Benefit consumption module / Enquire


Provide a mechanism to increase the performance to calculate the balance per insuree - currently full table scans. It will be used by both modular BE and REST API.


Create a policy_balance table with those columns per “benefit”

  • type

    • numberOf

    • amount

    • periodicity

  • benefit detail (visit hospital … )

    • Type

      • Item

      • service

      • policy limits

    • id

      • id of item/service

      • OR limits type (new table ?)

  • insuree (only for limits that are personnal)

  • benefit id (policy)

  • date of validity (policy end date) ??

  • balance (actually approved)

  • provisional (submitted claim)

  • temporary (draft claim)

  • limits


Initial update

  • For all policy,

    • for all insuree covered by policy

      • get all claim details covered by policy (column in item and services)

      • update the common limits

      • update the individual limit

      • save limits for item and service that have limits (date or number , 2 limits if both)

      • save all cached enquiry

Schedule task to update

  • For all claims updates since the last run

    • get all policy details covered by claims (column in item and services)

      • get all the member of the policy

        • update the common limits

        • update the individual limits

        • save all cached enquiry

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