2025-08-12 13:33:25 +03:00

698 lines
36 KiB
HTML

{% extends "base.html" %}
{% load static %}
{% block title %}Claim {{ object.claim_number }} - {{ block.super }}{% endblock %}
{% block content %}
<div class="container-fluid">
<!-- Page Header -->
<div class="d-flex justify-content-between align-items-center mb-4">
<div>
<h1 class="h3 mb-1">Insurance Claim {{ object.claim_number }}</h1>
<nav aria-label="breadcrumb">
<ol class="breadcrumb mb-0">
<li class="breadcrumb-item"><a href="{% url 'billing:dashboard' %}">Billing</a></li>
<li class="breadcrumb-item"><a href="{% url 'billing:claim_list' %}">Insurance Claims</a></li>
<li class="breadcrumb-item active">{{ object.claim_number }}</li>
</ol>
</nav>
</div>
<div class="btn-group">
<a href="{% url 'billing:claim_list' %}" class="btn btn-outline-secondary">
<i class="fas fa-arrow-left me-2"></i>Back to List
</a>
{% if object.status == 'DRAFT' %}
<a href="{% url 'billing:claim_update' object.claim_id %}" class="btn btn-primary">
<i class="fas fa-edit me-2"></i>Edit Claim
</a>
{% endif %}
<div class="btn-group" role="group">
<button type="button" class="btn btn-outline-secondary dropdown-toggle" data-bs-toggle="dropdown">
<i class="fas fa-cog me-2"></i>Actions
</button>
<ul class="dropdown-menu">
<li><a class="dropdown-item" href="{% url 'billing:claim_print' object.claim_id %}">
<i class="fas fa-print me-2"></i>Print Claim
</a></li>
<li><a class="dropdown-item" href="{% url 'billing:claim_download' object.claim_id %}">
<i class="fas fa-download me-2"></i>Download PDF
</a></li>
<li><a class="dropdown-item" href="{% url 'billing:claim_export' object.claim_id %}">
<i class="fas fa-file-export me-2"></i>Export to EDI
</a></li>
<li><hr class="dropdown-divider"></li>
{% if object.status == 'DRAFT' %}
<li><a class="dropdown-item text-info" href="{% url 'billing:claim_submit' object.claim_id %}">
<i class="fas fa-paper-plane me-2"></i>Submit Claim
</a></li>
{% elif object.status == 'DENIED' %}
<li><a class="dropdown-item text-warning" href="{% url 'billing:claim_appeal' object.claim_id %}">
<i class="fas fa-gavel me-2"></i>Appeal Claim
</a></li>
<li><a class="dropdown-item text-info" href="{% url 'billing:claim_resubmit' object.claim_id %}">
<i class="fas fa-redo me-2"></i>Resubmit Claim
</a></li>
{% elif object.status in 'SUBMITTED,PENDING' %}
<li><a class="dropdown-item text-primary" href="{% url 'billing:claim_status_check' object.claim_id %}">
<i class="fas fa-sync me-2"></i>Check Status
</a></li>
{% endif %}
{% if object.status in 'DRAFT,DENIED' %}
<li><hr class="dropdown-divider"></li>
<li><a class="dropdown-item text-danger" href="{% url 'billing:claim_delete' object.claim_id %}">
<i class="fas fa-trash me-2"></i>Delete Claim
</a></li>
{% endif %}
</ul>
</div>
</div>
</div>
<div class="row">
<!-- Main Content -->
<div class="col-lg-8">
<!-- Claim Status Alert -->
{% if object.status == 'DENIED' %}
<div class="alert alert-danger mb-4">
<h6 class="alert-heading"><i class="fas fa-times-circle me-2"></i>Claim Denied</h6>
This claim has been denied by the insurance company.
{% if object.denial_reason %}
<br><strong>Reason:</strong> {{ object.denial_reason }}
{% endif %}
<div class="mt-2">
<a href="{% url 'billing:claim_appeal' object.claim_id %}" class="btn btn-sm btn-warning me-2">
<i class="fas fa-gavel me-1"></i>Appeal
</a>
<a href="{% url 'billing:claim_resubmit' object.claim_id %}" class="btn btn-sm btn-info">
<i class="fas fa-redo me-1"></i>Resubmit
</a>
</div>
</div>
{% elif object.status == 'DRAFT' %}
<div class="alert alert-warning mb-4">
<h6 class="alert-heading"><i class="fas fa-edit me-2"></i>Draft Claim</h6>
This claim is still in draft status. Review and submit when ready.
<div class="mt-2">
<a href="{% url 'billing:claim_submit' object.claim_id %}" class="btn btn-sm btn-info">
<i class="fas fa-paper-plane me-1"></i>Submit Claim
</a>
</div>
</div>
{% elif object.status == 'APPROVED' %}
<div class="alert alert-success mb-4">
<h6 class="alert-heading"><i class="fas fa-check-circle me-2"></i>Claim Approved</h6>
This claim has been approved for ${{ object.approved_amount|floatformat:2 }} on {{ object.approval_date|date:"M d, Y" }}.
</div>
{% elif object.status == 'PAID' %}
<div class="alert alert-success mb-4">
<h6 class="alert-heading"><i class="fas fa-money-bill-wave me-2"></i>Claim Paid</h6>
This claim has been paid by the insurance company on {{ object.payment_date|date:"M d, Y" }}.
</div>
{% elif object.status == 'PENDING' and object.days_pending > 30 %}
<div class="alert alert-warning mb-4">
<h6 class="alert-heading"><i class="fas fa-clock me-2"></i>Long Pending Claim</h6>
This claim has been pending for {{ object.days_pending }} days. Consider following up with the insurance company.
</div>
{% endif %}
<!-- Claim Information -->
<div class="card mb-4">
<div class="card-header">
<h5 class="mb-0">
<i class="fas fa-file-medical me-2"></i>Claim Information
</h5>
</div>
<div class="card-body">
<div class="row">
<div class="col-md-6">
<table class="table table-borderless table-sm">
<tr>
<td class="fw-bold">Claim Number:</td>
<td>{{ object.claim_number }}</td>
</tr>
<tr>
<td class="fw-bold">Submission Date:</td>
<td>
{% if object.submission_date %}
{{ object.submission_date|date:"M d, Y" }}
{% else %}
<span class="text-muted">Not submitted</span>
{% endif %}
</td>
</tr>
<tr>
<td class="fw-bold">Status:</td>
<td>
{% if object.status == 'DRAFT' %}
<span class="badge bg-secondary">Draft</span>
{% elif object.status == 'SUBMITTED' %}
<span class="badge bg-info">Submitted</span>
{% elif object.status == 'PENDING' %}
<span class="badge bg-warning">Pending</span>
{% elif object.status == 'APPROVED' %}
<span class="badge bg-success">Approved</span>
{% elif object.status == 'PARTIALLY_APPROVED' %}
<span class="badge bg-primary">Partially Approved</span>
{% elif object.status == 'DENIED' %}
<span class="badge bg-danger">Denied</span>
{% elif object.status == 'PAID' %}
<span class="badge bg-success">Paid</span>
{% elif object.status == 'APPEALED' %}
<span class="badge bg-dark">Appealed</span>
{% endif %}
</td>
</tr>
<tr>
<td class="fw-bold">Days Pending:</td>
<td>
{% if object.submission_date %}
<span class="{% if object.days_pending > 30 %}text-warning{% elif object.days_pending > 60 %}text-danger{% endif %}">
{{ object.days_pending }} days
</span>
{% else %}
<span class="text-muted">-</span>
{% endif %}
</td>
</tr>
</table>
</div>
<div class="col-md-6">
<table class="table table-borderless table-sm">
<tr>
<td class="fw-bold">Billed Amount:</td>
<td class="fw-bold">${{ object.billed_amount|floatformat:2 }}</td>
</tr>
<tr>
<td class="fw-bold">Approved Amount:</td>
<td>
{% if object.approved_amount %}
<span class="text-success fw-bold">${{ object.approved_amount|floatformat:2 }}</span>
{% else %}
<span class="text-muted">-</span>
{% endif %}
</td>
</tr>
<tr>
<td class="fw-bold">Paid Amount:</td>
<td>
{% if object.paid_amount %}
<span class="text-success fw-bold">${{ object.paid_amount|floatformat:2 }}</span>
{% else %}
<span class="text-muted">-</span>
{% endif %}
</td>
</tr>
<tr>
<td class="fw-bold">Created:</td>
<td>{{ object.created_at|date:"M d, Y g:i A" }}</td>
</tr>
</table>
</div>
</div>
{% if object.notes %}
<div class="mt-3">
<h6 class="fw-bold">Notes:</h6>
<p class="text-muted">{{ object.notes }}</p>
</div>
{% endif %}
</div>
</div>
<!-- Bill Information -->
<div class="card mb-4">
<div class="card-header">
<h5 class="mb-0">
<i class="fas fa-file-invoice me-2"></i>Related Bill
</h5>
</div>
<div class="card-body">
<div class="row">
<div class="col-md-6">
<table class="table table-borderless table-sm">
<tr>
<td class="fw-bold">Bill Number:</td>
<td>
<a href="{% url 'billing:bill_detail' object.medical_bill.bill_id %}" class="text-decoration-none">
{{ object.medical_bill.bill_number }}
</a>
</td>
</tr>
<tr>
<td class="fw-bold">Bill Date:</td>
<td>{{ object.medical_bill.bill_date|date:"M d, Y" }}</td>
</tr>
<tr>
<td class="fw-bold">Service Date:</td>
<td>{{ object.service_date|date:"M d, Y" }}</td>
</tr>
</table>
</div>
<div class="col-md-6">
<table class="table table-borderless table-sm">
<tr>
<td class="fw-bold">Total Amount:</td>
<td class="fw-bold">${{ object.medical_bill.total_amount|floatformat:2 }}</td>
</tr>
<tr>
<td class="fw-bold">Bill Status:</td>
<td>
{% if object.medical_bill.status == 'DRAFT' %}
<span class="badge bg-secondary">Draft</span>
{% elif object.medical_bill.status == 'PENDING' %}
<span class="badge bg-warning">Pending</span>
{% elif object.medical_bill.status == 'SUBMITTED' %}
<span class="badge bg-info">Submitted</span>
{% elif object.medical_bill.status == 'PARTIAL_PAID' %}
<span class="badge bg-primary">Partially Paid</span>
{% elif object.medical_bill.status == 'PAID' %}
<span class="badge bg-success">Paid</span>
{% elif object.medical_bill.status == 'OVERDUE' %}
<span class="badge bg-danger">Overdue</span>
{% elif object.medical_bill.status == 'COLLECTIONS' %}
<span class="badge bg-dark">Collections</span>
{% elif object.medical_bill.status == 'WRITTEN_OFF' %}
<span class="badge bg-secondary">Written Off</span>
{% elif object.medical_bill.status == 'CANCELLED' %}
<span class="badge bg-secondary">Cancelled</span>
{% endif %}
</td>
</tr>
<tr>
<td class="fw-bold">Provider:</td>
<td>{{ object.medical_bill.billing_provider|default:"-" }}</td>
</tr>
</table>
</div>
</div>
</div>
</div>
<!-- Patient Information -->
<div class="card mb-4">
<div class="card-header">
<h5 class="mb-0">
<i class="fas fa-user me-2"></i>Patient Information
</h5>
</div>
<div class="card-body">
<div class="row">
<div class="col-md-6">
<table class="table table-borderless table-sm">
<tr>
<td class="fw-bold">Patient Name:</td>
<td>{{ object.medical_bill.patient.get_full_name }}</td>
</tr>
<tr>
<td class="fw-bold">MRN:</td>
<td>{{ object.medical_bill.patient.mrn }}</td>
</tr>
<tr>
<td class="fw-bold">Date of Birth:</td>
<td>{{ object.medical_bill.patient.date_of_birth|date:"M d, Y" }}</td>
</tr>
<tr>
<td class="fw-bold">Gender:</td>
<td>{{ object.medical_bill.patient.get_gender_display|default:"-" }}</td>
</tr>
</table>
</div>
<div class="col-md-6">
<table class="table table-borderless table-sm">
<tr>
<td class="fw-bold">Phone:</td>
<td>{{ object.medical_bill.patient.phone_number|default:"-" }}</td>
</tr>
<tr>
<td class="fw-bold">Email:</td>
<td>{{ object.medical_bill.patient.email|default:"-" }}</td>
</tr>
<tr>
<td class="fw-bold">Address:</td>
<td>
{% if object.medical_bill.patient.address %}
{{ object.medical_bill.patient.address }}<br>
{{ object.medical_bill.patient.city }}, {{ object.medical_bill.patient.state }} {{ object.medical_bill.patient.zip_code }}
{% else %}
-
{% endif %}
</td>
</tr>
</table>
</div>
</div>
</div>
</div>
<!-- Insurance Information -->
<div class="card mb-4">
<div class="card-header">
<h5 class="mb-0">
<i class="fas fa-shield-alt me-2"></i>Insurance Information
</h5>
</div>
<div class="card-body">
<div class="row">
<div class="col-md-6">
<table class="table table-borderless table-sm">
<tr>
<td class="fw-bold">Insurance Company:</td>
<td>{{ object.insurance_info.insurance_company }}</td>
</tr>
<tr>
<td class="fw-bold">Policy Number:</td>
<td>{{ object.insurance_info.policy_number }}</td>
</tr>
<tr>
<td class="fw-bold">Group Number:</td>
<td>{{ object.insurance_info.group_number|default:"-" }}</td>
</tr>
<tr>
<td class="fw-bold">Member ID:</td>
<td>{{ object.insurance_info.member_id|default:"-" }}</td>
</tr>
</table>
</div>
<div class="col-md-6">
<table class="table table-borderless table-sm">
<tr>
<td class="fw-bold">Plan Type:</td>
<td>{{ object.insurance_info.plan_type|default:"-" }}</td>
</tr>
<tr>
<td class="fw-bold">Effective Date:</td>
<td>{{ object.insurance_info.effective_date|date:"M d, Y"|default:"-" }}</td>
</tr>
<tr>
<td class="fw-bold">Expiration Date:</td>
<td>{{ object.insurance_info.expiration_date|date:"M d, Y"|default:"-" }}</td>
</tr>
<tr>
<td class="fw-bold">Copay:</td>
<td>
{% if object.insurance_info.copay_amount %}
${{ object.insurance_info.copay_amount|floatformat:2 }}
{% else %}
-
{% endif %}
</td>
</tr>
</table>
</div>
</div>
</div>
</div>
<!-- Claim Line Items -->
<div class="card">
<div class="card-header">
<h5 class="mb-0">
<i class="fas fa-list me-2"></i>Claim Line Items
</h5>
</div>
<div class="card-body p-0">
<div class="table-responsive">
<table class="table table-hover mb-0">
<thead class="table-light">
<tr>
<th>Service Code</th>
<th>Description</th>
<th>Service Date</th>
<th class="text-center">Quantity</th>
<th class="text-end">Billed Amount</th>
<th class="text-end">Approved Amount</th>
<th>Status</th>
</tr>
</thead>
<tbody>
{% for line_item in object.claimlineitem_set.all %}
<tr>
<td>
<code>{{ line_item.service_code }}</code>
</td>
<td>{{ line_item.description }}</td>
<td>{{ line_item.service_date|date:"M d, Y" }}</td>
<td class="text-center">{{ line_item.quantity }}</td>
<td class="text-end">${{ line_item.billed_amount|floatformat:2 }}</td>
<td class="text-end">
{% if line_item.approved_amount %}
<span class="text-success fw-bold">${{ line_item.approved_amount|floatformat:2 }}</span>
{% else %}
<span class="text-muted">-</span>
{% endif %}
</td>
<td>
{% if line_item.status == 'PENDING' %}
<span class="badge bg-warning">Pending</span>
{% elif line_item.status == 'APPROVED' %}
<span class="badge bg-success">Approved</span>
{% elif line_item.status == 'DENIED' %}
<span class="badge bg-danger">Denied</span>
{% elif line_item.status == 'PARTIALLY_APPROVED' %}
<span class="badge bg-primary">Partially Approved</span>
{% endif %}
</td>
</tr>
{% empty %}
<tr>
<td colspan="7" class="text-center text-muted py-4">
No line items found for this claim.
</td>
</tr>
{% endfor %}
</tbody>
</table>
</div>
</div>
</div>
</div>
<!-- Sidebar -->
<div class="col-lg-4">
<!-- Claim Summary -->
<div class="card mb-4">
<div class="card-header">
<h5 class="mb-0">
<i class="fas fa-calculator me-2"></i>Claim Summary
</h5>
</div>
<div class="card-body">
<div class="d-flex justify-content-between mb-2">
<span>Billed Amount:</span>
<span class="fw-bold">${{ object.billed_amount|floatformat:2 }}</span>
</div>
<div class="d-flex justify-content-between mb-2">
<span>Approved Amount:</span>
<span class="{% if object.approved_amount %}text-success fw-bold{% else %}text-muted{% endif %}">
{% if object.approved_amount %}
${{ object.approved_amount|floatformat:2 }}
{% else %}
-
{% endif %}
</span>
</div>
<div class="d-flex justify-content-between mb-2">
<span>Paid Amount:</span>
<span class="{% if object.paid_amount %}text-success fw-bold{% else %}text-muted{% endif %}">
{% if object.paid_amount %}
${{ object.paid_amount|floatformat:2 }}
{% else %}
-
{% endif %}
</span>
</div>
<hr>
<div class="d-flex justify-content-between">
<span class="fw-bold">Outstanding:</span>
<span class="fw-bold {% if object.outstanding_amount > 0 %}text-danger{% else %}text-success{% endif %}">
${{ object.outstanding_amount|floatformat:2 }}
</span>
</div>
</div>
</div>
<!-- Quick Actions -->
<div class="card mb-4">
<div class="card-header">
<h5 class="mb-0">
<i class="fas fa-bolt me-2"></i>Quick Actions
</h5>
</div>
<div class="card-body">
<div class="d-grid gap-2">
{% if object.status == 'DRAFT' %}
<a href="{% url 'billing:claim_submit' object.claim_id %}" class="btn btn-info">
<i class="fas fa-paper-plane me-2"></i>Submit Claim
</a>
<a href="{% url 'billing:claim_update' object.claim_id %}" class="btn btn-outline-warning">
<i class="fas fa-edit me-2"></i>Edit Claim
</a>
{% elif object.status == 'DENIED' %}
<a href="{% url 'billing:claim_appeal' object.claim_id %}" class="btn btn-warning">
<i class="fas fa-gavel me-2"></i>Appeal Claim
</a>
<a href="{% url 'billing:claim_resubmit' object.claim_id %}" class="btn btn-info">
<i class="fas fa-redo me-2"></i>Resubmit Claim
</a>
{% elif object.status in 'SUBMITTED,PENDING' %}
<a href="{% url 'billing:claim_status_check' object.claim_id %}" class="btn btn-primary">
<i class="fas fa-sync me-2"></i>Check Status
</a>
{% endif %}
<a href="{% url 'billing:claim_print' object.claim_id %}" class="btn btn-outline-primary">
<i class="fas fa-print me-2"></i>Print Claim
</a>
<a href="{% url 'billing:claim_download' object.claim_id %}" class="btn btn-outline-secondary">
<i class="fas fa-download me-2"></i>Download PDF
</a>
<a href="{% url 'billing:bill_detail' object.medical_bill.bill_id %}" class="btn btn-outline-info">
<i class="fas fa-file-invoice me-2"></i>View Bill
</a>
</div>
</div>
</div>
<!-- Claim Timeline -->
<div class="card">
<div class="card-header">
<h5 class="mb-0">
<i class="fas fa-history me-2"></i>Claim Timeline
</h5>
</div>
<div class="card-body">
<div class="timeline">
<div class="timeline-item">
<div class="timeline-marker bg-primary"></div>
<div class="timeline-content">
<h6 class="timeline-title">Claim Created</h6>
<p class="timeline-text">{{ object.created_at|date:"M d, Y g:i A" }}</p>
</div>
</div>
{% if object.submission_date %}
<div class="timeline-item">
<div class="timeline-marker bg-info"></div>
<div class="timeline-content">
<h6 class="timeline-title">Claim Submitted</h6>
<p class="timeline-text">{{ object.submission_date|date:"M d, Y g:i A" }}</p>
</div>
</div>
{% endif %}
{% if object.status == 'APPROVED' %}
<div class="timeline-item">
<div class="timeline-marker bg-success"></div>
<div class="timeline-content">
<h6 class="timeline-title">Claim Approved</h6>
<p class="timeline-text">
${{ object.approved_amount|floatformat:2 }} approved
<br><small class="text-muted">{{ object.approval_date|date:"M d, Y g:i A"|default:"Unknown" }}</small>
</p>
</div>
</div>
{% elif object.status == 'DENIED' %}
<div class="timeline-item">
<div class="timeline-marker bg-danger"></div>
<div class="timeline-content">
<h6 class="timeline-title">Claim Denied</h6>
<p class="timeline-text">
{% if object.denial_reason %}
{{ object.denial_reason }}
<br><small class="text-muted">{{ object.denial_date|date:"M d, Y g:i A"|default:"Unknown" }}</small>
{% else %}
{{ object.denial_date|date:"M d, Y g:i A"|default:"Unknown" }}
{% endif %}
</p>
</div>
</div>
{% elif object.status == 'PARTIALLY_APPROVED' %}
<div class="timeline-item">
<div class="timeline-marker bg-primary"></div>
<div class="timeline-content">
<h6 class="timeline-title">Partially Approved</h6>
<p class="timeline-text">
${{ object.approved_amount|floatformat:2 }} of ${{ object.billed_amount|floatformat:2 }}
<br><small class="text-muted">{{ object.approval_date|date:"M d, Y g:i A"|default:"Unknown" }}</small>
</p>
</div>
</div>
{% endif %}
{% if object.status == 'PAID' %}
<div class="timeline-item">
<div class="timeline-marker bg-success"></div>
<div class="timeline-content">
<h6 class="timeline-title">Payment Received</h6>
<p class="timeline-text">
${{ object.paid_amount|floatformat:2 }} received
<br><small class="text-muted">{{ object.payment_date|date:"M d, Y g:i A"|default:"Unknown" }}</small>
</p>
</div>
</div>
{% endif %}
{% if object.status == 'APPEALED' %}
<div class="timeline-item">
<div class="timeline-marker bg-dark"></div>
<div class="timeline-content">
<h6 class="timeline-title">Claim Appealed</h6>
<p class="timeline-text">{{ object.appeal_date|date:"M d, Y g:i A"|default:"Unknown" }}</p>
</div>
</div>
{% endif %}
</div>
</div>
</div>
</div>
</div>
</div>
<style>
.timeline {
position: relative;
padding-left: 30px;
}
.timeline::before {
content: '';
position: absolute;
left: 15px;
top: 0;
bottom: 0;
width: 2px;
background: #dee2e6;
}
.timeline-item {
position: relative;
margin-bottom: 20px;
}
.timeline-marker {
position: absolute;
left: -22px;
top: 0;
width: 12px;
height: 12px;
border-radius: 50%;
border: 2px solid #fff;
box-shadow: 0 0 0 2px #dee2e6;
}
.timeline-content {
background: #f8f9fa;
padding: 10px 15px;
border-radius: 8px;
border-left: 3px solid #dee2e6;
}
.timeline-title {
margin: 0 0 5px 0;
font-size: 0.9rem;
font-weight: 600;
}
.timeline-text {
margin: 0;
font-size: 0.85rem;
color: #6c757d;
}
</style>
{% endblock %}