356 lines
19 KiB
HTML
356 lines
19 KiB
HTML
{% extends "base.html" %}
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{% load static %}
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{% block title %}Delete Claim {{ object.claim_number }} - {{ block.super }}{% endblock %}
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{% block content %}
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<div class="container-fluid">
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<!-- Page Header -->
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<div class="d-flex justify-content-between align-items-center mb-4">
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<div>
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<h1 class="h3 mb-1 text-danger">
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<i class="fas fa-exclamation-triangle me-2"></i>Delete Insurance Claim
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</h1>
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<nav aria-label="breadcrumb">
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<ol class="breadcrumb mb-0">
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<li class="breadcrumb-item"><a href="{% url 'billing:dashboard' %}">Billing</a></li>
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<li class="breadcrumb-item"><a href="{% url 'billing:claim_list' %}">Insurance Claims</a></li>
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<li class="breadcrumb-item"><a href="{% url 'billing:claim_detail' object.claim_id %}">{{ object.claim_number }}</a></li>
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<li class="breadcrumb-item active">Delete</li>
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</ol>
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</nav>
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</div>
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<div class="btn-group">
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<a href="{% url 'billing:claim_detail' object.claim_id %}" class="btn btn-outline-secondary">
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<i class="fas fa-arrow-left me-2"></i>Back to Claim
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</a>
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</div>
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</div>
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<div class="row justify-content-center">
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<div class="col-lg-8">
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<!-- Warning Alert -->
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<div class="alert alert-danger mb-4">
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<div class="d-flex align-items-center">
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<div class="me-3">
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<i class="fas fa-exclamation-triangle fa-2x"></i>
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</div>
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<div>
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<h5 class="alert-heading mb-1">Warning: Permanent Deletion</h5>
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<p class="mb-0">
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You are about to permanently delete this insurance claim. This action cannot be undone and may affect reimbursement tracking.
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</p>
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</div>
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</div>
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</div>
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<!-- Claim Information Card -->
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<div class="card mb-4">
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<div class="card-header bg-light">
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<h5 class="mb-0">
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<i class="fas fa-file-medical me-2"></i>Claim to be Deleted
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</h5>
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</div>
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<div class="card-body">
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<div class="row">
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<div class="col-md-6">
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<table class="table table-borderless table-sm">
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<tr>
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<td class="fw-bold">Claim Number:</td>
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<td>{{ object.claim_number }}</td>
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</tr>
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<tr>
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<td class="fw-bold">Patient:</td>
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<td>{{ object.medical_bill.patient.get_full_name }}</td>
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</tr>
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<tr>
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<td class="fw-bold">Bill Number:</td>
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<td>
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<a href="{% url 'billing:bill_detail' object.medical_bill.bill_id %}" class="text-decoration-none">
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{{ object.medical_bill.bill_number }}
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</a>
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</td>
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</tr>
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<tr>
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<td class="fw-bold">Insurance Company:</td>
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<td>{{ object.insurance_info.insurance_company }}</td>
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</tr>
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</table>
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</div>
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<div class="col-md-6">
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<table class="table table-borderless table-sm">
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<tr>
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<td class="fw-bold">Billed Amount:</td>
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<td class="fw-bold text-primary">${{ object.billed_amount|floatformat:2 }}</td>
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</tr>
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<tr>
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<td class="fw-bold">Status:</td>
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<td>
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{% if object.status == 'DRAFT' %}
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<span class="badge bg-secondary">Draft</span>
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{% elif object.status == 'SUBMITTED' %}
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<span class="badge bg-info">Submitted</span>
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{% elif object.status == 'PENDING' %}
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<span class="badge bg-warning">Pending</span>
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{% elif object.status == 'APPROVED' %}
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<span class="badge bg-success">Approved</span>
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{% elif object.status == 'PARTIALLY_APPROVED' %}
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<span class="badge bg-primary">Partially Approved</span>
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{% elif object.status == 'DENIED' %}
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<span class="badge bg-danger">Denied</span>
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{% elif object.status == 'PAID' %}
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<span class="badge bg-success">Paid</span>
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{% elif object.status == 'APPEALED' %}
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<span class="badge bg-dark">Appealed</span>
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{% endif %}
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</td>
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</tr>
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<tr>
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<td class="fw-bold">Submission Date:</td>
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<td>
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{% if object.submission_date %}
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{{ object.submission_date|date:"M d, Y" }}
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{% else %}
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<span class="text-muted">Not submitted</span>
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{% endif %}
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</td>
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</tr>
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<tr>
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<td class="fw-bold">Created:</td>
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<td>{{ object.created_at|date:"M d, Y" }}</td>
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</tr>
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</table>
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</div>
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</div>
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</div>
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</div>
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<!-- Impact Assessment -->
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<div class="card mb-4">
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<div class="card-header bg-warning text-dark">
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<h5 class="mb-0">
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<i class="fas fa-impact me-2"></i>Deletion Impact
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</h5>
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</div>
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<div class="card-body">
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<div class="row">
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<div class="col-md-6">
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<h6 class="fw-bold text-danger">Will be Deleted:</h6>
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<ul class="list-unstyled">
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<li><i class="fas fa-times text-danger me-2"></i>Claim record and all line items</li>
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<li><i class="fas fa-times text-danger me-2"></i>Claim submission history</li>
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<li><i class="fas fa-times text-danger me-2"></i>Insurance correspondence records</li>
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<li><i class="fas fa-times text-danger me-2"></i>Approval/denial documentation</li>
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<li><i class="fas fa-times text-danger me-2"></i>Reimbursement tracking data</li>
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</ul>
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</div>
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<div class="col-md-6">
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<h6 class="fw-bold text-success">Will be Preserved:</h6>
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<ul class="list-unstyled">
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<li><i class="fas fa-check text-success me-2"></i>Original medical bill</li>
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<li><i class="fas fa-check text-success me-2"></i>Patient insurance information</li>
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<li><i class="fas fa-check text-success me-2"></i>Medical records and encounters</li>
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<li><i class="fas fa-check text-success me-2"></i>Payment records (if any)</li>
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</ul>
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</div>
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</div>
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</div>
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</div>
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<!-- Deletion Restrictions -->
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{% if object.status not in 'DRAFT,DENIED' %}
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<div class="card mb-4">
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<div class="card-header bg-danger text-white">
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<h5 class="mb-0">
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<i class="fas fa-ban me-2"></i>Deletion Restrictions
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</h5>
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</div>
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<div class="card-body">
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<div class="alert alert-warning">
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<h6 class="alert-heading">Cannot Delete This Claim</h6>
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<p class="mb-2">This claim cannot be deleted because:</p>
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<ul class="mb-0">
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{% if object.status == 'SUBMITTED' %}
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<li>The claim has been submitted to the insurance company</li>
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{% endif %}
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{% if object.status == 'PENDING' %}
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<li>The claim is currently pending with the insurance company</li>
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{% endif %}
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{% if object.status == 'APPROVED' %}
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<li>The claim has been approved by the insurance company</li>
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{% endif %}
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{% if object.status == 'PARTIALLY_APPROVED' %}
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<li>The claim has been partially approved by the insurance company</li>
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{% endif %}
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{% if object.status == 'PAID' %}
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<li>The claim has been paid by the insurance company</li>
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{% endif %}
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{% if object.status == 'APPEALED' %}
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<li>The claim is currently under appeal</li>
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{% endif %}
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</ul>
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</div>
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<div class="text-center">
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{% if object.status == 'SUBMITTED' or object.status == 'PENDING' %}
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<a href="{% url 'billing:claim_withdraw' object.claim_id %}" class="btn btn-warning me-2">
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<i class="fas fa-undo me-2"></i>Withdraw Claim First
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</a>
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{% endif %}
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<a href="{% url 'billing:claim_detail' object.claim_id %}" class="btn btn-primary">
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<i class="fas fa-arrow-left me-2"></i>Return to Claim Details
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</a>
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</div>
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</div>
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</div>
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{% else %}
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<!-- Confirmation Form -->
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<div class="card">
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<div class="card-header bg-danger text-white">
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<h5 class="mb-0">
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<i class="fas fa-trash me-2"></i>Confirm Deletion
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</h5>
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</div>
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<div class="card-body">
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<form method="post">
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{% csrf_token %}
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<!-- Confirmation Checkbox -->
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<div class="form-check mb-3">
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<input class="form-check-input" type="checkbox" id="confirmDeletion" required>
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<label class="form-check-label fw-bold" for="confirmDeletion">
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I understand that this action is permanent and cannot be undone
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</label>
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</div>
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<!-- Reason for Deletion -->
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<div class="mb-3">
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<label for="deletionReason" class="form-label fw-bold">Reason for Deletion *</label>
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<select class="form-select" id="deletionReason" name="deletion_reason" required>
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<option value="">Select a reason...</option>
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<option value="DUPLICATE">Duplicate claim created in error</option>
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<option value="INCORRECT_PATIENT">Incorrect patient assigned</option>
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<option value="INCORRECT_INSURANCE">Wrong insurance information</option>
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<option value="INCORRECT_SERVICES">Incorrect services claimed</option>
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<option value="BILLING_ERROR">Billing error or mistake</option>
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<option value="DENIED_FINAL">Claim denied and no appeal planned</option>
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<option value="SUPERSEDED">Superseded by corrected claim</option>
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<option value="OTHER">Other (specify in notes)</option>
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</select>
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</div>
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<!-- Replacement Claim Information -->
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<div id="replacementClaimSection" style="display: none;">
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<div class="mb-3">
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<label for="replacementClaim" class="form-label fw-bold">Replacement Claim Number</label>
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<input type="text" class="form-control" id="replacementClaim" name="replacement_claim" placeholder="Enter replacement claim number if applicable">
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<div class="form-text">If this claim is being replaced by a corrected claim, enter the new claim number.</div>
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</div>
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</div>
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<!-- Additional Notes -->
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<div class="mb-4">
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<label for="deletionNotes" class="form-label fw-bold">Additional Notes</label>
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<textarea class="form-control" id="deletionNotes" name="deletion_notes" rows="3" placeholder="Provide additional details about why this claim is being deleted..."></textarea>
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</div>
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<!-- Insurance Company Notification -->
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{% if object.status == 'SUBMITTED' %}
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<div class="mb-4">
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<div class="alert alert-info">
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<h6 class="alert-heading">Insurance Company Notification</h6>
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<div class="form-check">
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<input class="form-check-input" type="checkbox" id="notifyInsurance" name="notify_insurance">
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<label class="form-check-label" for="notifyInsurance">
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Notify {{ object.insurance_info.insurance_company }} about claim withdrawal
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</label>
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</div>
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<div class="form-text">Check this box to automatically notify the insurance company that this claim is being withdrawn.</div>
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</div>
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</div>
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{% endif %}
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<!-- Final Warning -->
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<div class="alert alert-danger">
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<div class="d-flex align-items-center">
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<i class="fas fa-exclamation-triangle fa-2x me-3"></i>
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<div>
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<h6 class="alert-heading mb-1">Final Warning</h6>
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<p class="mb-0">
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Once you click "Delete Claim", this claim and all associated data will be permanently removed from the system.
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This action cannot be reversed and may affect reimbursement tracking.
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</p>
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</div>
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</div>
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</div>
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<!-- Action Buttons -->
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<div class="d-flex justify-content-between">
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<a href="{% url 'billing:claim_detail' object.claim_id %}" class="btn btn-outline-secondary">
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<i class="fas fa-times me-2"></i>Cancel
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</a>
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<button type="submit" class="btn btn-danger" id="deleteButton" disabled>
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<i class="fas fa-trash me-2"></i>Delete Claim Permanently
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</button>
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</div>
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</form>
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</div>
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</div>
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{% endif %}
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</div>
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</div>
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</div>
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<script>
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// Enable delete button only when confirmation is checked and reason is selected
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function checkFormValidity() {
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const confirmCheckbox = document.getElementById('confirmDeletion');
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const reasonSelect = document.getElementById('deletionReason');
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const deleteButton = document.getElementById('deleteButton');
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const isValid = confirmCheckbox.checked && reasonSelect.value;
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deleteButton.disabled = !isValid;
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}
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// Show/hide replacement claim section based on reason
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function toggleReplacementSection() {
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const reasonSelect = document.getElementById('deletionReason');
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const replacementSection = document.getElementById('replacementClaimSection');
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if (reasonSelect.value === 'SUPERSEDED') {
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replacementSection.style.display = 'block';
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} else {
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replacementSection.style.display = 'none';
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document.getElementById('replacementClaim').value = '';
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}
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}
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// Add event listeners
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document.getElementById('confirmDeletion').addEventListener('change', checkFormValidity);
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document.getElementById('deletionReason').addEventListener('change', function() {
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checkFormValidity();
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toggleReplacementSection();
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});
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// Final confirmation before submission
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document.querySelector('form').addEventListener('submit', function(e) {
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const claimNumber = '{{ object.claim_number }}';
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const billedAmount = '{{ object.billed_amount|floatformat:2 }}';
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const confirmation = confirm(
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`Are you absolutely sure you want to delete claim ${claimNumber}?\n\n` +
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`Billed Amount: $${billedAmount}\n` +
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'Insurance Company: {{ object.insurance_info.insurance_company }}\n\n' +
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'This action is PERMANENT and cannot be undone.\n' +
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'This may affect reimbursement tracking and reporting.\n\n' +
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'Click OK to proceed with deletion, or Cancel to abort.'
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);
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if (!confirmation) {
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e.preventDefault();
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return false;
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}
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});
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</script>
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{% endblock %}
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