ?? null;
+ } else {
+
+ $reason = sprintf(
+ 'The policy number "%s" does not exist in our system. ' .
+ 'Details - Client ID: %s, Client Policy ID: %s, Employee Number: %s, Relationship: %s',
+ $row['insurer_policy_number'],
+ $file_data['client_id'],
+ $file_data['client_policy_id'],
+ $row['employee_number'],
+ $item['relationship']
+ );
+
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ foreach ($this->ticketMasterMapping as $tpaKey => $ticketMasterKey) {
+ $item[$ticketMasterKey] = array_key_exists($tpaKey, $row) ? $row[$tpaKey] : null;
+ }
+
+ // Meta fields
+ $item['claim_status_id'] = $statusMapping[$row['updated_status']] ?? 61;
+ $item['file_id'] = $file_id;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+ $item['claim_type'] = 1;
+
+ $mapped[] = $item;
+ }
+
+ return ['status' => true, 'mapped_array' => $mapped, 'rejected_reason_array' => $rejecetd_reason];
+
+ } catch (\Throwable $th) {
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+
+ return ['status' => false, "message" => $errorData['message'], 'error_data' => $errorData];
+ }
+ }
+
+
+ /**
+ * HELPER FUNCTIONs
+ */
+
+ public function isDateValue($value): bool
+ {
+ if (empty($value)) {
+ return false;
+ }
+
+ // Excel numeric date (e.g. 44927)
+ if (is_numeric($value) && $value > 30000) {
+ return true;
+ }
+
+ // Common date formats
+ return preg_match(
+ '/^\d{1,2}[\/\-]\d{1,2}[\/\-]\d{2,4}$|^\d{4}[\/\-]\d{1,2}[\/\-]\d{1,2}$/',
+ (string) $value
+ ) === 1;
+ }
+
+
+ public function normalizeDate($value): ?string
+ {
+ try {
+ // Excel numeric date
+ if (is_numeric($value)) {
+ return date('Y-m-d', \PhpOffice\PhpSpreadsheet\Shared\Date::excelToTimestamp($value));
+ }
+
+ // String date
+ return date('Y-m-d', strtotime(str_replace('/', '-', $value)));
+ } catch (\Throwable $e) {
+ return null;
+ }
+ }
+
+
+ public function convertRelation(string $relation, string $gender): ?string
+ {
+ if (empty($relation)) {
+ return null;
+ }
+
+ $relation = strtolower($relation);
+ $gender = strtolower($gender);
+
+ if ($relation == 'self') {
+ return $relation;
+ }
+
+ if ($relation == 'spouse') {
+ return $relation;
+ }
+
+ if ($relation == 'child' && $gender == 'male') {
+ return 'son';
+ }
+
+ if ($relation == 'child' && $gender == 'female') {
+ return 'daughter';
+ }
+
+ if ($relation == 'parents' && $gender == 'male') {
+ return 'father';
+ }
+
+ if ($relation == 'parents' && $gender == 'female') {
+ return 'mother';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'male') {
+ return 'father-in-law';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'female') {
+ return 'mother-in-law';
+ }
+
+ return null;
+ }
+
+
+
+}
diff --git a/app/Libraries/TPAClaimsImportServices/MediAssistClaimImportService.php b/app/Libraries/TPAClaimsImportServices/MediAssistClaimImportService.php
new file mode 100644
index 00000000..c8e39b21
--- /dev/null
+++ b/app/Libraries/TPAClaimsImportServices/MediAssistClaimImportService.php
@@ -0,0 +1,491 @@
+ ["col_name" => "insurance_company", "col_index" => 0], "db_column" => "insurance_company"],
+ ["excel_column" => ["col_name" => "insurer_region_name", "col_index" => 1], "db_column" => "insurer_region_name"],
+ ["excel_column" => ["col_name" => "insurer_ro_code", "col_index" => 2], "db_column" => "insurer_ro_code"],
+ ["excel_column" => ["col_name" => "insurer_do_code", "col_index" => 3], "db_column" => "insurer_do_code"],
+ ["excel_column" => ["col_name" => "insurer_bo_code", "col_index" => 4], "db_column" => "insurer_bo_code"],
+ ["excel_column" => ["col_name" => "event_id", "col_index" => 5], "db_column" => "event_id"],
+ ["excel_column" => ["col_name" => "claim_id", "col_index" => 6], "db_column" => "claim_id"],
+ ["excel_column" => ["col_name" => "insurer_claim_ref_no", "col_index" => 7], "db_column" => "insurer_claim_ref_no"],
+ ["excel_column" => ["col_name" => "claim_pre_auths", "col_index" => 8], "db_column" => "claim_pre_auths"],
+ ["excel_column" => ["col_name" => "ma_policy_id", "col_index" => 9], "db_column" => "ma_policy_id"],
+ ["excel_column" => ["col_name" => "policy_no", "col_index" => 10], "db_column" => "policy_no"],
+ ["excel_column" => ["col_name" => "policy_holder_name", "col_index" => 11], "db_column" => "policy_holder_name"],
+ ["excel_column" => ["col_name" => "policy_type", "col_index" => 12], "db_column" => "policy_type"],
+ ["excel_column" => ["col_name" => "policy_subtype_desc", "col_index" => 13], "db_column" => "policy_subtype_desc"],
+ ["excel_column" => ["col_name" => "policy_start_date", "col_index" => 14], "db_column" => "policy_start_date"],
+ ["excel_column" => ["col_name" => "policy_end_date", "col_index" => 15], "db_column" => "policy_end_date"],
+ ["excel_column" => ["col_name" => "devlopment_officer", "col_index" => 16], "db_column" => "devlopment_officer"],
+ ["excel_column" => ["col_name" => "agent", "col_index" => 17], "db_column" => "agent"],
+ ["excel_column" => ["col_name" => "broker", "col_index" => 18], "db_column" => "broker"],
+ ["excel_column" => ["col_name" => "pribenef_employee_code", "col_index" => 19], "db_column" => "pribenef_employee_code"],
+ ["excel_column" => ["col_name" => "pribenef_name", "col_index" => 20], "db_column" => "pribenef_name"],
+ ["excel_column" => ["col_name" => "pribenef_floater_sum", "col_index" => 21], "db_column" => "pribenef_floater_sum"],
+ ["excel_column" => ["col_name" => "benef_maid", "col_index" => 22], "db_column" => "benef_maid"],
+ ["excel_column" => ["col_name" => "benef_insurer_id", "col_index" => 23], "db_column" => "benef_insurer_id"],
+ ["excel_column" => ["col_name" => "benef_name", "col_index" => 24], "db_column" => "benef_name"],
+ ["excel_column" => ["col_name" => "benef_gender", "col_index" => 25], "db_column" => "benef_gender"],
+ ["excel_column" => ["col_name" => "benef_relation", "col_index" => 26], "db_column" => "benef_relation"],
+ ["excel_column" => ["col_name" => "benef_age", "col_index" => 27], "db_column" => "benef_age"],
+ ["excel_column" => ["col_name" => "benef_sum_insured", "col_index" => 28], "db_column" => "benef_sum_insured"],
+ ["excel_column" => ["col_name" => "balance_sum_insured", "col_index" => 29], "db_column" => "balance_sum_insured"],
+ ["excel_column" => ["col_name" => "intimation_id", "col_index" => 30], "db_column" => "intimation_id"],
+ ["excel_column" => ["col_name" => "intimation_date", "col_index" => 31], "db_column" => "intimation_date"],
+ ["excel_column" => ["col_name" => "settled_date", "col_index" => 32], "db_column" => "settled_date"],
+ ["excel_column" => ["col_name" => "ClaimSource", "col_index" => 33], "db_column" => "claim_source"],
+ ["excel_column" => ["col_name" => "claim_mode_of_rcpt", "col_index" => 34], "db_column" => "claim_mode_of_rcpt"],
+ ["excel_column" => ["col_name" => "claim_type", "col_index" => 35], "db_column" => "claim_type"],
+ ["excel_column" => ["col_name" => "claim_sub_type", "col_index" => 36], "db_column" => "claim_sub_type"],
+ ["excel_column" => ["col_name" => "claim_stage", "col_index" => 37], "db_column" => "claim_stage"],
+ ["excel_column" => ["col_name" => "claim_status", "col_index" => 38], "db_column" => "claim_status"],
+ ["excel_column" => ["col_name" => "is_cashlessanywhere", "col_index" => 39], "db_column" => "is_cashlessanywhere"],
+ ["excel_column" => ["col_name" => "date_of_admission", "col_index" => 40], "db_column" => "date_of_admission"],
+ ["excel_column" => ["col_name" => "date_of_discharge", "col_index" => 41], "db_column" => "date_of_discharge"],
+ ["excel_column" => ["col_name" => "claim_amount", "col_index" => 42], "db_column" => "claim_amount"],
+ ["excel_column" => ["col_name" => "claim_approved_amount", "col_index" => 43], "db_column" => "claim_approved_amount"],
+ ["excel_column" => ["col_name" => "incurred_amount", "col_index" => 44], "db_column" => "incurred_amount"],
+ ["excel_column" => ["col_name" => "primary_icd_group", "col_index" => 45], "db_column" => "primary_icd_group"],
+ ["excel_column" => ["col_name" => "primary_ailment_name", "col_index" => 46], "db_column" => "primary_ailment_name"],
+ ["excel_column" => ["col_name" => "primary_ailment_code", "col_index" => 47], "db_column" => "primary_ailment_code"],
+ ["excel_column" => ["col_name" => "treatment_type", "col_index" => 48], "db_column" => "treatment_type"],
+ ["excel_column" => ["col_name" => "treatment_name", "col_index" => 49], "db_column" => "treatment_name"],
+ ["excel_column" => ["col_name" => "hospital_id", "col_index" => 50], "db_column" => "hospital_id"],
+ ["excel_column" => ["col_name" => "hospital_name", "col_index" => 51], "db_column" => "hospital_name"],
+ ["excel_column" => ["col_name" => "hospital_city", "col_index" => 52], "db_column" => "hospital_city"],
+ ["excel_column" => ["col_name" => "hospital_state", "col_index" => 53], "db_column" => "hospital_state"],
+ ["excel_column" => ["col_name" => "hospital_pincode", "col_index" => 54], "db_column" => "hospital_pincode"],
+ ["excel_column" => ["col_name" => "hospital_address", "col_index" => 55], "db_column" => "hospital_address"],
+ ["excel_column" => ["col_name" => "Clinic_DoctorName_Hospital", "col_index" => 56], "db_column" => "clinic_doctorname_hospital"],
+ ["excel_column" => ["col_name" => "OPD_pincode", "col_index" => 57], "db_column" => "opd_pincode"],
+ ["excel_column" => ["col_name" => "payable_amount_OPD_Consultation", "col_index" => 58], "db_column" => "payable_amount_opd_consultation"],
+ ["excel_column" => ["col_name" => "payable_amount_Dental", "col_index" => 59], "db_column" => "payable_amount_dental"],
+ ["excel_column" => ["col_name" => "payable_amount_Diagnostics", "col_index" => 60], "db_column" => "payable_amount_diagnostics"],
+ ["excel_column" => ["col_name" => "payable_amount_Other", "col_index" => 61], "db_column" => "payable_amount_other"],
+ ["excel_column" => ["col_name" => "payable_amount_Pharmacy", "col_index" => 62], "db_column" => "payable_amount_pharmacy"],
+ ["excel_column" => ["col_name" => "payable_amount_Vaccination", "col_index" => 63], "db_column" => "payable_amount_vaccination"],
+ ["excel_column" => ["col_name" => "payable_amount_Miscellaneous_Charges", "col_index" => 64], "db_column" => "payable_amount_miscellaneous_charges"],
+ ["excel_column" => ["col_name" => "payable_amount_Health_Checkup", "col_index" => 65], "db_column" => "payable_amount_health_checkup"],
+ ["excel_column" => ["col_name" => "deduction_amount_copay", "col_index" => 66], "db_column" => "deduction_amount_copay"],
+ ["excel_column" => ["col_name" => "deduction_amount_excess_ailment", "col_index" => 67], "db_column" => "deduction_amount_excess_ailment"],
+ ["excel_column" => ["col_name" => "deduction_amount_excess_policy", "col_index" => 68], "db_column" => "deduction_amount_excess_policy"],
+ ["excel_column" => ["col_name" => "deduction_amount_prorata", "col_index" => 69], "db_column" => "deduction_amount_prorata"],
+ ["excel_column" => ["col_name" => "deduction_amount_hospital_discount", "col_index" => 70], "db_column" => "deduction_amount_hospital_discount"],
+ ["excel_column" => ["col_name" => "deduction_amount_paid_by_patient", "col_index" => 71], "db_column" => "deduction_amount_paid_by_patient"],
+ ["excel_column" => ["col_name" => "deduction_amount_issurer_approved", "col_index" => 72], "db_column" => "deduction_amount_issurer_approved"],
+ ["excel_column" => ["col_name" => "deduction_amount_deductible", "col_index" => 73], "db_column" => "deduction_amount_deductible"],
+ ["excel_column" => ["col_name" => "deduction_amount_intimation_penalty", "col_index" => 74], "db_column" => "deduction_amount_intimation_penalty"],
+ ["excel_column" => ["col_name" => "claim_payable_to_name", "col_index" => 75], "db_column" => "claim_payable_to_name"],
+ ["excel_column" => ["col_name" => "utr_no", "col_index" => 76], "db_column" => "utr_no"],
+ ["excel_column" => ["col_name" => "utr_date", "col_index" => 77], "db_column" => "utr_date"],
+ ["excel_column" => ["col_name" => "denial_short_description", "col_index" => 78], "db_column" => "denial_short_description"],
+ ["excel_column" => ["col_name" => "claim_received_date", "col_index" => 79], "db_column" => "claim_received_date"],
+ ["excel_column" => ["col_name" => "last_necessary_doc_rec_date", "col_index" => 80], "db_column" => "last_necessary_doc_rec_date"],
+ ["excel_column" => ["col_name" => "processed_date", "col_index" => 81], "db_column" => "processed_date"],
+ ["excel_column" => ["col_name" => "first_document_attached_date", "col_index" => 82], "db_column" => "first_document_attached_date"],
+ ["excel_column" => ["col_name" => "claim_processing_tat_days", "col_index" => 83], "db_column" => "claim_processing_tat_days"],
+ ["excel_column" => ["col_name" => "ready_for_payment_date", "col_index" => 84], "db_column" => "ready_for_payment_date"],
+ ["excel_column" => ["col_name" => "payment_date", "col_index" => 85], "db_column" => "payment_date"],
+ ["excel_column" => ["col_name" => "claim_payment_tat_days", "col_index" => 86], "db_column" => "claim_payment_tat_days"],
+ ["excel_column" => ["col_name" => "denial_description", "col_index" => 87], "db_column" => "denial_description"],
+ ["excel_column" => ["col_name" => "error_group", "col_index" => 88], "db_column" => "error_group"],
+ ["excel_column" => ["col_name" => "tpa_name", "col_index" => 89], "db_column" => "tpa_name"],
+ ["excel_column" => ["col_name" => "new_short_error_group", "col_index" => 90], "db_column" => "new_short_error_group"],
+ ["excel_column" => ["col_name" => "death_claim", "col_index" => 91], "db_column" => "death_claim"],
+ ["excel_column" => ["col_name" => "vip_claim", "col_index" => 92], "db_column" => "vip_claim"],
+ ["excel_column" => ["col_name" => "balance_sum_insured_exhausted", "col_index" => 93], "db_column" => "balance_sum_insured_exhausted"],
+ ];
+
+
+ protected $ticketMasterMapping = [
+
+ // Employee / Beneficiary details
+ 'pribenef_employee_code' => 'emp_code',
+ 'benef_relation' => 'relationship',
+
+ // Policy / Claim identifiers
+ 'policy_no' => 'policy_no',
+ 'claim_id' => 'tpa_claim_id',
+ 'insurer_claim_ref_no' => 'tpa_no',
+ 'claim_pre_auths' => 'tpa_claim_push_reference_no',
+
+ // Claim type & status
+ 'claim_type' => 'claim_type',
+ 'claim_status' => 'tpa_claim_status',
+
+ // Dates
+ 'date_of_admission' => 'doa',
+ 'date_of_discharge' => 'dod',
+ 'intimation_date' => 'date_of_intimat',
+ 'settled_date' => 'settled_date',
+ 'claim_received_date' => 'registration_date',
+ 'processed_date' => 'approved_date',
+
+ // Amounts
+ 'claim_amount' => 'claim_amount',
+ 'claim_approved_amount' => 'approved_amount',
+
+ // Hospital details
+ 'hospital_name' => 'hospital_name',
+ 'hospital_address' => 'hospital_address',
+ 'hospital_city' => 'hospital_city',
+ 'hospital_state' => 'hospital_state',
+ 'hospital_pincode' => 'hospital_pin_code',
+ 'hospital_phone_no' => 'hospital_phone_no',
+
+ // Denial / approval
+ 'denial_description' => 'denial_reason',
+ 'approved_description' => 'approved_description',
+
+ // Payment
+ 'utr_no' => 'utr_details',
+ 'priority' => 1,
+ 'mode_of_intimation' => 5,
+ 'ticket_type_id' => 1,
+ ];
+
+
+ protected $statusMapping = [
+ 'Settled' => 11,
+ 'Rejected' => 8,
+ 'Denied' => 8,
+ 'Cancelled' => 13,
+ 'Processed' => 61,
+ 'Information Awaited' => 4,
+ 'Denied Letter Sent' => 66,
+ 'Cashless Document Awaited' => 3,
+ ];
+
+
+ /**
+ * ABSTRACT FUNCTIONs
+ */
+ public function bulkInsertTPATable(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_medi_assist');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function importClaimMaster(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $ticketMasterModel = new TicketMasterModel();
+ $ticketMasterModel->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketIdInTPATable(): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_medi_assist');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketMasterRejectedReasonInTPATable($data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_medi_assist');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ /**
+ * MAPPING FUNCTIONs
+ */
+
+ public function mapTPAData(array $rows, $file_id): array
+ {
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $mapped = [];
+
+ foreach ($rows as $row) {
+
+ $item = [];
+
+ foreach ($this->mapping as $map) {
+ $excelColumn = $map['excel_column']['col_name'];
+ $dbColumn = $map['db_column'];
+
+ $value = $row[$excelColumn] ?? null;
+
+ if ($this->isDateValue($value)) {
+ $value = $this->normalizeDate($value);
+ }
+
+ $item[$dbColumn] = $value;
+ }
+
+ $params = [
+ 'date_of_admission' => change_date_format($item['date_of_admission'] ?? '') ?? null,
+ 'employee_number' => $item['employee_number'] ?? null,
+ 'claim_amount' => $item['claim_amount'] ?? null,
+ 'primary_policy_holder_card_id' => $item['primary_policy_holder_card_id'] ?? null
+ ];
+
+ $is_duplicate = $this->checkDuplicateTpaClaim('claims_dump_medi_assist', $params);
+
+ if ($is_duplicate) {
+ $item = [];
+ continue;
+ }
+
+ $item['file_id'] = $file_id ?? null;
+ $item['client_id'] = $file_data['client_id'] ?? null;
+ $item['client_policy_id'] = $file_data['client_policy_id'] ?? null;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+
+ $mapped[] = $item;
+ }
+
+ return $mapped;
+ }
+
+ public function mapClaimMasterData($file_id): array
+ {
+
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $tpaClaimDumpData = $this->getTpaClaimDumpData('claims_dump_medi_assist', ['file_id' => $file_id]);
+
+ if (empty($tpaClaimDumpData)) {
+ return ['status' => false, 'message' => "No data to insert in TICKET MASTER"];
+ }
+
+
+ $ClientPolicyModel = new ClientPolicyModel();
+ $client_policy_data = $ClientPolicyModel
+ ->select("
+ client_policy.*,
+ (
+ SELECT id
+ FROM client_rm
+ WHERE is_active = 1
+ AND level = 3
+ AND client_id = client_policy.client_id
+ ORDER BY id ASC
+ LIMIT 1
+ ) AS acm_id
+ ")
+ ->where('client_policy.id', $file_data['client_policy_id'])
+ ->where('client_policy.is_active', 1)
+ ->first();
+
+ try {
+
+ $mapped = [];
+ $rejecetd_reason = [];
+
+ foreach ($tpaClaimDumpData as $row) {
+
+ $params = [
+ 'doa' => change_date_format($row['date_of_admission'] ?? '') ?? null,
+ 'emp_code' => $row['employee_number'] ?? null,
+ 'claim_amount' => $row['claim_amount'] ?? null,
+ 'tpa_no' => $row['primary_policy_holder_card_id'] ?? null
+ ];
+
+ $isduplicate = $this->checkDublicateTicketMasterClaim($params);
+
+ if ($isduplicate) {
+ $reason = "This claim already exists in our system.";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ $item = [];
+
+ $item['client_id'] = $client_policy_data['client_id'] ?? null;
+ $item['client_policy_id'] = $client_policy_data['id'] ?? null;
+ $item['insurer_id'] = $client_policy_data['insurer_id'] ?? null;
+ $item['tpa_id'] = $client_policy_data['tpa_id'] ?? null;
+ $item['acm_id'] = $client_policy_data['acm_id'] ?? null;
+ $item['policy_no'] = $client_policy_data['policy_no'] ?? null;
+ $item['relationship'] = $this->convertRelation($row['relation'] ?? null, $row['gender'] ?? null);
+
+ $employee_data = $this->getEmployeeDetails($file_data['client_id'], $file_data['client_policy_id'], $row['employee_number'], $item['relationship']);
+
+ if (!empty($employee_data)) {
+ $item['emp_id'] = $employee_data['id'] ?? null;
+ $item['emp_name'] = $employee_data['name'] ?? null;
+ $item['emp_mail'] = $employee_data['email_corporate'] ?? null;
+ $item['emp_mobile'] = $employee_data['mobile'] ?? null;
+ $item['insured_emp_id'] = $employee_data['insured_emp_id'] ?? null;
+ $item['insured_name'] = $employee_data['insured_name'] ?? null;
+ } else {
+
+ $reason = sprintf(
+ 'The policy number "%s" does not exist in our system. ' .
+ 'Details - Client ID: %s, Client Policy ID: %s, Employee Number: %s, Relationship: %s',
+ $row['insurer_policy_number'],
+ $file_data['client_id'],
+ $file_data['client_policy_id'],
+ $row['employee_number'],
+ $item['relationship']
+ );
+
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ foreach ($this->ticketMasterMapping as $tpaKey => $ticketMasterKey) {
+ $item[$ticketMasterKey] = array_key_exists($tpaKey, $row) ? $row[$tpaKey] : null;
+ }
+
+ // Meta fields
+ $item['claim_dump_ref_id'] = $row['id'];
+ $item['file_id'] = $file_id;
+ $item['claim_status_id'] = $statusMapping[$row['claim_status']] ?? 61;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+ $item['claim_type'] = isset($row['mainclaim_prepost_type']) && !empty($row['mainclaim_prepost_type']) && strtolower($row['mainclaim_prepost_type']) == 'normal' ? 1 : 3;
+
+ $mapped[] = $item;
+ }
+
+ return ['status' => true, 'mapped_array' => $mapped, 'rejected_reason_array' => $rejecetd_reason];
+
+ } catch (\Throwable $th) {
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+
+ return ['status' => false, "message" => $errorData['message'], 'error_data' => $errorData];
+ }
+ }
+
+
+ /**
+ * HELPER FUNCTIONs
+ */
+
+ public function isDateValue($value): bool
+ {
+ if (empty($value)) {
+ return false;
+ }
+
+ // Excel numeric date (e.g. 44927)
+ if (is_numeric($value) && $value > 30000) {
+ return true;
+ }
+
+ // Common date formats
+ return preg_match(
+ '/^\d{1,2}[\/\-]\d{1,2}[\/\-]\d{2,4}$|^\d{4}[\/\-]\d{1,2}[\/\-]\d{1,2}$/',
+ (string) $value
+ ) === 1;
+ }
+
+
+ public function normalizeDate($value): ?string
+ {
+ try {
+ // Excel numeric date
+ if (is_numeric($value)) {
+ return date('Y-m-d', \PhpOffice\PhpSpreadsheet\Shared\Date::excelToTimestamp($value));
+ }
+
+ // String date
+ return date('Y-m-d', strtotime(str_replace('/', '-', $value)));
+ } catch (\Throwable $e) {
+ return null;
+ }
+ }
+
+
+ public function convertRelation(string $relation, string $gender): ?string
+ {
+ if (empty($relation)) {
+ return null;
+ }
+
+ $relation = strtolower($relation);
+ $gender = strtolower($gender);
+
+ if ($relation == 'self') {
+ return $relation;
+ }
+
+ if ($relation == 'spouse') {
+ return $relation;
+ }
+
+ if ($relation == 'child' && $gender == 'male') {
+ return 'son';
+ }
+
+ if ($relation == 'child' && $gender == 'female') {
+ return 'daughter';
+ }
+
+ if ($relation == 'parents' && $gender == 'male') {
+ return 'father';
+ }
+
+ if ($relation == 'parents' && $gender == 'female') {
+ return 'mother';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'male') {
+ return 'father-in-law';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'female') {
+ return 'mother-in-law';
+ }
+
+ return null;
+ }
+
+
+
+}
diff --git a/app/Libraries/TPAClaimsImportServices/RcareClaimImportService.php b/app/Libraries/TPAClaimsImportServices/RcareClaimImportService.php
new file mode 100644
index 00000000..8fef8232
--- /dev/null
+++ b/app/Libraries/TPAClaimsImportServices/RcareClaimImportService.php
@@ -0,0 +1,447 @@
+ ["col_name" => "CLInwardNo", "col_index" => 0], "db_column" => "cl_inward_no"],
+ ["excel_column" => ["col_name" => "Inward Date", "col_index" => 1], "db_column" => "inward_date"],
+ ["excel_column" => ["col_name" => "Claim Classification", "col_index" => 2], "db_column" => "claim_classification"],
+ ["excel_column" => ["col_name" => "Policy Name", "col_index" => 3], "db_column" => "policy_name"],
+ ["excel_column" => ["col_name" => "Policy Number", "col_index" => 4], "db_column" => "policy_number"],
+ ["excel_column" => ["col_name" => "Policy Start Date", "col_index" => 5], "db_column" => "policy_start_date"],
+ ["excel_column" => ["col_name" => "Policy End Date", "col_index" => 6], "db_column" => "policy_end_date"],
+ ["excel_column" => ["col_name" => "UHID", "col_index" => 7], "db_column" => "uhid"],
+ ["excel_column" => ["col_name" => "Insured Name", "col_index" => 8], "db_column" => "insured_name"],
+ ["excel_column" => ["col_name" => "Patient Name", "col_index" => 9], "db_column" => "patient_name"],
+ ["excel_column" => ["col_name" => "Employee/Member Id", "col_index" => 10], "db_column" => "employee_member_id"],
+ ["excel_column" => ["col_name" => "Grade", "col_index" => 11], "db_column" => "grade"],
+ ["excel_column" => ["col_name" => "Relation", "col_index" => 12], "db_column" => "relation"],
+ ["excel_column" => ["col_name" => "Age", "col_index" => 13], "db_column" => "age"],
+ ["excel_column" => ["col_name" => "Gender", "col_index" => 14], "db_column" => "gender"],
+ ["excel_column" => ["col_name" => "DF/DNF idenitifcation", "col_index" => 15], "db_column" => "df_dnf_identification"],
+ ["excel_column" => ["col_name" => "Sum Insured", "col_index" => 16], "db_column" => "sum_insured"],
+ ["excel_column" => ["col_name" => "DOA/OPD Treatment From", "col_index" => 17], "db_column" => "doa_opd_treatment_from"],
+ ["excel_column" => ["col_name" => "DOD/OPD Treatment To", "col_index" => 18], "db_column" => "dod_opd_treatment_to"],
+ ["excel_column" => ["col_name" => "Hospital Name", "col_index" => 19], "db_column" => "hospital_name"],
+ ["excel_column" => ["col_name" => "Hospital District", "col_index" => 20], "db_column" => "hospital_district"],
+ ["excel_column" => ["col_name" => "Hospital State", "col_index" => 21], "db_column" => "hospital_state"],
+ ["excel_column" => ["col_name" => "ICDCode", "col_index" => 22], "db_column" => "icd_code"],
+ ["excel_column" => ["col_name" => "Disease Category", "col_index" => 23], "db_column" => "disease_category"],
+ ["excel_column" => ["col_name" => "Final Status", "col_index" => 24], "db_column" => "final_status"],
+ ["excel_column" => ["col_name" => "Approved Date", "col_index" => 25], "db_column" => "approved_date"],
+ ["excel_column" => ["col_name" => "Claimed Amount", "col_index" => 26], "db_column" => "claimed_amount"],
+ ["excel_column" => ["col_name" => "Disallowed Amount", "col_index" => 27], "db_column" => "disallowed_amount"],
+ ["excel_column" => ["col_name" => "Net Sanct Amt", "col_index" => 28], "db_column" => "net_sanction_amount"],
+ ["excel_column" => ["col_name" => "Reason For Disallowance", "col_index" => 29], "db_column" => "reason_for_disallowance"],
+ ["excel_column" => ["col_name" => "External Query Remarks", "col_index" => 30], "db_column" => "external_query_remarks"],
+ ["excel_column" => ["col_name" => "Rejection Remarks", "col_index" => 31], "db_column" => "rejection_remarks"],
+ ["excel_column" => ["col_name" => "Cheque/NEFT Number", "col_index" => 32], "db_column" => "cheque_neft_number"],
+ ["excel_column" => ["col_name" => "Cheque/NEFT Date", "col_index" => 33], "db_column" => "cheque_neft_date"],
+ ["excel_column" => ["col_name" => "Diagnosis", "col_index" => 34], "db_column" => "diagnosis"],
+ ["excel_column" => ["col_name" => "Treatment Detail", "col_index" => 35], "db_column" => "treatment_detail"],
+ ["excel_column" => ["col_name" => "Member Reimbursement CL Type", "col_index" => 36], "db_column" => "member_reimbursement_cl_type"],
+ ];
+
+ protected $ticketMasterMapping = [
+
+ // Employee / Member
+ 'employee_member_id' => 'emp_code',
+ 'insured_name' => 'insured_name',
+ 'patient_name' => 'emp_name',
+ 'relation' => 'relationship',
+
+ // Policy
+ 'policy_number' => 'policy_no',
+ 'policy_start_date' => 'date_of_incep',
+
+ // Claim Dates
+ 'doa_opd_treatment_from' => 'doa',
+ 'dod_opd_treatment_to' => 'dod',
+ 'approved_date' => 'approved_date',
+
+ // Claim Amounts
+ 'claimed_amount' => 'claim_amount',
+ 'net_sanction_amount' => 'approved_amount',
+
+ // Status / Remarks
+ 'final_status' => 'tpa_claim_status',
+ 'reason_for_disallowance' => 'denial_reason',
+ 'rejection_remarks' => 'return_remark',
+
+ // Hospital
+ 'hospital_name' => 'hospital_name',
+ 'hospital_state' => 'hospital_state',
+ 'hospital_district' => 'hospital_city',
+
+ 'diagnosis' => 'claim_description',
+
+ // Payment
+ 'cheque_neft_number' => 'utr_details',
+ 'cheque_neft_date' => 'settled_date',
+
+ // References
+ 'cl_inward_no' => 'claim_number',
+
+ 'priority' => 1,
+ 'mode_of_intimation' => 5,
+ 'ticket_type_id' => 1,
+ ];
+
+ protected $statusMapping = [
+ 'Settled' => 11,
+ 'Rejected' => 8,
+ 'Denied' => 8,
+ 'Cancelled' => 13,
+ 'Processed' => 61,
+ 'Information Awaited' => 4,
+ 'Denied Letter Sent' => 66,
+ 'Cashless Document Awaited' => 3,
+ ];
+
+ /**
+ * ABSTRACT FUNCTIONs
+ */
+ public function bulkInsertTPATable(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ try {
+
+ $builder = $this->db->table('claims_dump_reliance');
+ $builder->insertBatch($data);
+
+ return true;
+
+ } catch (\Throwable $th) {
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+ dd($errorData);
+ return false;
+ }
+
+ }
+
+
+ public function importClaimMaster(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $ticketMasterModel = new TicketMasterModel();
+ $ticketMasterModel->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketIdInTPATable(): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_reliance');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketMasterRejectedReasonInTPATable($data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_reliance');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ /**
+ * MAPPING FUNCTIONs
+ */
+
+ public function mapTPAData(array $rows, $file_id): array
+ {
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $mapped = [];
+ foreach ($rows as $row) {
+
+ $item = [];
+
+ foreach ($this->mapping as $map) {
+ $excelColumn = $map['excel_column']['col_name'];
+ $dbColumn = $map['db_column'];
+
+ $value = $row[$excelColumn] ?? null;
+
+ if ($this->isDateValue($value)) {
+ $value = $this->normalizeDate($value);
+ }
+
+ $item[$dbColumn] = $value;
+ }
+
+ $params = [
+ 'doa_opd_treatment_from' => $item['doa_opd_treatment_from'] ?? null,
+ 'employee_member_id' => $item['employee_member_id'] ?? null,
+ 'claimed_amount' => $item['claimed_amount'] ?? null,
+ 'uhid' => $item['uhid'] ?? null
+ ];
+
+ $is_duplicate = $this->checkDuplicateTpaClaim('claims_dump_reliance', $params);
+
+ if ($is_duplicate) {
+ $item = [];
+ continue;
+ }
+
+ $item['file_id'] = $file_id ?? null;
+ $item['client_id'] = $file_data['client_id'] ?? null;
+ $item['client_policy_id'] = $file_data['client_policy_id'] ?? null;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+
+ $mapped[] = $item;
+ }
+
+ return $mapped;
+ }
+
+ public function mapClaimMasterData($file_id): array
+ {
+
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $tpaClaimDumpData = $this->getTpaClaimDumpData('claims_dump_reliance', ['file_id' => $file_id]);
+
+ if (empty($tpaClaimDumpData)) {
+ return ['status' => false, 'message' => "No data to insert in TICKET MASTER"];
+ }
+
+
+ $ClientPolicyModel = new ClientPolicyModel();
+ $client_policy_data = $ClientPolicyModel
+ ->select("
+ client_policy.*,
+ (
+ SELECT id
+ FROM client_rm
+ WHERE is_active = 1
+ AND level = 3
+ AND client_id = client_policy.client_id
+ ORDER BY id ASC
+ LIMIT 1
+ ) AS acm_id
+ ")
+ ->where('client_policy.id', $file_data['client_policy_id'])
+ ->where('client_policy.is_active', 1)
+ ->first();
+
+ try {
+
+ $mapped = [];
+ $rejecetd_reason = [];
+
+ foreach ($tpaClaimDumpData as $row) {
+
+ $params = [
+ 'doa' => change_date_format($row['doa_opd_treatment_from'] ?? '') ?? null,
+ 'emp_code' => $row['employee_member_id'] ?? null,
+ 'claim_amount' => $row['claimed_amount'] ?? null,
+ 'tpa_no' => $row['uhid'] ?? null
+ ];
+
+ $isduplicate = $this->checkDublicateTicketMasterClaim($params);
+
+ if ($isduplicate) {
+ $reason = "This claim already exists in our system.";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ $item = [];
+
+ $item['client_id'] = $client_policy_data['client_id'] ?? null;
+ $item['client_policy_id'] = $client_policy_data['id'] ?? null;
+ $item['insurer_id'] = $client_policy_data['insurer_id'] ?? null;
+ $item['tpa_id'] = $client_policy_data['tpa_id'] ?? null;
+ $item['acm_id'] = $client_policy_data['acm_id'] ?? null;
+ $item['policy_no'] = $client_policy_data['policy_no'] ?? null;
+ $item['relationship'] = $this->convertRelation($row['relation'] ?? null, $row['gender'] ?? null);
+
+ $employee_data = $this->getEmployeeDetails($file_data['client_id'], $file_data['client_policy_id'], $row['employee_member_id'], $item['relationship']);
+
+ if (!empty($employee_data)) {
+ $item['emp_id'] = $employee_data['id'] ?? null;
+ $item['emp_name'] = $employee_data['name'] ?? null;
+ $item['emp_mail'] = $employee_data['email_corporate'] ?? null;
+ $item['emp_mobile'] = $employee_data['mobile'] ?? null;
+ $item['insured_emp_id'] = $employee_data['insured_emp_id'] ?? null;
+ $item['insured_name'] = $employee_data['insured_name'] ?? null;
+ } else {
+
+ $reason = sprintf(
+ 'The policy number "%s" does not exist in our system. ' .
+ 'Details - Client ID: %s, Client Policy ID: %s, Employee Number: %s, Relationship: %s',
+ $row['insurer_policy_number'],
+ $file_data['client_id'],
+ $file_data['client_policy_id'],
+ $row['employee_number'],
+ $item['relationship']
+ );
+
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ foreach ($this->ticketMasterMapping as $tpaKey => $ticketMasterKey) {
+ $item[$ticketMasterKey] = array_key_exists($tpaKey, $row) ? $row[$tpaKey] : null;
+ }
+
+ // Meta fields
+ $item['claim_status_id'] = $statusMapping[$row['final_status']] ?? 61;
+ $item['file_id'] = $file_id;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+ $item['claim_type'] = 1;
+
+ $mapped[] = $item;
+ }
+
+ return ['status' => true, 'mapped_array' => $mapped, 'rejected_reason_array' => $rejecetd_reason];
+
+ } catch (\Throwable $th) {
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+
+ return ['status' => false, "message" => $errorData['message'], 'error_data' => $errorData];
+ }
+ }
+
+
+ /**
+ * HELPER FUNCTIONs
+ */
+
+ public function isDateValue($value): bool
+ {
+ if (empty($value)) {
+ return false;
+ }
+
+ // Excel numeric date (e.g. 44927)
+ if (is_numeric($value) && $value > 30000) {
+ return true;
+ }
+
+ // Common date formats
+ return preg_match(
+ '/^\d{1,2}[\/\-]\d{1,2}[\/\-]\d{2,4}$|^\d{4}[\/\-]\d{1,2}[\/\-]\d{1,2}$/',
+ (string) $value
+ ) === 1;
+ }
+
+
+ public function normalizeDate($value): ?string
+ {
+ try {
+ // Excel numeric date
+ if (is_numeric($value)) {
+ return date('Y-m-d', \PhpOffice\PhpSpreadsheet\Shared\Date::excelToTimestamp($value));
+ }
+
+ // String date
+ return date('Y-m-d', strtotime(str_replace('/', '-', $value)));
+ } catch (\Throwable $e) {
+ return null;
+ }
+ }
+
+
+ public function convertRelation(string $relation, string $gender): ?string
+ {
+ if (empty($relation)) {
+ return null;
+ }
+
+ $relation = strtolower($relation);
+ $gender = strtolower($gender);
+
+ if ($relation == 'self') {
+ return $relation;
+ }
+
+ if ($relation == 'spouse') {
+ return $relation;
+ }
+
+ if ($relation == 'child' && $gender == 'male') {
+ return 'son';
+ }
+
+ if ($relation == 'child' && $gender == 'female') {
+ return 'daughter';
+ }
+
+ if ($relation == 'parents' && $gender == 'male') {
+ return 'father';
+ }
+
+ if ($relation == 'parents' && $gender == 'female') {
+ return 'mother';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'male') {
+ return 'father-in-law';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'female') {
+ return 'mother-in-law';
+ }
+
+ return null;
+ }
+
+
+
+}
diff --git a/app/Libraries/TPAClaimsImportServices/VidalClaimImportService.php b/app/Libraries/TPAClaimsImportServices/VidalClaimImportService.php
new file mode 100644
index 00000000..33243d22
--- /dev/null
+++ b/app/Libraries/TPAClaimsImportServices/VidalClaimImportService.php
@@ -0,0 +1,811 @@
+ "TPA Policy Number", "db_column" => "tpa_policy_number"],
+ ["excel_column" => "Insurer Policy Number", "db_column" => "insurer_policy_number"],
+ ["excel_column" => "Corporate Name", "db_column" => "corporate_name"],
+ ["excel_column" => "Proposer Name", "db_column" => "proposer_name"],
+ ["excel_column" => "Corporate Group ID", "db_column" => "corporate_group_id"],
+
+ ["excel_column" => "Policy Start Date", "db_column" => "policy_start_date"],
+ ["excel_column" => "Policy End date", "db_column" => "policy_end_date"],
+
+ ["excel_column" => "Insurance Company Name", "db_column" => "insurance_company_name"],
+
+ ["excel_column" => "Employee Number", "db_column" => "employee_number"],
+ ["excel_column" => "Employee Location", "db_column" => "employee_location"],
+
+ ["excel_column" => "Primary Policy Holder Name", "db_column" => "primary_policy_holder_name"],
+ ["excel_column" => "Primary Policy Holder Card ID", "db_column" => "primary_policy_holder_card_id"],
+
+ ["excel_column" => "Employee Grade", "db_column" => "employee_grade"],
+
+ ["excel_column" => "Patient Health Card ID", "db_column" => "patient_health_card_id"],
+ ["excel_column" => "Patient Name", "db_column" => "patient_name"],
+ ["excel_column" => "Date of Birth", "db_column" => "date_of_birth"],
+ ["excel_column" => "Age", "db_column" => "age"],
+ ["excel_column" => "Gender", "db_column" => "gender"],
+ ["excel_column" => "Relation", "db_column" => "relation"],
+
+ ["excel_column" => "Sum Insured", "db_column" => "sum_insured"],
+ ["excel_column" => "Balance Sum Insured", "db_column" => "balance_sum_insured"],
+ ["excel_column" => "Top Up Sum Insured", "db_column" => "top_up_sum_insured"],
+
+ ["excel_column" => "Enrollment status", "db_column" => "enrollment_status"],
+
+ ["excel_column" => "Policy Inception date", "db_column" => "policy_inception_date"],
+ ["excel_column" => "Policy Exit Date", "db_column" => "policy_exit_date"],
+
+ ["excel_column" => "Insurer Risk ID", "db_column" => "insurer_risk_id"],
+
+ ["excel_column" => "Claim Preauth Identifier", "db_column" => "claim_preauth_identifier"],
+ ["excel_column" => "TPA Claim Number", "db_column" => "tpa_claim_number"],
+ ["excel_column" => "Preauth Number", "db_column" => "preauth_number"],
+ ["excel_column" => "Insurer Claim Number", "db_column" => "insurer_claim_number"],
+
+ ["excel_column" => "Claim Received date", "db_column" => "claim_received_date"],
+ ["excel_column" => "Date of Admission", "db_column" => "date_of_admission"],
+ ["excel_column" => "Date of Discharge", "db_column" => "date_of_discharge"],
+
+ ["excel_column" => "Hospital Name", "db_column" => "hospital_name"],
+ ["excel_column" => "Hospital ID", "db_column" => "hospital_id"],
+ ["excel_column" => "Hospital Address", "db_column" => "hospital_address"],
+ ["excel_column" => "Hospital City", "db_column" => "hospital_city"],
+ ["excel_column" => "Hospital State", "db_column" => "hospital_state"],
+ ["excel_column" => "Hospital Pincode", "db_column" => "hospital_pincode"],
+ ["excel_column" => "Hospital Network status", "db_column" => "hospital_network_status"],
+ ["excel_column" => "PPN Hospital Status", "db_column" => "ppn_hospital_status"],
+
+ ["excel_column" => "Room Category", "db_column" => "room_category"],
+ ["excel_column" => "Room Days", "db_column" => "room_days"],
+ ["excel_column" => "ICU Days", "db_column" => "icu_days"],
+
+ ["excel_column" => "Medical Surgical Identifier", "db_column" => "medical_surgical_identifier"],
+ ["excel_column" => "Treatment Type of AYUSH", "db_column" => "treatment_type_of_ayush"],
+ ["excel_column" => "Package", "db_column" => "package"],
+
+ ["excel_column" => "Diagnosis", "db_column" => "diagnosis"],
+ ["excel_column" => "Illness Details", "db_column" => "illness_details"],
+ ["excel_column" => "Ailment Grouping", "db_column" => "ailment_grouping"],
+
+ ["excel_column" => "Primary ICD Code", "db_column" => "primary_icd_code"],
+ ["excel_column" => "Secondary ICD Code", "db_column" => "secondary_icd_code"],
+
+ ["excel_column" => "Procedure Code", "db_column" => "procedure_code"],
+ ["excel_column" => "Procedure Description", "db_column" => "procedure_description"],
+ ["excel_column" => "Procedure Grouping", "db_column" => "procedure_grouping"],
+
+ ["excel_column" => "Claim Submission mode", "db_column" => "claim_submission_mode"],
+ ["excel_column" => "Admission Category", "db_column" => "admission_category"],
+ ["excel_column" => "Type of Claim", "db_column" => "type_of_claim"],
+ ["excel_column" => "MainClaim_Prepost type", "db_column" => "mainclaim_prepost_type"],
+ ["excel_column" => "Type of Hospitalization", "db_column" => "type_of_hospitalization"],
+ ["excel_column" => "Death Status", "db_column" => "death_status"],
+ ["excel_column" => "Treatement Given", "db_column" => "treatment_given"],
+
+ ["excel_column" => "Claim Amount", "db_column" => "claim_amount"],
+ ["excel_column" => "Total Billed Amount", "db_column" => "total_billed_amount"],
+
+ ["excel_column" => "Claim Consultation Charges", "db_column" => "claim_consultation_charges"],
+ ["excel_column" => "Claim Investigation Charges", "db_column" => "claim_investigation_charges"],
+ ["excel_column" => "Claim Medicines", "db_column" => "claim_medicines"],
+ ["excel_column" => "Claim Nursing", "db_column" => "claim_nursing"],
+ ["excel_column" => "Claim Room Charges", "db_column" => "claim_room_charges"],
+ ["excel_column" => "Claim Icu Charges", "db_column" => "claim_icu_charges"],
+ ["excel_column" => "Claim Stay Charges", "db_column" => "claim_stay_charges"],
+ ["excel_column" => "Claim Surgeon Charges", "db_column" => "claim_surgeon_charges"],
+ ["excel_column" => "Claim Surgery Charges", "db_column" => "claim_surgery_charges"],
+ ["excel_column" => "Claim Miscellaneous Charges", "db_column" => "claim_miscellaneous_charges"],
+ ["excel_column" => "Claim Other Charges", "db_column" => "claim_other_charges"],
+
+ ["excel_column" => "Approved Consultation Charges", "db_column" => "approved_consultation_charges"],
+ ["excel_column" => "Approved Investigation Charges", "db_column" => "approved_investigation_charges"],
+ ["excel_column" => "Approved Medicines", "db_column" => "approved_medicines"],
+ ["excel_column" => "Approved Nursing", "db_column" => "approved_nursing"],
+ ["excel_column" => "Approved Room Charges", "db_column" => "approved_room_charges"],
+ ["excel_column" => "Approved Icu Charges", "db_column" => "approved_icu_charges"],
+ ["excel_column" => "Approved Stay Charges", "db_column" => "approved_stay_charges"],
+ ["excel_column" => "Approved Surgeon Charges", "db_column" => "approved_surgeon_charges"],
+ ["excel_column" => "Approved Surgery Charges", "db_column" => "approved_surgery_charges"],
+ ["excel_column" => "Approved Miscellaneous Charges", "db_column" => "approved_miscellaneous_charges"],
+ ["excel_column" => "Approved Others Charges", "db_column" => "approved_others_charges"],
+
+ ["excel_column" => "Total Disallowed Amount", "db_column" => "total_disallowed_amount"],
+ ["excel_column" => "Copayment Amount", "db_column" => "copayment_amount"],
+ ["excel_column" => "Deposit Amount", "db_column" => "deposit_amount"],
+
+ ["excel_column" => "Exceeds Policy Limit", "db_column" => "exceeds_policy_limit"],
+ ["excel_column" => "Copay Buffer", "db_column" => "copay_buffer"],
+ ["excel_column" => "Hospital Discount Amount", "db_column" => "hospital_discount_amount"],
+ ["excel_column" => "Deductible Amount", "db_column" => "deductible_amount"],
+
+ ["excel_column" => "Approved Amount", "db_column" => "approved_amount"],
+ ["excel_column" => "Total Incurred Amount", "db_column" => "total_incurred_amount"],
+ ["excel_column" => "Total Buffer Approved", "db_column" => "total_buffer_approved"],
+ ["excel_column" => "Total Buffer Utlilized", "db_column" => "total_buffer_utilized"],
+
+ ["excel_column" => "TDS Amount", "db_column" => "tds_amount"],
+ ["excel_column" => "Net Amount", "db_column" => "net_amount"],
+
+ ["excel_column" => "Claim Decision date", "db_column" => "claim_decision_date"],
+ ["excel_column" => "Payment Reference Number", "db_column" => "payment_reference_number"],
+ ["excel_column" => "Payment Reference Date", "db_column" => "payment_reference_date"],
+
+ ["excel_column" => "Claim Status", "db_column" => "claim_status"],
+ ["excel_column" => "Deduction Remarks", "db_column" => "deduction_remarks"],
+ ["excel_column" => "Rejection Reasons", "db_column" => "rejection_reasons"],
+ ["excel_column" => "Claim Query Reasons", "db_column" => "claim_query_reasons"],
+
+ ["excel_column" => "Insurer Request Sent date", "db_column" => "insurer_request_sent_date"],
+ ["excel_column" => "Insurer Conf. Received date", "db_column" => "insurer_conf_received_date"],
+ ["excel_column" => "Claim Reopen Date", "db_column" => "claim_reopen_date"],
+
+ ["excel_column" => "First Query Raised date", "db_column" => "first_query_raised_date"],
+ ["excel_column" => "First Query response date", "db_column" => "first_query_response_date"],
+ ["excel_column" => "Last Query Raised date", "db_column" => "last_query_raised_date"],
+ ["excel_column" => "Last Query response date", "db_column" => "last_query_response_date"],
+ ["excel_column" => "Last Document Received date", "db_column" => "last_document_received_date"],
+ ];
+
+
+ protected $mapping = [
+
+ ["excel_column" => ["col_name" => "TPA Policy Number", "col_index" => 0], "db_column" => "tpa_policy_number"],
+ ["excel_column" => ["col_name" => "Insurer Policy Number", "col_index" => 1], "db_column" => "insurer_policy_number"],
+ ["excel_column" => ["col_name" => "Corporate Name", "col_index" => 2], "db_column" => "corporate_name"],
+ ["excel_column" => ["col_name" => "Proposer Name", "col_index" => 3], "db_column" => "proposer_name"],
+ ["excel_column" => ["col_name" => "Corporate Group ID", "col_index" => 4], "db_column" => "corporate_group_id"],
+
+ ["excel_column" => ["col_name" => "Policy Start Date", "col_index" => 5], "db_column" => "policy_start_date"],
+ ["excel_column" => ["col_name" => "Policy End date", "col_index" => 6], "db_column" => "policy_end_date"],
+
+ ["excel_column" => ["col_name" => "Insurance Company Name", "col_index" => 7], "db_column" => "insurance_company_name"],
+
+ ["excel_column" => ["col_name" => "Employee Number", "col_index" => 8], "db_column" => "employee_number"],
+ ["excel_column" => ["col_name" => "Employee Location", "col_index" => 9], "db_column" => "employee_location"],
+
+ ["excel_column" => ["col_name" => "Primary Policy Holder Name", "col_index" => 10], "db_column" => "primary_policy_holder_name"],
+ ["excel_column" => ["col_name" => "Primary Policy Holder Card ID", "col_index" => 11], "db_column" => "primary_policy_holder_card_id"],
+
+ ["excel_column" => ["col_name" => "Employee Grade", "col_index" => 12], "db_column" => "employee_grade"],
+
+ ["excel_column" => ["col_name" => "Patient Health Card ID", "col_index" => 13], "db_column" => "patient_health_card_id"],
+ ["excel_column" => ["col_name" => "Patient Name", "col_index" => 14], "db_column" => "patient_name"],
+ ["excel_column" => ["col_name" => "Date of Birth", "col_index" => 15], "db_column" => "date_of_birth"],
+ ["excel_column" => ["col_name" => "Age", "col_index" => 16], "db_column" => "age"],
+ ["excel_column" => ["col_name" => "Gender", "col_index" => 17], "db_column" => "gender"],
+ ["excel_column" => ["col_name" => "Relation", "col_index" => 18], "db_column" => "relation"],
+
+ ["excel_column" => ["col_name" => "Sum Insured", "col_index" => 19], "db_column" => "sum_insured"],
+ ["excel_column" => ["col_name" => "Balance Sum Insured", "col_index" => 20], "db_column" => "balance_sum_insured"],
+ ["excel_column" => ["col_name" => "Top Up Sum Insured", "col_index" => 21], "db_column" => "top_up_sum_insured"],
+
+ ["excel_column" => ["col_name" => "Enrollment status", "col_index" => 22], "db_column" => "enrollment_status"],
+
+ ["excel_column" => ["col_name" => "Policy Inception date", "col_index" => 23], "db_column" => "policy_inception_date"],
+ ["excel_column" => ["col_name" => "Policy Exit Date", "col_index" => 24], "db_column" => "policy_exit_date"],
+
+ ["excel_column" => ["col_name" => "Insurer Risk ID", "col_index" => 25], "db_column" => "insurer_risk_id"],
+
+ ["excel_column" => ["col_name" => "Claim Preauth Identifier", "col_index" => 26], "db_column" => "claim_preauth_identifier"],
+ ["excel_column" => ["col_name" => "TPA Claim Number", "col_index" => 27], "db_column" => "tpa_claim_number"],
+ ["excel_column" => ["col_name" => "Preauth Number", "col_index" => 28], "db_column" => "preauth_number"],
+ ["excel_column" => ["col_name" => "Insurer Claim Number", "col_index" => 29], "db_column" => "insurer_claim_number"],
+
+ ["excel_column" => ["col_name" => "Claim Received date", "col_index" => 30], "db_column" => "claim_received_date"],
+ ["excel_column" => ["col_name" => "Date of Admission", "col_index" => 31], "db_column" => "date_of_admission"],
+ ["excel_column" => ["col_name" => "Date of Discharge", "col_index" => 32], "db_column" => "date_of_discharge"],
+
+ ["excel_column" => ["col_name" => "Hospital Name", "col_index" => 33], "db_column" => "hospital_name"],
+ ["excel_column" => ["col_name" => "Hospital ID", "col_index" => 34], "db_column" => "hospital_id"],
+ ["excel_column" => ["col_name" => "Hospital Address", "col_index" => 35], "db_column" => "hospital_address"],
+ ["excel_column" => ["col_name" => "Hospital City", "col_index" => 36], "db_column" => "hospital_city"],
+ ["excel_column" => ["col_name" => "Hospital State", "col_index" => 37], "db_column" => "hospital_state"],
+ ["excel_column" => ["col_name" => "Hospital Pincode", "col_index" => 38], "db_column" => "hospital_pincode"],
+ ["excel_column" => ["col_name" => "Hospital Network status", "col_index" => 39], "db_column" => "hospital_network_status"],
+ ["excel_column" => ["col_name" => "PPN Hospital Status", "col_index" => 40], "db_column" => "ppn_hospital_status"],
+
+ ["excel_column" => ["col_name" => "Room Category", "col_index" => 41], "db_column" => "room_category"],
+ ["excel_column" => ["col_name" => "Room Days", "col_index" => 42], "db_column" => "room_days"],
+ ["excel_column" => ["col_name" => "ICU Days", "col_index" => 43], "db_column" => "icu_days"],
+
+ ["excel_column" => ["col_name" => "Medical Surgical Identifier", "col_index" => 44], "db_column" => "medical_surgical_identifier"],
+ ["excel_column" => ["col_name" => "Treatment Type of AYUSH", "col_index" => 45], "db_column" => "treatment_type_of_ayush"],
+ ["excel_column" => ["col_name" => "Package", "col_index" => 46], "db_column" => "package"],
+
+ ["excel_column" => ["col_name" => "Diagnosis", "col_index" => 47], "db_column" => "diagnosis"],
+ ["excel_column" => ["col_name" => "Illness Details", "col_index" => 48], "db_column" => "illness_details"],
+ ["excel_column" => ["col_name" => "Ailment Grouping", "col_index" => 49], "db_column" => "ailment_grouping"],
+
+ ["excel_column" => ["col_name" => "Primary ICD Code", "col_index" => 50], "db_column" => "primary_icd_code"],
+ ["excel_column" => ["col_name" => "Secondary ICD Code", "col_index" => 51], "db_column" => "secondary_icd_code"],
+
+ ["excel_column" => ["col_name" => "Procedure Code", "col_index" => 52], "db_column" => "procedure_code"],
+ ["excel_column" => ["col_name" => "Procedure Description", "col_index" => 53], "db_column" => "procedure_description"],
+ ["excel_column" => ["col_name" => "Procedure Grouping", "col_index" => 54], "db_column" => "procedure_grouping"],
+
+ ["excel_column" => ["col_name" => "Claim Submission mode", "col_index" => 55], "db_column" => "claim_submission_mode"],
+ ["excel_column" => ["col_name" => "Admission Category", "col_index" => 56], "db_column" => "admission_category"],
+ ["excel_column" => ["col_name" => "Type of Claim", "col_index" => 57], "db_column" => "type_of_claim"],
+ ["excel_column" => ["col_name" => "MainClaim_Prepost type", "col_index" => 58], "db_column" => "mainclaim_prepost_type"],
+ ["excel_column" => ["col_name" => "Type of Hospitalization", "col_index" => 59], "db_column" => "type_of_hospitalization"],
+ ["excel_column" => ["col_name" => "Death Status", "col_index" => 60], "db_column" => "death_status"],
+ ["excel_column" => ["col_name" => "Treatement Given", "col_index" => 61], "db_column" => "treatment_given"],
+
+ ["excel_column" => ["col_name" => "Claim Amount", "col_index" => 62], "db_column" => "claim_amount"],
+ ["excel_column" => ["col_name" => "Total Billed Amount", "col_index" => 63], "db_column" => "total_billed_amount"],
+
+ ["excel_column" => ["col_name" => "Claim Consultation Charges", "col_index" => 64], "db_column" => "claim_consultation_charges"],
+ ["excel_column" => ["col_name" => "Claim Investigation Charges", "col_index" => 65], "db_column" => "claim_investigation_charges"],
+ ["excel_column" => ["col_name" => "Claim Medicines", "col_index" => 66], "db_column" => "claim_medicines"],
+ ["excel_column" => ["col_name" => "Claim Nursing", "col_index" => 67], "db_column" => "claim_nursing"],
+ ["excel_column" => ["col_name" => "Claim Room Charges", "col_index" => 68], "db_column" => "claim_room_charges"],
+ ["excel_column" => ["col_name" => "Claim Icu Charges", "col_index" => 69], "db_column" => "claim_icu_charges"],
+ ["excel_column" => ["col_name" => "Claim Stay Charges", "col_index" => 70], "db_column" => "claim_stay_charges"],
+ ["excel_column" => ["col_name" => "Claim Surgeon Charges", "col_index" => 71], "db_column" => "claim_surgeon_charges"],
+ ["excel_column" => ["col_name" => "Claim Surgery Charges", "col_index" => 72], "db_column" => "claim_surgery_charges"],
+ ["excel_column" => ["col_name" => "Claim Miscellaneous Charges", "col_index" => 73], "db_column" => "claim_miscellaneous_charges"],
+ ["excel_column" => ["col_name" => "Claim Other Charges", "col_index" => 74], "db_column" => "claim_other_charges"],
+
+ ["excel_column" => ["col_name" => "Approved Consultation Charges", "col_index" => 75], "db_column" => "approved_consultation_charges"],
+ ["excel_column" => ["col_name" => "Approved Investigation Charges", "col_index" => 76], "db_column" => "approved_investigation_charges"],
+ ["excel_column" => ["col_name" => "Approved Medicines", "col_index" => 77], "db_column" => "approved_medicines"],
+ ["excel_column" => ["col_name" => "Approved Nursing", "col_index" => 78], "db_column" => "approved_nursing"],
+ ["excel_column" => ["col_name" => "Approved Room Charges", "col_index" => 79], "db_column" => "approved_room_charges"],
+ ["excel_column" => ["col_name" => "Approved Icu Charges", "col_index" => 80], "db_column" => "approved_icu_charges"],
+ ["excel_column" => ["col_name" => "Approved Stay Charges", "col_index" => 81], "db_column" => "approved_stay_charges"],
+ ["excel_column" => ["col_name" => "Approved Surgeon Charges", "col_index" => 82], "db_column" => "approved_surgeon_charges"],
+ ["excel_column" => ["col_name" => "Approved Surgery Charges", "col_index" => 83], "db_column" => "approved_surgery_charges"],
+ ["excel_column" => ["col_name" => "Approved Miscellaneous Charges", "col_index" => 84], "db_column" => "approved_miscellaneous_charges"],
+ ["excel_column" => ["col_name" => "Approved Others Charges", "col_index" => 85], "db_column" => "approved_others_charges"],
+
+ ["excel_column" => ["col_name" => "Total Disallowed Amount", "col_index" => 86], "db_column" => "total_disallowed_amount"],
+ ["excel_column" => ["col_name" => "Copayment Amount", "col_index" => 87], "db_column" => "copayment_amount"],
+ ["excel_column" => ["col_name" => "Deposit Amount", "col_index" => 88], "db_column" => "deposit_amount"],
+
+ ["excel_column" => ["col_name" => "Exceeds Policy Limit", "col_index" => 89], "db_column" => "exceeds_policy_limit"],
+ ["excel_column" => ["col_name" => "Copay Buffer", "col_index" => 90], "db_column" => "copay_buffer"],
+ ["excel_column" => ["col_name" => "Hospital Discount Amount", "col_index" => 91], "db_column" => "hospital_discount_amount"],
+ ["excel_column" => ["col_name" => "Deductible Amount", "col_index" => 92], "db_column" => "deductible_amount"],
+
+ ["excel_column" => ["col_name" => "Approved Amount", "col_index" => 93], "db_column" => "approved_amount"],
+ ["excel_column" => ["col_name" => "Total Incurred Amount", "col_index" => 94], "db_column" => "total_incurred_amount"],
+ ["excel_column" => ["col_name" => "Total Buffer Approved", "col_index" => 95], "db_column" => "total_buffer_approved"],
+ ["excel_column" => ["col_name" => "Total Buffer Utlilized", "col_index" => 96], "db_column" => "total_buffer_utilized"],
+
+ ["excel_column" => ["col_name" => "TDS Amount", "col_index" => 97], "db_column" => "tds_amount"],
+ ["excel_column" => ["col_name" => "Net Amount", "col_index" => 98], "db_column" => "net_amount"],
+
+ ["excel_column" => ["col_name" => "Claim Decision date", "col_index" => 99], "db_column" => "claim_decision_date"],
+ ["excel_column" => ["col_name" => "Payment Reference Number", "col_index" => 100], "db_column" => "payment_reference_number"],
+ ["excel_column" => ["col_name" => "Payment Reference Date", "col_index" => 101], "db_column" => "payment_reference_date"],
+
+ ["excel_column" => ["col_name" => "Claim Status", "col_index" => 102], "db_column" => "claim_status"],
+ ["excel_column" => ["col_name" => "Deduction Remarks", "col_index" => 103], "db_column" => "deduction_remarks"],
+ ["excel_column" => ["col_name" => "Rejection Reasons", "col_index" => 104], "db_column" => "rejection_reasons"],
+ ["excel_column" => ["col_name" => "Claim Query Reasons", "col_index" => 105], "db_column" => "claim_query_reasons"],
+
+ ["excel_column" => ["col_name" => "Insurer Request Sent date", "col_index" => 106], "db_column" => "insurer_request_sent_date"],
+ ["excel_column" => ["col_name" => "Insurer Conf. Received date", "col_index" => 107], "db_column" => "insurer_conf_received_date"],
+ ["excel_column" => ["col_name" => "Claim Reopen Date", "col_index" => 108], "db_column" => "claim_reopen_date"],
+
+ ["excel_column" => ["col_name" => "First Query Raised date", "col_index" => 109], "db_column" => "first_query_raised_date"],
+ ["excel_column" => ["col_name" => "First Query response date", "col_index" => 110], "db_column" => "first_query_response_date"],
+ ["excel_column" => ["col_name" => "Last Query Raised date", "col_index" => 111], "db_column" => "last_query_raised_date"],
+ ["excel_column" => ["col_name" => "Last Query response date", "col_index" => 112], "db_column" => "last_query_response_date"],
+ ["excel_column" => ["col_name" => "Last Document Received date", "col_index" => 113], "db_column" => "last_document_received_date"],
+ ];
+
+
+ protected $ticketMasterMapping = [
+
+ // Policy / Claim identifiers
+ 'insurer_policy_number' => 'policy_no',
+ 'insurer_claim_number' => 'claim_number',
+ 'tpa_claim_number' => 'tpa_claim_id',
+
+ // Employee / Insured details
+ 'employee_number' => 'emp_code',
+ 'primary_policy_holder_name' => 'emp_name',
+ 'patient_name' => 'insured_name',
+
+ // Dates
+ 'date_of_admission' => 'doa',
+ 'date_of_discharge' => 'dod',
+ 'date_of_birth' => 'dob',
+ 'claim_received_date' => 'registration_date',
+
+ // Claim details
+ 'claim_amount' => 'claim_amount',
+ 'approved_amount' => 'approved_amount',
+ 'sum_insured' => 'si_amt',
+ 'claim_status' => 'tpa_claim_status',
+
+ // Hospital details
+ 'hospital_name' => 'hospital_name',
+ 'hospital_address' => 'hospital_address',
+ 'hospital_city' => 'hospital_city',
+ 'hospital_state' => 'hospital_state',
+ 'hospital_pincode' => 'hospital_pin_code',
+
+ // Meta
+ 'file_id' => 'file_id',
+ 'priority' => 1,
+ 'mode_of_intimation' => 5,
+ 'ticket_type_id' => 1,
+ ];
+
+
+ protected $statusMapping = [
+ 'CL Paid with Settlement Letter' => 11,
+ 'CL Rejected' => 8,
+ 'CL Approved' => 9,
+ 'AL Closed' => 12,
+ ];
+
+
+ /**
+ * ABSTRACT FUNCTIONs
+ */
+ public function bulkInsertTPATable(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_vidal');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function importClaimMaster(array $data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $ticketMasterModel = new TicketMasterModel();
+ $ticketMasterModel->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketIdInTPATable(): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_vidal');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ public function updateTicketMasterRejectedReasonInTPATable($data): bool
+ {
+ if (empty($data)) {
+ return false;
+ }
+
+ $builder = $this->db->table('claims_dump_vidal');
+ $builder->insertBatch($data);
+
+ return true;
+ }
+
+
+ /**
+ * MAPPING FUNCTIONs
+ */
+
+ public function mapTPAData(array $rows, $file_id): array
+ {
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $mapped = [];
+
+ foreach ($rows as $row) {
+
+ $item = [];
+
+ foreach ($this->mapping as $map) {
+ $excelColumn = $map['excel_column']['col_name'];
+ $dbColumn = $map['db_column'];
+
+ $value = $row[$excelColumn] ?? null;
+
+ if ($this->isDateValue($value)) {
+ $value = $this->normalizeDate($value);
+ }
+
+ $item[$dbColumn] = $value;
+ }
+
+ $params = [
+ 'date_of_admission' => change_date_format($item['date_of_admission'] ?? '') ?? null,
+ 'employee_number' => $item['employee_number'] ?? null,
+ 'claim_amount' => $item['claim_amount'] ?? null,
+ 'primary_policy_holder_card_id' => $item['primary_policy_holder_card_id'] ?? null
+ ];
+
+ $is_duplicate = $this->checkDuplicateTpaClaim('claims_dump_vidal', $params);
+
+ if ($is_duplicate) {
+ $item = [];
+ continue;
+ }
+
+ $item['file_id'] = $file_id ?? null;
+ $item['client_id'] = $file_data['client_id'] ?? null;
+ $item['client_policy_id'] = $file_data['client_policy_id'] ?? null;
+ $item['created_by'] = $file_data['created_by'] ?? null;
+
+ $mapped[] = $item;
+ }
+
+ return $mapped;
+ }
+
+ public function mapClaimMasterData($file_id): array
+ {
+
+ $ClientPolicyModel = new ClaimDumpFileModel();
+ $file_data = $ClientPolicyModel->where('id', $file_id)->first();
+
+ $tpaClaimDumpData = $this->getTpaClaimDumpData('claims_dump_vidal', ['file_id' => $file_id]);
+
+ if (empty($tpaClaimDumpData)) {
+ return ['status' => false, 'message' => "No data to insert in TICKET MASTER"];
+ }
+
+
+ $ClientPolicyModel = new ClientPolicyModel();
+ $client_policy_data = $ClientPolicyModel
+ ->select("
+ client_policy.*,
+ (
+ SELECT id
+ FROM client_rm
+ WHERE is_active = 1
+ AND level = 3
+ AND client_id = client_policy.client_id
+ ORDER BY id ASC
+ LIMIT 1
+ ) AS acm_id
+ ")
+ ->where('client_policy.id', $file_data['client_policy_id'])
+ ->where('client_policy.is_active', 1)
+ ->first();
+
+ try {
+
+ $mapped = [];
+ $rejecetd_reason = [];
+
+ foreach ($tpaClaimDumpData as $row) {
+
+ $params = [
+ 'doa' => change_date_format($row['date_of_admission'] ?? '') ?? null,
+ 'emp_code' => $row['employee_number'] ?? null,
+ 'claim_amount' => $row['claim_amount'] ?? null,
+ 'tpa_no' => $row['primary_policy_holder_card_id'] ?? null
+ ];
+
+ $isduplicate = $this->checkDublicateTicketMasterClaim($params);
+
+ if ($isduplicate) {
+ $reason = "This claim already exists in our system.";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ $item = [];
+
+ $item['client_id'] = $client_policy_data['client_id'] ?? null;
+ $item['client_policy_id'] = $client_policy_data['id'] ?? null;
+ $item['insurer_id'] = $client_policy_data['insurer_id'] ?? null;
+ $item['tpa_id'] = $client_policy_data['tpa_id'] ?? null;
+ $item['acm_id'] = $client_policy_data['acm_id'] ?? null;
+ $item['policy_no'] = $client_policy_data['policy_no'] ?? null;
+ $item['relationship'] = $this->convertRelation($row['relation'] ?? null, $row['gender'] ?? null);
+
+ $employee_data = $this->getEmployeeDetails($file_data['client_id'], $file_data['client_policy_id'], $row['employee_number'], $item['relationship']);
+
+ if (!empty($employee_data)) {
+ $item['emp_id'] = $employee_data['id'] ?? null;
+ $item['emp_name'] = $employee_data['name'] ?? null;
+ $item['emp_mail'] = $employee_data['email_corporate'] ?? null;
+ $item['emp_mobile'] = $employee_data['mobile'] ?? null;
+ $item['insured_emp_id'] = $employee_data['insured_emp_id'] ?? null;
+ $item['insured_name'] = $employee_data['insured_name'] ?? null;
+ } else {
+
+ $reason = sprintf(
+ 'The policy number "%s" does not exist in our system. ' .
+ 'Details - Client ID: %s, Client Policy ID: %s, Employee Number: %s, Relationship: %s',
+ $row['insurer_policy_number'],
+ $file_data['client_id'],
+ $file_data['client_policy_id'],
+ $row['employee_number'],
+ $item['relationship']
+ );
+
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ foreach ($this->ticketMasterMapping as $tpaKey => $ticketMasterKey) {
+ $item[$ticketMasterKey] = array_key_exists($tpaKey, $row) ? $row[$tpaKey] : null;
+ }
+
+ // Meta fields
+ $item['claim_status_id'] = $statusMapping[$row['status']] ?? 61;
+ $item['file_id'] = $file_id;
+ $item['claim_dump_ref_id'] = $row['id'];
+ $item['created_by'] = $file_data['created_by'] ?? null;
+ $item['claim_type'] = isset($row['mainclaim_prepost_type']) && !empty($row['mainclaim_prepost_type']) && strtolower($row['mainclaim_prepost_type']) == 'normal' ? 1 : 3;
+
+ $mapped[] = $item;
+ }
+
+ return ['status' => true, 'mapped_array' => $mapped, 'rejected_reason_array' => $rejecetd_reason];
+
+ } catch (\Throwable $th) {
+
+ $errorData = [
+ 'message' => $th->getMessage(),
+ 'file' => $th->getFile(),
+ 'line' => $th->getLine(),
+ 'code' => $th->getCode(),
+ 'trace' => $th->getTraceAsString(),
+ 'trace_array' => $th->getTrace(), // full array version (optional)
+ 'function' => $th->getTrace()[0]['function'] ?? null,
+ 'class' => $th->getTrace()[0]['class'] ?? null,
+ ];
+
+ return ['status' => false, "message" => $errorData['message'], 'error_data' => $errorData];
+ }
+ }
+
+ public function mapClaimMasterDataOld($file_id): array
+ {
+
+ $tpaClaimDumpData = $this->db
+ ->table('claims_dump_vidal')
+ ->where('is_active', 1)
+ ->where('file_id', $file_id)
+ ->where('ticket_id IS NULL')
+ ->get()
+ ->getResultArray();
+
+ if (empty($tpaClaimDumpData)) {
+ return [];
+ }
+
+ $ClientPolicyModel = new ClientPolicyModel();
+ $client_policy_data = $ClientPolicyModel->where('is_active', 1)->findAll();
+
+ $mapped = [];
+ $rejecetd_reason = [];
+
+ foreach ($tpaClaimDumpData as $row) {
+
+ $item = [];
+
+ if(isset($row['insurer_policy_number']) && !empty($row['insurer_policy_number'])){
+
+ $basic_claim_data = $this->getClientPolicyDataBypolicyNo($client_policy_data, $row['insurer_policy_number']);
+ if(empty($basic_claim_data)){
+ $reason = " This policy no ( " . $row['insurer_policy_number'] ." ) does not exist in our system";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ $item['client_id'] = $basic_claim_data['client_id'] ?? null;
+ $item['client_policy_id'] = $basic_claim_data['id'] ?? null;
+ $item['insurer_id'] = $basic_claim_data['insurer_id'] ?? null;
+ $item['tpa_id'] = $basic_claim_data['tpa_id'] ?? null;
+ $item['acm_id'] = $basic_claim_data['acm_id'] ?? null;
+ $item['policy_no'] = $basic_claim_data['policy_no'] ?? null;
+ $item['relationship'] = $this->convertRelation($row['relation'] ?? null, $row['gender'] ?? null);
+
+ $employee_data = $this->getEmployeeDetails($item['client_id'], $item['client_policy_id'], $row['employee_number'], $item['relationship']);
+ if(!empty($employee_data)){
+ $item['emp_id'] = $employee_data['client_id'] ?? null;
+ $item['emp_name'] = $employee_data['id'] ?? null;
+ $item['emp_mail'] = $employee_data['insurer_id'] ?? null;
+ $item['emp_mobile'] = $employee_data['tpa_id'] ?? null;
+ $item['insured_emp_id'] = $employee_data['insured_emp_id'] ?? null;
+ $item['insured_name'] = $employee_data['insured_name'] ?? null;
+ }else{
+ $reason = " This policy no ( " . $row['insurer_policy_number'] ." ) does not exist in our system";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ }else{
+ $reason = " Policy Number is empty";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ foreach ($this->ticketMasterMapping as $tpaKey => $ticketMasterKey) {
+ $item[$ticketMasterKey] = array_key_exists($tpaKey, $row)
+ ? $row[$tpaKey]
+ : null;
+ }
+
+ $isduplicate = checkDuplicateClaim([
+ 'doa' => change_date_format($item['doa'] ?? '') ?? null,
+ 'emp_code' => $item['emp_code'] ?? null,
+ 'claim_amount' => $item['claim_amount'] ?? null,
+ 'policy_no' => $item['policy_no'] ?? null
+ ]);
+
+ if($isduplicate){
+ $reason = " This claim ( " . $row['insurer_policy_number'] ." ) does not exist in our system";
+ $rejecetd_reason[$row['id']] = ["ticket_master_insert_reject_reason" => $reason];
+ continue;
+ }
+
+ // Meta fields
+ $item['file_id'] = $file_id;
+ $item['created_by'] = get_session_userid() ?? null;
+ $item['claim_type'] = isset($row['mainclaim_prepost_type']) && !empty($row['mainclaim_prepost_type']) && strtolower($row['mainclaim_prepost_type']) == 'normal' ? 1 : 3;
+
+ $mapped[] = $item;
+
+ }
+
+ return ['mapped_array' => $mapped, 'rejected_reason_array' => $rejecetd_reason];
+ }
+
+
+ /**
+ * HELPER FUNCTIONs
+ */
+
+ public function isDateValue($value): bool
+ {
+ if (empty($value)) {
+ return false;
+ }
+
+ // Excel numeric date (e.g. 44927)
+ if (is_numeric($value) && $value > 30000) {
+ return true;
+ }
+
+ // Common date formats
+ return preg_match(
+ '/^\d{1,2}[\/\-]\d{1,2}[\/\-]\d{2,4}$|^\d{4}[\/\-]\d{1,2}[\/\-]\d{1,2}$/',
+ (string) $value
+ ) === 1;
+ }
+
+
+ public function normalizeDate($value): ?string
+ {
+ try {
+ // Excel numeric date
+ if (is_numeric($value)) {
+ return date('Y-m-d', \PhpOffice\PhpSpreadsheet\Shared\Date::excelToTimestamp($value));
+ }
+
+ // String date
+ return date('Y-m-d', strtotime(str_replace('/', '-', $value)));
+ } catch (\Throwable $e) {
+ return null;
+ }
+ }
+
+
+ public function looksLikeDate($value): bool
+ {
+ if (empty($value)) {
+ return false;
+ }
+
+ // Excel numeric date
+ if (is_numeric($value) && $value > 30000) {
+ return true;
+ }
+
+ return preg_match(
+ '/\d{1,2}[\/\-]\d{1,2}[\/\-]\d{2,4}|
+ \d{4}[\/\-]\d{1,2}[\/\-]\d{1,2}|
+ \d{1,2}\s?[A-Za-z]{3,}\s?\d{2,4}|
+ \d{8}/x',
+ (string) $value
+ ) === 1;
+ }
+
+
+ public function convertRelation(string $relation, string $gender): ?string
+ {
+ if (empty($relation)) {
+ return null;
+ }
+
+ $relation = strtolower($relation);
+ $gender = strtolower($gender);
+
+ if ($relation == 'self') {
+ return $relation;
+ }
+
+ if ($relation == 'spouse') {
+ return $relation;
+ }
+
+ if ($relation == 'child' && $gender == 'male') {
+ return 'son';
+ }
+
+ if ($relation == 'child' && $gender == 'female') {
+ return 'daughter';
+ }
+
+ if ($relation == 'parents' && $gender == 'male') {
+ return 'father';
+ }
+
+ if ($relation == 'parents' && $gender == 'female') {
+ return 'mother';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'male') {
+ return 'father-in-law';
+ }
+
+ if ($relation == 'parents-in-law' && $gender == 'female') {
+ return 'mother-in-law';
+ }
+
+ return null;
+ }
+
+
+ public function getClientPolicyDataBypolicyNo(array $client_policy_data, string $policy_number): array
+ {
+ $matched_data = [];
+ foreach ($client_policy_data as $key => $value) {
+ if(trim($value) == trim($policy_number)){
+ $matched_data = $value;
+ }
+ }
+
+ if(!empty($matched_data)){
+ $ClientRMModel = new ClientRMModel();
+ $acm_data = $ClientRMModel->where('is_active', 1)->where('level', 3)->where('client_id', $matched_data['client_id'])->orderBy('id', 'asc')->first();
+ if(!empty($acm_data)){
+ $matched_data['acm_id'] = $acm_data['id'] ?? null;
+ }
+ }
+
+ return $matched_data;
+ }
+
+}
diff --git a/app/Libraries/TpaClaimsImportFactory.php b/app/Libraries/TpaClaimsImportFactory.php
new file mode 100644
index 00000000..baeef074
--- /dev/null
+++ b/app/Libraries/TpaClaimsImportFactory.php
@@ -0,0 +1,37 @@
+ new VidalClaimImportService(),
+ (int) env('ABHI_PRIMARY_KEY_CONSTANT') => new AbhiClaimImportService(),
+ (int) env('MEDI_ASSIST_PRIMARY_KEY_CONSTANT') => new MediAssistClaimImportService(),
+ (int) env('FHPL_PRIMARY_KEY_CONSTANT') => new FhplClaimImportService(),
+ (int) env('R_CARE_PRIMARY_KEY_CONSTANT') => new RcareClaimImportService(),
+ (int) env('ICICI_PRIMARY_KEY_CONSTANT') => new IciciClaimImportService(),
+ default => throw new InvalidArgumentException(
+ "Unsupported TPA ID: {$tpaId}"
+ ),
+ };
+ }
+}
diff --git a/app/Models/ClaimDumpFileModel.php b/app/Models/ClaimDumpFileModel.php
index 224adafc..e34d6116 100644
--- a/app/Models/ClaimDumpFileModel.php
+++ b/app/Models/ClaimDumpFileModel.php
@@ -10,6 +10,9 @@ class ClaimDumpFileModel extends Model
protected $primaryKey = 'id';
protected $allowedFields = [
"id",
+ "client_id",
+ "client_policy_id",
+ "tpa_id",
"file_name",
"status",
"reason",
diff --git a/app/Models/ClaimsDumpFhplModel.php b/app/Models/ClaimsDumpFhplModel.php
new file mode 100644
index 00000000..d8cd6632
--- /dev/null
+++ b/app/Models/ClaimsDumpFhplModel.php
@@ -0,0 +1,141 @@
+getResultArray();
// $countofalldata = count($result);
// dd($result);
- // dd($this->db->getLastQuery()->getQuery());
+ dd($this->db->getLastQuery()->getQuery());
$keys = [];
$filtered = [];
diff --git a/app/Views/claim_dump_file_list.php b/app/Views/claim_dump_file_list.php
index 696d97ce..0cf55ed9 100644
--- a/app/Views/claim_dump_file_list.php
+++ b/app/Views/claim_dump_file_list.php
@@ -22,6 +22,8 @@
}
.dataTables_length label {height: 21px !important;}
+
+ .readonly-select { background-color: #f3f3f3 !important; cursor: not-allowed; pointer-events: none; }
+ [ Sample Excel ]
@@ -172,14 +199,47 @@
+
+
\ No newline at end of file