erp-clinicas-backend-v2/src/modules/insurance/entities/insurance-plan.entity.ts

import {
  Entity,
  PrimaryGeneratedColumn,
  Column,
  CreateDateColumn,
  UpdateDateColumn,
  DeleteDateColumn,
  Index,
  ManyToOne,
  JoinColumn,
  OneToMany,
} from 'typeorm';
import { InsuranceCompany } from './insurance-company.entity';
import { PatientInsurance } from './patient-insurance.entity';

export type InsurancePlanStatus = 'active' | 'inactive' | 'discontinued';
export type CoverageType = 'individual' | 'family' | 'group' | 'medicare' | 'medicaid' | 'other';

export interface CoverageDetails {
  consultations?: number;
  hospitalizations?: number;
  emergencies?: number;
  surgeries?: number;
  laboratory?: number;
  imaging?: number;
  pharmacy?: number;
  dental?: number;
  vision?: number;
  mentalHealth?: number;
  preventiveCare?: number;
}

export interface DeductibleInfo {
  individual?: number;
  family?: number;
  inNetwork?: number;
  outOfNetwork?: number;
}

export interface CopayInfo {
  primaryCare?: number;
  specialist?: number;
  urgentCare?: number;
  emergency?: number;
  laboratory?: number;
  imaging?: number;
  genericDrugs?: number;
  brandDrugs?: number;
  specialtyDrugs?: number;
}

export interface OutOfPocketMax {
  individual?: number;
  family?: number;
  inNetwork?: number;
  outOfNetwork?: number;
}

@Entity({ name: 'insurance_plans', schema: 'clinica' })
export class InsurancePlan {
  @PrimaryGeneratedColumn('uuid')
  id: string;

  @Index()
  @Column({ name: 'tenant_id', type: 'uuid' })
  tenantId: string;

  @Index()
  @Column({ name: 'insurance_company_id', type: 'uuid' })
  insuranceCompanyId: string;

  @ManyToOne(() => InsuranceCompany, (company) => company.plans)
  @JoinColumn({ name: 'insurance_company_id' })
  insuranceCompany: InsuranceCompany;

  @Index()
  @Column({ type: 'varchar', length: 50 })
  code: string;

  @Column({ type: 'varchar', length: 200 })
  name: string;

  @Column({ type: 'text', nullable: true })
  description?: string;

  @Column({ name: 'coverage_type', type: 'enum', enum: ['individual', 'family', 'group', 'medicare', 'medicaid', 'other'], default: 'individual' })
  coverageType: CoverageType;

  @Column({ name: 'coverage_percentage', type: 'jsonb', nullable: true })
  coveragePercentage?: CoverageDetails;

  @Column({ type: 'jsonb', nullable: true })
  deductible?: DeductibleInfo;

  @Column({ type: 'jsonb', nullable: true })
  copay?: CopayInfo;

  @Column({ name: 'out_of_pocket_max', type: 'jsonb', nullable: true })
  outOfPocketMax?: OutOfPocketMax;

  @Column({ name: 'coinsurance_percentage', type: 'decimal', precision: 5, scale: 2, nullable: true })
  coinsurancePercentage?: number;

  @Column({ name: 'annual_benefit_max', type: 'decimal', precision: 12, scale: 2, nullable: true })
  annualBenefitMax?: number;

  @Column({ name: 'lifetime_benefit_max', type: 'decimal', precision: 15, scale: 2, nullable: true })
  lifetimeBenefitMax?: number;

  @Column({ name: 'waiting_period_days', type: 'int', default: 0 })
  waitingPeriodDays: number;

  @Column({ name: 'preauthorization_required', type: 'boolean', default: false })
  preauthorizationRequired: boolean;

  @Column({ name: 'referral_required', type: 'boolean', default: false })
  referralRequired: boolean;

  @Column({ name: 'network_restrictions', type: 'text', nullable: true })
  networkRestrictions?: string;

  @Column({ name: 'exclusions', type: 'text', nullable: true })
  exclusions?: string;

  @Column({ name: 'effective_date', type: 'date', nullable: true })
  effectiveDate?: Date;

  @Column({ name: 'termination_date', type: 'date', nullable: true })
  terminationDate?: Date;

  @Column({ type: 'enum', enum: ['active', 'inactive', 'discontinued'], default: 'active' })
  status: InsurancePlanStatus;

  @Column({ type: 'text', nullable: true })
  notes?: string;

  @OneToMany(() => PatientInsurance, (patientInsurance) => patientInsurance.insurancePlan)
  patientPolicies?: PatientInsurance[];

  @CreateDateColumn({ name: 'created_at', type: 'timestamptz' })
  createdAt: Date;

  @UpdateDateColumn({ name: 'updated_at', type: 'timestamptz' })
  updatedAt: Date;

  @DeleteDateColumn({ name: 'deleted_at', type: 'timestamptz', nullable: true })
  deletedAt?: Date;
}