FIX_MEDIASSIT_TPA_API

app/Controllers/FhplApiController.php

@@ -992,6 +992,7 @@ class FhplApiController extends BaseController
 
                     'claim_created_by' => 'TPA',
                     'created_at'       => date('Y-m-d H:i:s'),
+                    'tpa_claim_push_reference_no' => $row['ClaimID'] ?? null,
                 ];
 
                 $this->db->table('ticket_master')->insert($claimData);

app/Controllers/HealthIndiaApiController.php

@@ -1028,6 +1028,7 @@ class HealthIndiaApiController extends BaseController
 
                 'claim_created_by' => 'TPA',
                 'created_at'       => date('Y-m-d H:i:s'),
+                'tpa_claim_push_reference_no' => $row['ccn'].'-'.$row['ccN_EXT'] ?? null,
             ];
 
             $this->db->table('ticket_master')->insert($claimData);

app/Controllers/MediAssistApiController.php

@@ -503,7 +503,7 @@ class MediAssistApiController extends BaseController
         }
     }
 
-    public function ClaimDetail($claimId = null) // 585 this id for test
+    public function ClaimDetailOLD($claimId = null) // 585 this id for test
     {
         helper('api');
 
@@ -523,7 +523,7 @@ class MediAssistApiController extends BaseController
                 tm.tpa_no as memberId,
                 tm.tpa_claim_push_reference_no as claimRefNo,
                 tm.tpa_claim_id,tm.doa,
-                tm.claim_number,
+                tm.claim_number,tm.claim_amount,
                 cp.policy_no as policyNo,
                 cp.policy_start_date as startDate,
                 cp.policy_end_date as endDate,
@@ -661,7 +661,8 @@ class MediAssistApiController extends BaseController
             }
 
 
-            if($ticket['doa'] == $this->mediDate($claimData['datE_OF_ADMISSION'] ?? null) || $ticket['claim_number'] == $tpa_claim_no){
+             if((isset($ticket['claim_number']) && $ticket['claim_number'] == $tpa_claim_no) || ($ticket['doa'] == $this->mediDate($claimData['datE_OF_ADMISSION'] ?? null) && $ticket['claimRefNo'] == $claimData['clM_COMP_REFNO']))
+            {
                 // UPDATE ticket_master
                 $this->db->table('ticket_master')->where('id', $claimId)->update($updateArray);
 
@@ -674,6 +675,210 @@ class MediAssistApiController extends BaseController
         }
 
         return ['status' => true,'message' => 'Claim Status updated.','updated_status' => $currentStatus,'api_response' => $response];
+    }
+
+     public function ClaimDetail($claimId = null) // 585 this id for test
+    {
+        helper('api');
+
+        $url    = getenv('MEDI_ASSIST_API_BASE_URL_CLAIMSTATUS');
+        $method = 'POST';
+
+        $headers = [
+            'Content-Type: application/json',
+            'Username:' . getenv('MEDI_ASSIST_API_USERNAME'),
+            'Password:' . getenv('MEDI_ASSIST_API_PASSWORD'),
+        ];
+
+        // Fetch ticket master details
+        $ticket = $this->db->table('ticket_master tm')
+            ->select("
+                tm.id,
+                tm.tpa_no as memberId,
+                tm.tpa_claim_push_reference_no as claimRefNo,
+                tm.tpa_claim_id,tm.doa,
+                tm.claim_number,tm.claim_amount,
+                cp.policy_no as policyNo,
+                cp.policy_start_date as startDate,
+                cp.policy_end_date as endDate,
+                e.emp_code as employeeCode
+            ")
+            ->join('employees e', 'e.id = tm.emp_id', 'left')
+            ->join('client_policy cp', 'tm.client_policy_id = cp.id', 'left')
+            ->where('tm.id', $claimId)
+            ->get()
+            ->getRowArray();
+
+            // print_rr($ticket);die;
+        if (!$ticket) {
+            return ['status' => false,'message' => 'Invalid Claim ID' ];
+        }
+
+
+        // REQUEST BODY
+        if($ticket['claimRefNo'] != null)
+        {
+            $body = [
+                "policyNo"     => $ticket['policyNo'] ?? "",
+                "startDate"    => "",
+                "endDate"      => "",
+                "employeeCode" => $ticket['employeeCode'] ?? "",
+                "memberID"     => "",
+                "claimNo"      => "",
+                "claimRefNo"   => $ticket['claimRefNo'] ?? "",
+            ];
+
+        }else{
+
+            $body = [
+                "policyNo"     => $ticket['policyNo'] ?? "",
+                "startDate"    => "",
+                "endDate"      => "",
+                "employeeCode" => $ticket['employeeCode'] ?? "",
+                "memberID"     => "",
+                "claimNo"      => "",
+                "claimRefNo"   => "",
+            ];
+
+        }
+
+        //  $body = [ 
+        //         "policyNo" => "97000063250400000031", 
+        //         "startDate" => "01/11/2025", 
+        //         "endDate" => "05/11/2025",
+        //         "employeeCode" => "",
+        //         "memberID" => "",
+        //         "claimNo" => "",
+        //         "claimRefNo" => ""
+        //     ];
+
+        // CALL API
+        $response = call_third_party_api($url, $method, $headers, $body);
+
+
+
+        if ($response['status'] != true || empty($response['data']['claimsData'][0])) {
+            log_message('error','MEDI_ASSIST - Claim Status FAILED | for ticket ID: ' . $claimId.' | response: '.json_encode($response));
+
+            return ['status'  => false,'message' => 'API call failed.','data'    => $response ];
+        }
+
+        // Extract Claim Status
+        $allClaimData = $response['data']['claimsData'];
+
+       $matched = false; // 🔥 Track if anything matched
+
+        foreach ($allClaimData as $claimData) {
+
+            $currentStatus   = $claimData['claim_Current_Status'] ?? '';
+            $tpa_claim_no    = $claimData['tpA_CLAIM_NO'] ?? '';
+            $tpa_claim_type  = $claimData['typE_OF_CLAIM'] ?? '';
+            $tpa_ailments    = ($claimData['ailment'] ?? '') . ' - ' . ($claimData['ailmenT_DESC'] ?? '');
+
+            $claimRefNo      = $claimData['clM_COMP_REFNO'] ?? '';
+            $doa             = $this->mediDate($claimData['datE_OF_ADMISSION'] ?? null);
+
+            $isMatch = false;
+
+            // -------------------------------
+            // ✅ Matching Logic
+            // -------------------------------
+
+            // Case 1: Claim number exists → match by claim number
+            if (!empty($ticket['claim_number'])) {
+                if ($ticket['claim_number'] == $tpa_claim_no) {
+                    $isMatch = true;
+                }
+            }
+            // Case 2: No claim number → match by DOA + claimRefNo
+            else {
+                if (
+                    $ticket['claimRefNo'] == $claimRefNo &&
+                    $ticket['doa'] == $doa
+                ) {
+                    $isMatch = true;
+                }
+            }
+
+            if (!$isMatch) {
+                continue;
+            }
+
+            // ✅ Mark matched
+            $matched = true;
+
+            // -------------------------------
+            // ✅ Prepare update
+            // -------------------------------
+            $updateArray = [
+                'tpa_claim_status' => $currentStatus,
+                'updated_at'       => date('Y-m-d H:i:s'),
+                'last_updated_by'  => 'API',
+            ];
+
+            if (isset($validStatuses[$currentStatus])) {
+                $updateArray['claim_status_id'] = $validStatuses[$currentStatus];
+            }
+
+            // Set claim number when first received
+            if (empty($ticket['claim_number']) && !empty($tpa_claim_no)) {
+                $updateArray['claim_number'] = $tpa_claim_no;
+                $updateArray['tpa_claim_id'] = $tpa_claim_no;
+            }
+
+            if (!empty($tpa_claim_type)) {
+                $updateArray['tpa_claim_type'] = $tpa_claim_type;
+            }
+
+            if (!empty($tpa_ailments)) {
+                $updateArray['tpa_ailments'] = $tpa_ailments;
+            }
+
+            // -------------------------------
+            // ✅ Update DB
+            // -------------------------------
+            $this->db->table('ticket_master')
+                ->where('id', $claimId)
+                ->update($updateArray);
+
+            log_message(
+                'error',
+                "MEDI_ASSIST Claim Status SUCCESS | Updated ticket ID ={$claimId} | Status={$currentStatus} | ClaimNo={$tpa_claim_no} | RefNo={$claimRefNo}"
+            );
+
+            // Stop after first valid match
+            break;
+        }
+
+        if ($matched) {
+            return [
+                'status' => true,
+                'message' => 'Claim Status updated.',
+                'updated_status' => $currentStatus,
+                'api_response' => $response
+            ];
+        }
+
+        // -----------------------------------
+        // ❌ If nothing matched → log failure
+        // -----------------------------------
+        if (!$matched) {
+
+            log_message(
+                'error',
+                "MEDI_ASSIST | Fetch Claim Status | Claim Status NOT UPDATED | | TicketID={$claimId} | TicketDOA={$ticket['doa']} | ClaimDOA={$claimData['datE_OF_ADMISSION']} | Status={$currentStatus}"
+            );
+
+            return [
+                'status' => true,
+                'message' => 'No matching claim found.',
+                'updated_status' => null,
+                'api_response' => $response
+            ];
+        }
+
+
+
     }
 
     public function IRSubmission($claimId = null) // 585 this id for test
@@ -860,7 +1065,7 @@ class MediAssistApiController extends BaseController
         // unlink($file_array['json_file_path']); // delete temp json file
     }
 
-    public function ClaimStatusUpdate()
+    public function ClaimStatusUpdateOLD()
     {
         helper('api');
 
@@ -879,7 +1084,7 @@ class MediAssistApiController extends BaseController
                 tm.id,
                 tm.tpa_no as memberId,
                 tm.tpa_claim_push_reference_no as claimRefNo,
-                tm.doa,tm.claim_no,
+                tm.doa,tm.claim_number,
                 cp.policy_no as policyNo,
                 cp.policy_start_date as startDate,
                 cp.policy_end_date as endDate,
@@ -1026,7 +1231,8 @@ class MediAssistApiController extends BaseController
                     $updateArray['tpa_ailments'] = $tpa_ailments;
                 }
 
-                if($ticket['doa'] == $this->mediDate($claimData['datE_OF_ADMISSION'] ?? null) || $ticket['claim_number'] == $tpa_claim_no){
+                 if((isset($ticket['claim_number']) && $ticket['claim_number'] == $tpa_claim_no) || ($ticket['doa'] == $this->mediDate($claimData['datE_OF_ADMISSION'] ?? null) && $ticket['claimRefNo'] == $claimData['clM_COMP_REFNO']))
+            {
                     // UPDATE ticket_master
                     $this->db->table('ticket_master')->where('id', $claimId)->update($updateArray);
                     $status_updated_count ++;
@@ -1051,6 +1257,227 @@ class MediAssistApiController extends BaseController
         ]);
     }
 
+    public function ClaimStatusUpdate()
+    {
+        helper('api');
+
+        $url    = getenv('MEDI_ASSIST_API_BASE_URL_CLAIMSTATUS');
+        $method = 'POST';
+
+        $headers = [
+            'Content-Type: application/json',
+            'Username:' . getenv('MEDI_ASSIST_API_USERNAME'),
+            'Password:' . getenv('MEDI_ASSIST_API_PASSWORD'),
+        ];
+
+        $TicketData = $this->db->table('ticket_master tm')
+            ->select("
+                tm.id,
+                tm.tpa_no as memberId,
+                tm.tpa_claim_push_reference_no as claimRefNo,
+                tm.doa,
+                tm.claim_number,
+                tm.tpa_claim_id,
+                cp.policy_no as policyNo,
+                cp.policy_start_date as startDate,
+                cp.policy_end_date as endDate,
+                e.emp_code as employeeCode
+            ")
+            ->join('employees e', 'e.id = tm.emp_id', 'left')
+            ->join('client_policy cp', 'tm.client_policy_id = cp.id', 'left')
+            ->where('tm.tpa_claim_push_reference_no IS NOT NULL')
+            ->where('tm.is_active', 1)
+            ->whereNotIn('tm.claim_status_id', [8, 11, 12, 13, 66, 22, 24, 47, 49, 32, 34, 53, 55, 42, 44, 58, 60])
+            ->where('tm.tpa_id', $this->mediAssistTpaId)
+            ->get()
+            ->getResultArray();
+
+        log_message('error','MEDI_ASSIST - Claim Status started | for ticket count: ' . count($TicketData));
+
+        if (!$TicketData) {
+            log_message('error',"MEDI_ASSIST - Claims not found to update Claim Status");
+            return $this->response->setJSON([
+                'status' => false,
+                'message' => 'Claims not found'
+            ]);
+        }
+
+        $error_data = [];
+        $status_updated_count = 0;
+
+        // ✅ Move outside loop (performance)
+        $validStatuses = [
+            "Claim Received" => 1,
+            "In Progress" => 5,
+            "Processed" => 11,
+            "Claim Paid" => 11,
+            "Denied" => 13,
+            "Cancelled" => 13,
+            "Information Awaited" => 4,
+            "Confirmation Awaited" => 4,
+            "Information Awaited Reminder" => 4,
+            "Information Awaited Final Reminder" => 4,
+            "Insurer Concurrence Awaited" => 7,
+            "Closed" => 12,
+            "Physical Documents Awaited" => 9,
+            "Processed - Payment Initiated" => 10,
+            "Processed - Transaction Failed" => 10,
+            "Processed - Account Details Updated" => 10,
+            "Processed - Debit Note Raised With Insurer for Payment" => 10,
+            "Processed - Payment Initiated by Insurer" => 10,
+            "Payment   - Refunded to Insurer" => 14,
+            "Processed - Processing Payment" => 10,
+            "Processed - Physical Documents Awaited" => 9,
+            "NON ID" => 1,
+            "ID NOT GENERATED" => 2,
+            "CDA" => 3,
+            "REJECTED" => 8,
+            "APPROVED" => 9,
+            "PAYMENT INITIATED" => 10,
+            "SETTLED" => 11,
+            "RETURNED" => 14,
+            "UNDER PROCESS - TPA" => 61,
+            "DENIAL REVIEW AWAITED" => 66,
+        ];
+
+        foreach ($TicketData as $ticket) {
+
+            $claimId = $ticket['id'];
+            $matched = false;
+
+            $body = [
+                "policyNo"     => $ticket['policyNo'] ?? "",
+                "startDate"    => "",
+                "endDate"      => "",
+                "employeeCode" => $ticket['employeeCode'] ?? "",
+                "memberID"     => "",
+                "claimNo"      => "",
+                "claimRefNo"   => $ticket['claimRefNo'] ?? "",
+            ];
+
+            $response = call_third_party_api($url, $method, $headers, $body);
+
+            log_message('error','MEDI_ASSIST - 2 hours Claim Status API Response: ' . json_encode($response));
+
+            if ($response['status'] != true || empty($response['data']['claimsData'])) {
+                log_message('error','MEDI_ASSIST - Claim Status FAILED | for ticket ID: ' . $claimId.' | response: '.json_encode($response));
+                $error_data[$claimId] = [
+                    'response' => $response,
+                    'body' => $body
+                ];
+                continue;
+            }
+
+            $allClaimData = $response['data']['claimsData'];
+
+            foreach ($allClaimData as $claimData) {
+
+                $currentStatus   = $claimData['claim_Current_Status'] ?? '';
+                $tpa_claim_no    = $claimData['tpA_CLAIM_NO'] ?? '';
+                $tpa_claim_type  = $claimData['typE_OF_CLAIM'] ?? '';
+                $tpa_ailments    = ($claimData['ailment'] ?? '') . ' - ' . ($claimData['ailmenT_DESC'] ?? '');
+                $claimRefNo      = $claimData['clM_COMP_REFNO'] ?? '';
+
+                // ✅ Normalize dates (critical fix)
+                $claimDOA = !empty($claimData['datE_OF_ADMISSION']) 
+                    ? date('Y-m-d', strtotime($claimData['datE_OF_ADMISSION'])) 
+                    : null;
+
+                $ticketDOA = !empty($ticket['doa']) 
+                    ? date('Y-m-d', strtotime($ticket['doa'])) 
+                    : null;
+
+                $isMatch = false;
+
+                // ================================
+                // ✅ STRICT MATCHING (NO LOOPHOLE)
+                // ================================
+
+                // Case 1: claim number exists → ONLY match by claim number
+                if (!empty($ticket['claim_number'])) {
+
+                    if ($ticket['claim_number'] == $tpa_claim_no) {
+                        $isMatch = true;
+                    }
+
+                } 
+                // Case 2: claim number empty → match by DOA + claimRefNo ONLY
+                else {
+
+                    if (
+                        !empty($ticket['claimRefNo']) &&
+                        $ticket['claimRefNo'] == $claimRefNo &&
+                        $ticketDOA == $claimDOA
+                    ) {
+                        $isMatch = true;
+                    }
+                }
+
+                // ❌ No fallback allowed
+
+                if (!$isMatch) {
+                    continue;
+                }
+
+                // ================================
+                // ✅ MATCH FOUND
+                // ================================
+                $matched = true;
+
+                $updateArray = [
+                    'tpa_claim_status' => $currentStatus,
+                    'updated_at'       => date('Y-m-d H:i:s'),
+                    'last_updated_by'  => 'API',
+                ];
+
+                if (isset($validStatuses[$currentStatus])) {
+                    $updateArray['claim_status_id'] = $validStatuses[$currentStatus];
+                }
+
+                // Set claim number only if empty
+                if (empty($ticket['claim_number']) && !empty($tpa_claim_no)) {
+                    $updateArray['claim_number'] = $tpa_claim_no;
+                    $updateArray['tpa_claim_id'] = $tpa_claim_no;
+                }
+
+                if (!empty($tpa_claim_type)) {
+                    $updateArray['tpa_claim_type'] = $tpa_claim_type;
+                }
+
+                if (!empty($tpa_ailments)) {
+                    $updateArray['tpa_ailments'] = $tpa_ailments;
+                }
+
+                // UPDATE DB
+                $this->db->table('ticket_master')
+                    ->where('id', $claimId)
+                    ->update($updateArray);
+
+                $status_updated_count++;
+
+                log_message('error',"MEDI_ASSIST - Claim Status SUCCESS | Updated ticket ID $claimId with Claim Status: $currentStatus");
+
+                break; // ✅ only inner loop
+            }
+
+            // ================================
+            // ❌ UNMATCHED LOG (once per ticket)
+            // ================================
+            if (!$matched) {
+                log_message('error', "MEDI_ASSIST | 2 hours | Claim Status NOT UPDATED | TicketID={$claimId} | TicketDOA={$ticket['doa']} | ClaimRefNo={$ticket['claimRefNo']}");
+            }
+        }
+
+        log_message('error',"MEDI_ASSIST - Claim Status ENDED | 2 hours | Total Tickets={".count($TicketData)."} | Status Updated={$status_updated_count} | Errors={".count($error_data)."}");
+
+        return $this->response->setJSON([
+            'status' => true,
+            'message' => 'Claim Status updated.',
+            'count' => $status_updated_count,
+            'error_data' => $error_data,
+        ]);
+    }
+
     public function syncTpaClaimToNhance()
     {
         helper(['api', 'date']);