class PaymentDetail(core_models.VersionedModel):
id = models.BigAutoField(db_column='PaymentDetailsID', primary_key=True)
payment = models.ForeignKey(Payment,
models.DO_NOTHING,
db_column='PaymentID',
related_name="payment_details")
# beware putting FKs: product code (,...): need to check if we can/must adapt payment info if code (,...) change
# i.e. normally, FK is pointing to PK, not to a field
product_code = models.CharField(db_column='ProductCode',
max_length=8,
blank=True,
null=True)
insurance_number = models.CharField(db_column='InsuranceNumber',
max_length=12,
blank=True,
null=True) # CHF_ID
policy_stage = models.CharField(db_column='PolicyStage',
max_length=1,
blank=True,
null=True)
amount = models.DecimalField(db_column='Amount',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
premium = models.ForeignKey(Premium,
models.SET_NULL,
db_column='PremiumID',
related_name="payment_details",
blank=True,
null=True)
enrollment_date = fields.DateField(db_column='enrollmentDate',
blank=True,
null=True)
expected_amount = models.DecimalField(db_column='ExpectedAmount',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
# rowid = models.TextField(db_column='RowID', blank=True, null=True) # Field name made lowercase. This field type is a guess.
# ! auditED in field name
audit_user_id = models.IntegerField(db_column='AuditedUserId',
blank=True,
null=True)
class Meta:
managed = False
db_table = 'tblPaymentDetails'
def __str__(self):
return f"id:{self.id}, payment:{self.payment_id}, ins_nb:{self.insurance_number}, amount:{self.amount}, " \
f"premium:{self.premium_id}"
class Policy(models.Model):
id = models.AutoField(db_column='PolicyID', primary_key=True)
legacy_id = models.IntegerField(db_column='LegacyID',
blank=True,
null=True)
stage = models.CharField(db_column='PolicyStage',
max_length=1,
blank=True,
null=True)
status = models.SmallIntegerField(db_column='PolicyStatus',
blank=True,
null=True)
value = models.DecimalField(db_column='PolicyValue',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
# familyid = models.ForeignKey(Tblfamilies, models.DO_NOTHING, db_column='FamilyID')
enroll_date = fields.DateField(db_column='EnrollDate')
start_date = fields.DateField(db_column='StartDate')
effective_date = fields.DateField(db_column='EffectiveDate',
blank=True,
null=True)
expiry_date = fields.DateField(db_column='ExpiryDate',
blank=True,
null=True)
# prodid = models.ForeignKey('Tblproduct', models.DO_NOTHING, db_column='ProdID')
# officerid = models.ForeignKey(Tblofficer, models.DO_NOTHING, db_column='OfficerID', blank=True, null=True)
validity_from = fields.DateTimeField(db_column='ValidityFrom')
validity_to = fields.DateTimeField(db_column='ValidityTo',
blank=True,
null=True)
offline = models.BooleanField(db_column='isOffline', blank=True, null=True)
audit_user_id = models.IntegerField(db_column='AuditUserID')
row_id = models.BinaryField(db_column='RowID', blank=True, null=True)
class Meta:
managed = False
db_table = 'tblPolicy'
class ClaimAttachment(core_models.UUIDModel, core_models.UUIDVersionedModel):
claim = models.ForeignKey(
Claim, models.DO_NOTHING, related_name='attachments')
type = models.TextField(blank=True, null=True)
title = models.TextField(blank=True, null=True)
date = fields.DateField(blank=True, null=True)
filename = models.TextField(blank=True, null=True)
mime = models.TextField(blank=True, null=True)
# frontend contributions may lead to externalized (nas) storage for documents
url = models.TextField(blank=True, null=True)
# Support of BinaryField is database-related: prefer to stick to b64-encoded
document = models.TextField(blank=True, null=True)
class Meta:
managed = True
db_table = "claim_ClaimAttachment"
class ServicesPricelist(VersionedModel):
id = models.AutoField(db_column='PLServiceID', primary_key=True)
uuid = models.CharField(db_column='PLServiceUUID',
max_length=36,
default=uuid.uuid4,
unique=True)
name = models.CharField(db_column='PLServName', max_length=100)
pricelist_date = fields.DateField(db_column='DatePL')
location = models.ForeignKey("location.Location",
db_column="LocationId",
blank=True,
null=True,
on_delete=models.DO_NOTHING)
audit_user_id = models.IntegerField(db_column='AuditUserID')
# row_id = models.BinaryField(db_column='RowID', blank=True, null=True)
class Meta:
managed = False
db_table = 'tblPLServices'
class Claim(core_models.VersionedModel):
id = models.AutoField(db_column='ClaimID', primary_key=True)
uuid = models.CharField(db_column='ClaimUUID',
max_length=36,
default=uuid.uuid4,
unique=True)
category = models.CharField(db_column='ClaimCategory',
max_length=1,
blank=True,
null=True)
insuree = models.ForeignKey(insuree_models.Insuree,
models.DO_NOTHING,
db_column='InsureeID')
code = models.CharField(db_column='ClaimCode', max_length=8, unique=True)
date_from = fields.DateField(db_column='DateFrom')
date_to = fields.DateField(db_column='DateTo', blank=True, null=True)
status = models.SmallIntegerField(db_column='ClaimStatus')
adjuster = models.ForeignKey(core_models.InteractiveUser,
models.DO_NOTHING,
db_column='Adjuster',
blank=True,
null=True)
adjustment = models.TextField(db_column='Adjustment',
blank=True,
null=True)
claimed = models.DecimalField(db_column='Claimed',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
approved = models.DecimalField(db_column='Approved',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
reinsured = models.DecimalField(db_column='Reinsured',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
valuated = models.DecimalField(db_column='Valuated',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
date_claimed = fields.DateField(db_column='DateClaimed')
date_processed = fields.DateField(db_column='DateProcessed',
blank=True,
null=True)
# Django uses the feedback_id column to create the feedback column, which conflicts with the boolean field
feedback_available = models.BooleanField(db_column='Feedback',
default=False)
feedback = models.OneToOneField(Feedback,
models.DO_NOTHING,
db_column='FeedbackID',
blank=True,
null=True,
related_name="+")
explanation = models.TextField(db_column='Explanation',
blank=True,
null=True)
feedback_status = models.SmallIntegerField(db_column='FeedbackStatus',
blank=True,
null=True)
review_status = models.SmallIntegerField(db_column='ReviewStatus',
blank=True,
null=True)
approval_status = models.SmallIntegerField(db_column='ApprovalStatus',
blank=True,
null=True)
rejection_reason = models.SmallIntegerField(db_column='RejectionReason',
blank=True,
null=True)
batch_run = models.ForeignKey(claim_batch_models.BatchRun,
models.DO_NOTHING,
db_column='RunID',
blank=True,
null=True)
audit_user_id = models.IntegerField(db_column='AuditUserID')
validity_from_review = fields.DateTimeField(db_column='ValidityFromReview',
blank=True,
null=True)
validity_to_review = fields.DateTimeField(db_column='ValidityToReview',
blank=True,
null=True)
health_facility = models.ForeignKey(location_models.HealthFacility,
models.DO_NOTHING,
db_column='HFID')
submit_stamp = fields.DateTimeField(db_column='SubmitStamp',
blank=True,
null=True)
process_stamp = fields.DateTimeField(db_column='ProcessStamp',
blank=True,
null=True)
remunerated = models.DecimalField(db_column='Remunerated',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
guarantee_id = models.CharField(db_column='GuaranteeId',
max_length=50,
blank=True,
null=True)
admin = models.ForeignKey(ClaimAdmin,
models.DO_NOTHING,
db_column='ClaimAdminId',
blank=True,
null=True)
icd = models.ForeignKey(medical_models.Diagnosis,
models.DO_NOTHING,
db_column='ICDID',
related_name="claim_icds")
icd_1 = models.ForeignKey(medical_models.Diagnosis,
models.DO_NOTHING,
db_column='ICDID1',
related_name="claim_icd1s",
blank=True,
null=True)
icd_2 = models.ForeignKey(medical_models.Diagnosis,
models.DO_NOTHING,
db_column='ICDID2',
related_name="claim_icd2s",
blank=True,
null=True)
icd_3 = models.ForeignKey(medical_models.Diagnosis,
models.DO_NOTHING,
db_column='ICDID3',
related_name="claim_icd3s",
blank=True,
null=True)
icd_4 = models.ForeignKey(medical_models.Diagnosis,
models.DO_NOTHING,
db_column='ICDID4',
related_name="claim_icd4s",
blank=True,
null=True)
visit_type = models.CharField(db_column='VisitType',
max_length=1,
blank=True,
null=True)
audit_user_id_review = models.IntegerField(db_column='AuditUserIDReview',
blank=True,
null=True)
audit_user_id_submit = models.IntegerField(db_column='AuditUserIDSubmit',
blank=True,
null=True)
audit_user_id_process = models.IntegerField(db_column='AuditUserIDProcess',
blank=True,
null=True)
scheme_type = models.IntegerField(db_column='SchemeType',
blank=True,
null=True)
subProduct_id = models.IntegerField(db_column='subProduct_id',
blank=True,
null=True)
# row_id = models.BinaryField(db_column='RowID', blank=True, null=True)
class Meta:
managed = False
db_table = 'tblClaim'
STATUS_REJECTED = 1
STATUS_ENTERED = 2
STATUS_CHECKED = 4
STATUS_PROCESSED = 8
STATUS_VALUATED = 16
FEEDBACK_IDLE = 1
FEEDBACK_NOT_SELECTED = 2
FEEDBACK_SELECTED = 4
FEEDBACK_DELIVERED = 8
FEEDBACK_BYPASSED = 16
REVIEW_IDLE = 1
REVIEW_NOT_SELECTED = 2
REVIEW_SELECTED = 4
REVIEW_DELIVERED = 8
REVIEW_BYPASSED = 16
def reject(self, rejection_code):
updated_items = self.items.filter(validity_to__isnull=True).update(
rejection_reason=rejection_code)
updated_services = self.services.filter(
validity_to__isnull=True).update(rejection_reason=rejection_code)
signal_claim_rejection.send(sender=self.__class__, claim=self)
return updated_items + updated_services
def save_history(self, **kwargs):
prev_id = super(Claim, self).save_history()
if prev_id:
prev_items = []
for item in self.items.all():
prev_items.append(item.save_history())
ClaimItem.objects.filter(id__in=prev_items).update(
claim_id=prev_id)
prev_services = []
for service in self.services.all():
prev_services.append(service.save_history())
ClaimService.objects.filter(id__in=prev_services).update(
claim_id=prev_id)
return prev_id
@classmethod
def get_queryset(cls, queryset, user):
queryset = Claim.filter_queryset(queryset)
# GraphQL calls with an info object while Rest calls with the user itself
if isinstance(user, ResolveInfo):
user = user.context.user
if settings.ROW_SECURITY and user.is_anonymous:
return queryset.filter(id=-1)
if settings.ROW_SECURITY:
# TechnicalUsers don't have health_facility_id attribute
if hasattr(user._u,
'health_facility_id') and user._u.health_facility_id:
return queryset.filter(
health_facility_id=user._u.health_facility_id)
else:
dist = UserDistrict.get_user_districts(user._u)
return queryset.filter(health_facility__location_id__in=[
l.location_id for l in dist
])
return queryset
class Payment(core_models.VersionedModel):
id = models.BigAutoField(db_column='PaymentID', primary_key=True)
uuid = models.CharField(db_column='PaymentUUID', max_length=36)
expected_amount = models.DecimalField(db_column='ExpectedAmount',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
received_amount = models.DecimalField(db_column='ReceivedAmount',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
officer_code = models.CharField(db_column='OfficerCode',
max_length=50,
blank=True,
null=True)
phone_number = models.CharField(db_column='PhoneNumber',
max_length=12,
blank=True,
null=True)
request_date = fields.DateField(db_column='RequestDate',
blank=True,
null=True)
received_date = fields.DateField(db_column='ReceivedDate',
blank=True,
null=True)
status = models.IntegerField(db_column='PaymentStatus',
blank=True,
null=True)
transaction_no = models.CharField(db_column='TransactionNo',
max_length=50,
blank=True,
null=True)
origin = models.CharField(db_column='PaymentOrigin',
max_length=50,
blank=True,
null=True)
matched_date = fields.DateField(db_column='MatchedDate',
blank=True,
null=True)
receipt_no = models.CharField(db_column='ReceiptNo',
max_length=100,
blank=True,
null=True)
payment_date = fields.DateField(db_column='PaymentDate',
blank=True,
null=True)
rejected_reason = models.CharField(db_column='RejectedReason',
max_length=255,
blank=True,
null=True)
date_last_sms = fields.DateField(db_column='DateLastSMS',
blank=True,
null=True)
language_name = models.CharField(db_column='LanguageName',
max_length=10,
blank=True,
null=True)
type_of_payment = models.CharField(db_column='TypeOfPayment',
max_length=50,
blank=True,
null=True)
transfer_fee = models.DecimalField(db_column='TransferFee',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
# rowid = models.TextField(db_column='RowID')
# auditED, not audit ???
# auditeduser_id = models.IntegerField(db_column='AuditedUSerID', blank=True, null=True)
class Meta:
managed = False
db_table = 'tblPayment'
class Contract(core_models.HistoryBusinessModel):
code = models.CharField(db_column='Code', max_length=64, null=False)
policy_holder = models.ForeignKey(PolicyHolder,
db_column="PolicyHolderUUID",
on_delete=models.deletion.DO_NOTHING,
blank=True,
null=True)
amount_notified = models.FloatField(db_column='AmountNotified',
blank=True,
null=True)
amount_rectified = models.FloatField(db_column='AmountRectified',
blank=True,
null=True)
amount_due = models.FloatField(db_column='AmountDue',
blank=True,
null=True)
date_approved = fields.DateTimeField(db_column='DateApproved',
blank=True,
null=True)
date_payment_due = fields.DateField(db_column='DatePaymentDue',
blank=True,
null=True)
state = models.SmallIntegerField(db_column='State', blank=True, null=True)
payment_reference = models.CharField(db_column='PaymentReference',
max_length=255,
blank=True,
null=True)
amendment = models.IntegerField(db_column='Amendment',
blank=False,
null=False,
default=0)
objects = ContractManager()
@property
def amount(self):
amount = 0
if self.state in [1, 2]:
amount = self.amount_notified
elif self.state in [4, 11, 3]:
amount = self.amount_rectified
elif self.state in [5, 6, 7, 8, 9, 10]:
amount = self.amount_due
else:
amount = self.amount_due
return amount
@classmethod
def get_queryset(cls, queryset, user):
queryset = cls.filter_queryset(queryset)
if isinstance(user, ResolveInfo):
user = user.context.user
if settings.ROW_SECURITY and user.is_anonymous:
return queryset.filter(id=-1)
if settings.ROW_SECURITY:
pass
return queryset
class Meta:
db_table = 'tblContract'
STATE_REQUEST_FOR_INFORMATION = 1
STATE_DRAFT = 2
STATE_OFFER = 3
STATE_NEGOTIABLE = 4
STATE_EXECUTABLE = 5
STATE_ADDENDUM = 6
STATE_EFFECTIVE = 7
STATE_EXECUTED = 8
STATE_DISPUTED = 9
STATE_TERMINATED = 10
STATE_COUNTER = 11
class Payment(core_models.VersionedModel):
STATUS_REJECTEDPOSTED_3 = -3
STATUS_REJECTEDPOSTED_2 = -2
STATUS_REJECTEDPOSTED_1 = -1
STATUS_NOTYETCONFIRMED = 1
STATUS_POSTED = 2
STATUS_ASSIGNED = 3
STATUS_UNMATCHED = 4
STATUS_PAYMENTMATCHED = 5
STATUS_CHOICES = (
(STATUS_REJECTEDPOSTED_3, _("REJECTEDPOSTED_3")),
(STATUS_REJECTEDPOSTED_2, _("REJECTEDPOSTED_2")),
(STATUS_REJECTEDPOSTED_1, _("REJECTEDPOSTED_1")),
(STATUS_NOTYETCONFIRMED, _("NOTYETCONFIRMED")),
(STATUS_POSTED, _("POSTED")),
(STATUS_ASSIGNED, _("ASSIGNED")),
(STATUS_UNMATCHED, _("UNMATCHED")),
(STATUS_PAYMENTMATCHED, _("PAYMENTMATCHED")),
)
id = models.BigAutoField(db_column='PaymentID', primary_key=True)
uuid = models.CharField(db_column='PaymentUUID',
max_length=36,
default=uuid.uuid4,
unique=True)
expected_amount = models.DecimalField(db_column='ExpectedAmount',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
received_amount = models.DecimalField(db_column='ReceivedAmount',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
officer_code = models.CharField(db_column='OfficerCode',
max_length=50,
blank=True,
null=True)
phone_number = models.CharField(db_column='PhoneNumber',
max_length=12,
blank=True,
null=True)
request_date = fields.DateField(db_column='RequestDate',
blank=True,
null=True)
received_date = fields.DateField(db_column='ReceivedDate',
blank=True,
null=True)
status = models.IntegerField(db_column='PaymentStatus',
blank=True,
null=True)
transaction_no = models.CharField(db_column='TransactionNo',
max_length=50,
blank=True,
null=True)
origin = models.CharField(db_column='PaymentOrigin',
max_length=50,
blank=True,
null=True)
matched_date = fields.DateField(db_column='MatchedDate',
blank=True,
null=True)
receipt_no = models.CharField(db_column='ReceiptNo',
max_length=100,
blank=True,
null=True)
payment_date = fields.DateField(db_column='PaymentDate',
blank=True,
null=True)
rejected_reason = models.CharField(db_column='RejectedReason',
max_length=255,
blank=True,
null=True)
date_last_sms = fields.DateField(db_column='DateLastSMS',
blank=True,
null=True)
language_name = models.CharField(db_column='LanguageName',
max_length=10,
blank=True,
null=True)
type_of_payment = models.CharField(db_column='TypeOfPayment',
max_length=50,
blank=True,
null=True)
transfer_fee = models.DecimalField(db_column='TransferFee',
max_digits=18,
decimal_places=2,
blank=True,
null=True)
# rowid = models.TextField(db_column='RowID')
# auditED, not audit ???
# auditeduser_id = models.IntegerField(db_column='AuditedUSerID', blank=True, null=True)
class Meta:
managed = False
db_table = 'tblPayment'
def __str__(self):
return f"id:{self.id}, expected_amount: {self.expected_amount}, status:{self.status}, " \
f"type:{self.type_of_payment}, uuid:{self.uuid}"