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In order to use openimis beyond health, the Product must be more generic, justification/use case could be found here : openIMIS beyond health features needs
Proposed Model
General
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Overall structure,
Enrollment plan (aka contribution plan) are there but not attached to the new model
Pool is a nice to have for financial reporting across program
priority are only for claiming process to know which needs to pick he coverage use
Benefit Package
Element
defined by modules that might comes with specific authorities
Elements class must inherit from the BaseElement abstract class
Element Bundle
2 possible usage:
if the validity and price strategy are set on the list level then it creates "episode of care" package
else it just a way to define package that could be used by diferent product such as "legal" packages
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create a benefit package that could group:
benefit consumptions (Benefit consumption module / Enquire ), replacement/extension of the insureeInsuree
invoice (Invoices (and bills) )
beneficiary
policyHolder ( beneficiacy or policyholder model)
upon the activation of the Benefit package the “benefit consumptions” will be filled
just the policy
other benefit consumption limits will be created with the first consumption related to the limit
Prioritization of benefit consumption in claims:
1- if the claim specify a benefit plan, use this on first
2- if not benefitplan specified OR does not provide coverage, take the benefit with the higher priority
3- if there is several benefit with the same priority, use the most favorable for the beneficiary
Model (outdated)
Main model
Generic Product that should be based on the HistoryBusinessModel
date_valid_from* (old date_from)
date_valid_to* old date_to)
replacement_uuid* (tbc old conversion_product)
is_deleted**
json_ext**
date_created**
date_updated**
user_created** (old audit_user_id)
user_updated**(old audit_user_id)
version**
history**
code: str
name : str
location : key to geo location, zone where the Benefit plan is available, nullable
acc_code_premiums
acc_code_remuneration
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