87 lines
3.3 KiB
HTML
87 lines
3.3 KiB
HTML
{% for claim in claims %}
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<tr>
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<td>
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<strong>{{ claim.claim_number }}</strong>
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{% if claim.prior_auth_number %}
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<br><small class="text-muted">Auth: {{ claim.prior_auth_number }}</small>
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{% endif %}
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</td>
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<td>
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<a href="{% url 'billing:bill_detail' claim.medical_bill.bill_id %}" class="text-decoration-none">
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{{ claim.medical_bill.bill_number }}
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</a>
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</td>
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<td>
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<div>
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<strong>{{ claim.medical_bill.patient.get_full_name }}</strong><br>
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<small class="text-muted">MRN: {{ claim.medical_bill.patient.mrn }}</small>
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</div>
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</td>
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<td>
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<span class="badge bg-secondary">{{ claim.get_claim_type_display }}</span>
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</td>
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<td>
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<div>
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<strong>{{ claim.insurance_info.insurance_company }}</strong><br>
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<small class="text-muted">{{ claim.insurance_info.policy_number }}</small>
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</div>
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</td>
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<td>{{ claim.submission_date|date:"M d, Y" }}</td>
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<td>${{ claim.billed_amount|floatformat:2 }}</td>
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<td>
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<strong class="text-success">${{ claim.paid_amount|floatformat:2 }}</strong>
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{% if claim.allowed_amount %}
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<br><small class="text-muted">Allowed: ${{ claim.allowed_amount|floatformat:2 }}</small>
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{% endif %}
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</td>
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<td>
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<strong class="text-warning">${{ claim.patient_responsibility|floatformat:2 }}</strong>
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{% if claim.deductible_amount %}
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<br><small class="text-muted">Deductible: ${{ claim.deductible_amount|floatformat:2 }}</small>
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{% endif %}
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</td>
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<td>
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{% if claim.status == 'DRAFT' %}
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<span class="badge bg-secondary">Draft</span>
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{% elif claim.status == 'SUBMITTED' %}
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<span class="badge bg-info">Submitted</span>
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{% elif claim.status == 'PENDING' %}
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<span class="badge bg-warning">Pending</span>
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{% elif claim.status == 'PROCESSING' %}
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<span class="badge bg-primary">Processing</span>
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{% elif claim.status == 'PAID' %}
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<span class="badge bg-success">Paid</span>
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{% elif claim.status == 'DENIED' %}
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<span class="badge bg-danger">Denied</span>
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{% elif claim.status == 'REJECTED' %}
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<span class="badge bg-danger">Rejected</span>
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{% elif claim.status == 'APPEALED' %}
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<span class="badge bg-warning">Appealed</span>
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{% elif claim.status == 'VOIDED' %}
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<span class="badge bg-secondary">Voided</span>
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{% endif %}
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{% if claim.denial_reason %}
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<br><small class="text-danger">{{ claim.denial_reason|truncatechars:30 }}</small>
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{% endif %}
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</td>
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<td>
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<span class="{% if claim.days_pending > 30 %}text-warning{% elif claim.days_pending > 60 %}text-danger{% endif %}">
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{{ claim.days_pending }} days
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</span>
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{% if claim.response_date %}
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<br><small class="text-muted">Response: {{ claim.response_date|date:"M d" }}</small>
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{% endif %}
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</td>
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</tr>
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{% empty %}
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<tr>
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<td colspan="11" class="text-center py-4">
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<div class="text-muted">
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<i class="fas fa-file-medical fa-3x mb-3"></i>
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<p>No insurance claims found.</p>
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</div>
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</td>
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</tr>
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{% endfor %}
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