...
list of impacted parameters: NULL (will take data from product, claims … )
FROM_TO = [ {"from": "QuerySet(Claim)", "to": "Bill"}, {"from": "Claim", "to": "BillItem"} ]
the claims part of the Queryset must have the same RUNID and HF
description = “ This calculation will, for the selected level and product, calculate how much the insurance need to pay the HF for the fee for service health financing “
...
return true (to be updated once real payment plan will be in place)
BatchRUn → ProdcutLocation
if HF → locationlocations
if location → ProductS (Product also related to Region if the location is a district)
if claim → claim product (MAX Product id from item and services)
...
convert the queryset
Save the invoice bill in database
get_linked_class
See classes defiened in check calculation
Converter
[to be updated]
two way of creating the bills are possible for the valuation, in both case there will be one “bill” per HF/Product
(Chosen)One asset (line) per claim, claim details as asset description: claimed amount as unit price, net amount as net price, discount calculated based on net and unit price
one asset (line) per item or service with claim detail as asset description: item/service claimed unit price as unit price, net as valuated price, quantity as quantity, discount calculated based on net and unit price
...
field | type | comment | ||
HistoryBusinessModel fields |
| validFrom: claim date from validTo:claim date to | ||
line_id |
| claim_id | ||
line_type |
| claim | ||
code | str | Claim-code | ||
description | str | Main Diag | ||
details | json | claim details (Item and service): name, qty, qty approved, price, price_approved, | ||
ledger_account | int | N/A | ||
quantity | float | 1 | ||
unit_price | type | claim_amontamount | ||
discount | float | claim_amont amount - claim_amount_payable | ||
tax_rate | Calculation uuid | N/A | ||
tax_analysis | json |
| ||
amount_total | float | net +tax | ||
amount_net |
| qty * unitprice - discount |