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CHANGE_CLAIMSICKET_TYPE_BASED_ON_POLICY_TYPE

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This commit is contained in:
VENKATESHWARAN 2026-03-11 17:08:28 +05:30
parent 8c09841c8f
commit f1a4d26386
6 changed files with 249 additions and 8 deletions
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2
app/Config/Routes.php
View File

@ -449,6 +449,8 @@ $routes->group("/util", ["filter" => "authMVC"], function ($routes) {
$routes->post('insufficientCdBalanceHrMailSend', 'EmployeeController::insufficientCdBalanceHrMailSend');
$routes->get('getTpaClaimDumpErrorData/(:any)', 'TicketServiceController::getTpaClaimDumpErrorData/$1');
$routes->get('croneDailyActivityReport', 'DashboardController::croneDailyActivityReport');
$routes->get('insertSampleTpaApiData/(:any)', 'TestingController::insertSampleTpaApiData/$1');
$routes->get('listEmployeeCountByClientPolicy', 'TestingController::listEmployeeCountByClientPolicy');
});
$routes->post("policy_tranction/sendInstallmentRemainderMail","PolicyTransactionController::sendInstallmentRemainderMail");

60
app/Controllers/EmployeeRestController.php
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@ -2404,6 +2404,9 @@ class EmployeeRestController extends AdminController
if ($this->request->is('get')) {
$client_id = $this->request->getGet('client_id') ?? null;
$data['claim_status'] = $this->claimStatusModel
->select('id,ticket_type, display_name as claim_status')
->where('is_active', 1)
@ -2411,12 +2414,57 @@ class EmployeeRestController extends AdminController
->groupBy('display_name')
->findAll();
$data['ticket_type'] = [
["ticket_type" => "1", "type_name" => "Claim-GMC"],
["ticket_type" => "2", "type_name" => "Claim-GPA"],
["ticket_type" => "3", "type_name" => "EDLI"],
["ticket_type" => "4", "type_name" => "GTLI"],
];
if (!empty($client_id)) {
if (is_string($client_id) && preg_match('/^[a-f0-9]{32}$/i', $client_id)) {
$client_data = $this->clientModel->where('MD5(id)', $client_id)->first();
$client_id = $client_data['id'] ?? null;
}
$client_data = $this->clientPolicyModel
->where('client_id', $client_id)
->where('is_active', 1)
->groupBy('policy_type_id')
->findAll();
$data['ticket_type'] = [];
$addedTypes = [];
foreach ($client_data as $value) {
if (in_array($value['policy_type_id'], [2,3,4,5]) && !in_array('1', $addedTypes)) {
$data['ticket_type'][] = ["ticket_type" => "1", "type_name" => "Claim-GMC"];
$addedTypes[] = '1';
} elseif (in_array($value['policy_type_id'], [1]) && !in_array('2', $addedTypes)) {
$data['ticket_type'][] = ["ticket_type" => "2", "type_name" => "Claim-GPA"];
$addedTypes[] = '2';
} elseif (in_array($value['policy_type_id'], [6]) && !in_array('3', $addedTypes)) {
$data['ticket_type'][] = ["ticket_type" => "3", "type_name" => "EDLI"];
$addedTypes[] = '3';
} elseif (in_array($value['policy_type_id'], [7]) && !in_array('4', $addedTypes)) {
$data['ticket_type'][] = ["ticket_type" => "4", "type_name" => "GTLI"];
$addedTypes[] = '4';
} elseif (in_array($value['policy_type_id'], [72]) && !in_array('72', $addedTypes)) {
$data['ticket_type'][] = ["ticket_type" => "72", "type_name" => "OPD"];
$addedTypes[] = '72';
}
}
usort($data['ticket_type'], fn($a,$b) => $a['ticket_type'] <=> $b['ticket_type']);
} else {
$data['ticket_type'] = [
["ticket_type" => "1", "type_name" => "Claim-GMC"],
["ticket_type" => "2", "type_name" => "Claim-GPA"],
["ticket_type" => "3", "type_name" => "EDLI"],
["ticket_type" => "4", "type_name" => "GTLI"],
];
}
$claim_type = $this->ticketController->claimType;
unset($claim_type[1][2]);

184
app/Controllers/TestingController.php
View File

@ -5,8 +5,11 @@ namespace App\Controllers;
use App\Controllers\BaseController;
use App\Models\EmployeePolicyModel;
use App\Models\ClientPolicyModel;
use App\Models\TpaApiDataModel;
use App\Models\BatchFileModel;
use App\Models\InsurerBranchModel;
use App\Models\RFQModel;
use App\Models\EmployeeModel;
use CodeIgniter\HTTP\ResponseInterface;
use CodeIgniter\API\ResponseTrait;
use Dompdf\Dompdf;
@ -1120,4 +1123,185 @@ class TestingController extends BaseController
'metabaseUrl' => 'https://nsights.nhanceindia.in',
]);
}
/**
* Insert sample data into tpa_api_data for testing variance report (Not in NHANCE, Not in TPA, Need to Review).
* Uses client_policy (policy_status=1, is_active=1), employee_policies (active), and employees.
*
* @param int|null $client_policy_id Optional. If not provided, first eligible policy is used.
* @return \CodeIgniter\HTTP\ResponseInterface
*/
public function insertSampleTpaApiData($client_policy_id = null)
{
$db = \Config\Database::connect();
$clientPolicyModel = new ClientPolicyModel();
$employeePolicyModel = new EmployeePolicyModel();
$employeeModel = new EmployeeModel();
$tpaApiDataModel = new TpaApiDataModel();
$batchFileModel = new BatchFileModel();
// 1. Get policies: policy_status = 1, is_active = 1
$policyBuilder = $clientPolicyModel
->where('policy_status', 1)
->where('is_active', 1);
if ($client_policy_id !== null && $client_policy_id !== '') {
$policyBuilder->where('id', (int) $client_policy_id);
}
$policies = $policyBuilder->orderBy('id', 'ASC')->findAll();
if (empty($policies)) {
return $this->respond([
'status' => false,
'message' => 'No active client policy found (policy_status=1, is_active=1).',
'data' => [],
], 400);
}
$policy = $policies[0];
$client_policy_id = (int) $policy['id'];
$client_id = (int) $policy['client_id'];
$client_branch_id = !empty($policy['client_branch_id']) ? (int) $policy['client_branch_id'] : 0;
// 2. Get related employees from employee_policies (active) + employees
$empPolicies = $db->table('employee_polices ep')
->select('ep.id AS emp_policy_id, ep.employee_id, ep.tpa_id, e.emp_code, e.name, e.dob, e.gender, e.relationship')
->join('employees e', 'e.id = ep.employee_id')
->where('ep.client_policy_id', $client_policy_id)
->where('ep.is_active', 1)
->whereIn('ep.status', ['active', 'expired'])
->where('e.is_active', 1)
->get()
->getResultArray();
if (empty($empPolicies)) {
return $this->respond([
'status' => false,
'message' => 'No active employee policies found for this client policy.',
'data' => ['client_policy_id' => $client_policy_id],
], 400);
}
// 3. Create a test batch file so we have a file_id for tpa_api_data
$createdBy = function_exists('get_session_userid') ? get_session_userid() : 1;
$batchCode = 'TPA_SAMPLE_' . date('YmdHis') . '_' . bin2hex(random_bytes(4));
$batchFileId = $batchFileModel->insert([
'client_id' => $client_id,
'client_policy_id' => $client_policy_id,
'client_branch_id' => $client_branch_id,
'batch_code' => $batchCode,
'file_name' => 'sample_tpa_data_test_' . date('Y-m-d_His') . '.xlsx',
'insurer_or_tpa' => 'tpa',
'event_type' => 'api',
'actions' => 'fetch',
'status' => 'partially success',
'count' => 0,
'created_by' => $createdBy,
'is_active' => 1,
]);
if (!$batchFileId) {
return $this->respond([
'status' => false,
'message' => 'Failed to create test batch file.',
'data' => [],
], 500);
}
$file_id = (int) $batchFileId;
$tpaApiDataModel->skipValidation(true);
$inserted = ['not_in_nhance' => 0, 'need_to_review' => 0];
$toInsert = [];
// 4. Not in NHANCE: insert TPA records with emp_codes that do NOT exist in NHANCE for this policy
$fakeEmpCodes = ['TPA_SAMPLE_NOTINNHANCE_1', 'TPA_SAMPLE_NOTINNHANCE_2'];
foreach ($fakeEmpCodes as $i => $empCode) {
$toInsert[] = [
'file_id' => $file_id,
'emp_code' => $empCode,
'name' => 'Sample TPA Only ' . ($i + 1),
'dob' => '1990-01-' . str_pad((string)(15 + $i), 2, '0', STR_PAD_LEFT),
'relation' => 'Self',
'gender' => ($i % 2 === 0) ? 'M' : 'F',
'self' => 'Sample TPA Only ' . ($i + 1),
'tpa_id' => 'TPA' . (1000 + $i),
'age' => 32 + $i,
'is_active' => 1,
'desc' => 'Sample data – Not in NHANCE',
'created_by'=> $createdBy,
];
$inserted['not_in_nhance']++;
}
// 5. Need to Review: same employee as in NHANCE but with different name/dob/gender
$needReview = array_slice($empPolicies, 0, min(2, count($empPolicies)));
foreach ($needReview as $emp) {
$dob = $emp['dob'];
if (is_string($dob) && preg_match('/^(\d{4})-(\d{2})-(\d{2})/', $dob, $m)) {
$altDob = $m[1] . '-' . $m[2] . '-' . str_pad((string)((int)$m[3] + 1), 2, '0', STR_PAD_LEFT);
} else {
$altDob = '1995-06-15';
}
$toInsert[] = [
'file_id' => $file_id,
'emp_code' => $emp['emp_code'],
'name' => '[TPA Altered] ' . ($emp['name'] ?? 'Unknown'),
'dob' => $altDob,
'relation' => $emp['relationship'] ?? 'Self',
'gender' => (strtoupper($emp['gender'] ?? 'M') === 'M') ? 'F' : 'M',
'self' => $emp['name'] ?? 'Unknown',
'tpa_id' => $emp['tpa_id'] ?? ('T' . $emp['employee_id']),
'age' => 30,
'is_active' => 1,
'desc' => 'Sample data – Need to Review (mismatch)',
'created_by'=> $createdBy,
];
$inserted['need_to_review']++;
}
foreach ($toInsert as $row) {
$tpaApiDataModel->insert($row);
}
// Not in TPA: we do NOT insert those into tpa_api_data; NHANCE already has employees. So any employee
// we did not add to tpa_api_data will appear as "Not in TPA". We added only "Need to Review" and
// "Not in NHANCE" rows; the rest of NHANCE employees remain without TPA rows => they show as Not in TPA.
return $this->respond([
'status' => true,
'message' => 'Sample TPA API data inserted successfully.',
'data' => [
'file_id' => $file_id,
'client_policy_id' => $client_policy_id,
'client_id' => $client_id,
'batch_code' => $batchCode,
'inserted' => $inserted,
'not_in_tpa_note' => 'Employees in NHANCE that were not added to TPA data will appear as "Not in TPA" when you run the variance report for this file.',
],
], 200);
}
/**
* List employee count per client policy.
* No input parameters. Checks all client_policy records and counts linked employee_policies per policy.
*
* @return \CodeIgniter\HTTP\ResponseInterface
*/
public function listEmployeeCountByClientPolicy()
{
$db = \Config\Database::connect();
$rows = $db->table('client_policy cp')
->select('cp.id AS client_policy_id, COUNT(ep.id) AS employee_policy_count', false)
->join('employee_polices ep', 'ep.client_policy_id = cp.id', 'left')
->groupBy('cp.id')
->orderBy('cp.id', 'ASC')
->get()
->getResultArray();
$list = array_map(function ($row) {
return [
'client_policy_id' => (int) $row['client_policy_id'],
'employee_policy_count' => (int) $row['employee_policy_count'],
];
}, $rows);
return $this->respond([
'status' => true,
'message' => 'Employee count per client policy.',
'data' => $list,
], 200);
}
}

8
app/Controllers/TicketController.php
View File

@ -1777,8 +1777,12 @@ class TicketController extends BaseController
$ticket_id = $this->request->getPost('ticket_master_id');
$old_ticket_data = $this->ticketMasterModel->where('id', $ticket_id)->where('is_active', 1)->first();
$ticket_data['claim_status_id'] = $this->getLastMatchedStatus($ticket_data, $old_ticket_data);
$ticket_data['last_updated_by'] = 'USER';
// print_rr($ticket_data); die;
$this->myLogger->logme('error', "[UPDATE_CLAIM] Ticket Master ID: {data}", ['data' => $ticket_id]);
$this->myLogger->logme('error', "[UPDATE_CLAIM] Old Ticket Data: {data}", ['data' => json_encode($old_ticket_data, JSON_PRETTY_PRINT)]);
$this->myLogger->logme('error', "[UPDATE_CLAIM] New Ticket Data: {data}", ['data' => json_encode($ticket_data, JSON_PRETTY_PRINT)]);
if ($ticket_data) {
$return_value = $this->ticketMasterModel->where('id', $ticket_id)->set($ticket_data)->update();
@ -2400,6 +2404,8 @@ class TicketController extends BaseController
th.old_value,
th.new_value,
th.created_at,
th.updated_by,
CONCAT_WS(' ', creator.first_name, creator.last_name) AS modified_by,
-- Claim Status
old_status.claim_status as old_status_value,
@ -2414,7 +2420,7 @@ class TicketController extends BaseController
new_insured_emp.name as new_insured_id_name,
ticket_master.ticket_type_id
FROM
ticket_history th

1
app/Models/TicketMasterModel.php
View File

@ -94,6 +94,7 @@ class TicketMasterModel extends Model
'tpa_claim_type',
'tpa_ailments',
'claim_dump_ref_id',
'last_updated_by',
];

2
app/Views/ticket_history.php
View File

@ -20,7 +20,7 @@
<td><?php echo $row['display_name']; ?></td>
<td><?php echo $row['old_value'].' => '.$row['new_value']; ?></td>
<!-- <td><?php //echo $row['new_value']; ?></td> -->
<td><?php echo !empty($row['modified_by'])? $row['modified_by'] : "Created by employee"; ?></td>
<td><?php echo !empty($row['modified_by'])? $row['modified_by'] : "Created by employee"; ?> <?= $row['updated_by'] == "0" ? "(API)" : ""; ?></td>
<!-- <td><?php //echo $row['created_at']; ?></td> -->
<td><?php echo date("d-m-Y h:i:s A", strtotime($row['created_at'])) ?? " - "; ?></td>
</tr>