965 lines
32 KiB
TypeScript
965 lines
32 KiB
TypeScript
import { useState, useEffect, useRef, useCallback } from "react";
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import { Button } from "@/components/ui/button";
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import { Input } from "@/components/ui/input";
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import {
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Select,
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SelectContent,
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SelectItem,
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SelectTrigger,
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SelectValue,
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} from "@/components/ui/select";
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import { Card, CardContent, CardHeader, CardTitle } from "@/components/ui/card";
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import { Label } from "@/components/ui/label";
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import { X, Calendar as CalendarIcon, HelpCircle, Trash2 } from "lucide-react";
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import { useToast } from "@/hooks/use-toast";
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import { Calendar } from "@/components/ui/calendar";
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import {
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Popover,
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PopoverContent,
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PopoverTrigger,
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} from "@/components/ui/popover";
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import { useQuery } from "@tanstack/react-query";
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import { apiRequest } from "@/lib/queryClient";
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import {
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MultipleFileUploadZone,
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MultipleFileUploadZoneHandle,
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} from "../file-upload/multiple-file-upload-zone";
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import { useAuth } from "@/hooks/use-auth";
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import {
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Tooltip,
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TooltipContent,
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TooltipTrigger,
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} from "@/components/ui/tooltip";
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import { formatLocalDate, parseLocalDate } from "@/utils/dateUtils";
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import {
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Claim,
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InputServiceLine,
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InsertAppointment,
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Patient,
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Staff,
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UpdateAppointment,
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UpdatePatient,
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} from "@repo/db/types";
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import { Decimal } from "decimal.js";
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import {
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mapPricesForForm,
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applyComboToForm,
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getDescriptionForCode,
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} from "@/utils/procedureCombosMapping";
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import { COMBO_CATEGORIES, PROCEDURE_COMBOS } from "@/utils/procedureCombos";
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interface ClaimFileMeta {
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filename: string;
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mimeType: string;
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}
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interface ClaimFormData {
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patientId: number;
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appointmentId: number;
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userId: number;
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staffId: number;
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patientName: string;
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memberId: string;
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dateOfBirth: string;
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remarks: string;
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serviceDate: string; // YYYY-MM-DD
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insuranceProvider: string;
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insuranceSiteKey?: string;
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status: string; // default "pending"
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serviceLines: InputServiceLine[];
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claimId?: number;
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claimFiles?: ClaimFileMeta[];
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}
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interface ClaimFormProps {
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patientId: number;
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onSubmit: (data: ClaimFormData) => Promise<Claim>;
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onHandleAppointmentSubmit: (
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appointmentData: InsertAppointment | UpdateAppointment
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) => void;
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onHandleUpdatePatient: (patient: UpdatePatient & { id: number }) => void;
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onHandleForMHSelenium: (data: ClaimFormData) => void;
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onClose: () => void;
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}
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export function ClaimForm({
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patientId,
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onHandleAppointmentSubmit,
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onHandleUpdatePatient,
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onHandleForMHSelenium,
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onSubmit,
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onClose,
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}: ClaimFormProps) {
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const { toast } = useToast();
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const { user } = useAuth();
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const [patient, setPatient] = useState<Patient | null>(null);
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// Query patient based on given patient id
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const {
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data: fetchedPatient,
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isLoading,
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error,
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} = useQuery<Patient>({
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queryKey: ["/api/patients/", patientId],
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queryFn: async () => {
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const res = await apiRequest("GET", `/api/patients/${patientId}`);
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if (!res.ok) throw new Error("Failed to fetch patient");
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return res.json();
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},
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enabled: !!patientId,
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});
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// Sync fetched patient when available
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useEffect(() => {
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if (fetchedPatient) {
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setPatient(fetchedPatient);
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}
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}, [fetchedPatient]);
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//Fetching staff memebers
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const [staff, setStaff] = useState<Staff | null>(null);
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const { data: staffMembersRaw = [] as Staff[], isLoading: isLoadingStaff } =
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useQuery<Staff[]>({
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queryKey: ["/api/staffs/"],
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queryFn: async () => {
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const res = await apiRequest("GET", "/api/staffs/");
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return res.json();
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},
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});
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useEffect(() => {
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if (staffMembersRaw.length > 0 && !staff) {
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const kaiGao = staffMembersRaw.find(
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(member) => member.name === "Kai Gao"
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);
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const defaultStaff = kaiGao || staffMembersRaw[0];
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if (defaultStaff) setStaff(defaultStaff);
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}
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}, [staffMembersRaw, staff]);
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// Service date state
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const [serviceDateValue, setServiceDateValue] = useState<Date>(new Date());
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const [serviceDate, setServiceDate] = useState<string>(
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formatLocalDate(new Date())
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);
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const [serviceDateOpen, setServiceDateOpen] = useState(false);
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const [openProcedureDateIndex, setOpenProcedureDateIndex] = useState<
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number | null
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>(null);
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// Update service date when calendar date changes
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const onServiceDateChange = (date: Date | undefined) => {
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if (date) {
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const formattedDate = formatLocalDate(date);
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setServiceDateValue(date);
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setServiceDate(formattedDate);
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setForm((prev) => ({ ...prev, serviceDate: formattedDate }));
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}
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};
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// when service date is chenged, it will change the each service lines procedure date in sync as well.
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useEffect(() => {
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setForm((prevForm) => {
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const updatedLines = prevForm.serviceLines.map((line) => ({
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...line,
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procedureDate: serviceDate, // set all to current serviceDate string
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}));
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return {
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...prevForm,
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serviceLines: updatedLines,
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serviceDate, // keep form.serviceDate in sync as well
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};
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});
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}, [serviceDate]);
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// Determine patient date of birth format - required as date extracted from pdfs has different format.
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const formatDOB = (dob: string | Date | undefined) => {
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if (!dob) return "";
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const normalized = formatLocalDate(parseLocalDate(dob));
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// If it's already MM/DD/YYYY, leave it alone
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if (/^\d{2}\/\d{2}\/\d{4}$/.test(normalized)) return normalized;
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// If it's yyyy-MM-dd, swap order to MM/DD/YYYY
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if (/^\d{4}-\d{2}-\d{2}$/.test(normalized)) {
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const [year, month, day] = normalized.split("-");
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return `${month}/${day}/${year}`;
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}
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return normalized;
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};
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// MAIN FORM INITIAL STATE
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const [form, setForm] = useState<ClaimFormData & { uploadedFiles: File[] }>({
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patientId: patientId || 0,
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appointmentId: 0,
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userId: Number(user?.id),
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staffId: Number(staff?.id),
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patientName: `${patient?.firstName} ${patient?.lastName}`.trim(),
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memberId: patient?.insuranceId ?? "",
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dateOfBirth: formatDOB(patient?.dateOfBirth),
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remarks: "",
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serviceDate: serviceDate,
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insuranceProvider: "",
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insuranceSiteKey: "",
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status: "PENDING",
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serviceLines: Array.from({ length: 10 }, () => ({
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procedureCode: "",
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procedureDate: serviceDate,
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oralCavityArea: "",
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toothNumber: "",
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toothSurface: "",
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totalBilled: new Decimal(0),
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totalAdjusted: new Decimal(0),
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totalPaid: new Decimal(0),
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})),
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uploadedFiles: [],
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});
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// Sync patient data to form when patient updates
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useEffect(() => {
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if (patient) {
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const fullName =
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`${patient.firstName || ""} ${patient.lastName || ""}`.trim();
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setForm((prev) => ({
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...prev,
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patientId: Number(patient.id),
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patientName: fullName,
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dateOfBirth: formatDOB(patient.dateOfBirth),
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memberId: patient.insuranceId || "",
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}));
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}
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}, [patient]);
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// Handle patient field changes (to make inputs controlled and editable)
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const updatePatientField = (field: keyof Patient, value: any) => {
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setPatient((prev) => (prev ? { ...prev, [field]: value } : null));
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};
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const updateServiceLine = (
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index: number,
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field: keyof InputServiceLine,
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value: any
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) => {
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const updatedLines = [...form.serviceLines];
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if (updatedLines[index]) {
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if (field === "totalBilled") {
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const num = typeof value === "string" ? parseFloat(value) : value;
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const rounded = Math.round((isNaN(num) ? 0 : num) * 100) / 100;
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updatedLines[index][field] = new Decimal(rounded);
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} else {
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updatedLines[index][field] = value;
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}
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}
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setForm({ ...form, serviceLines: updatedLines });
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};
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const updateProcedureDate = (index: number, date: Date | undefined) => {
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if (!date) return;
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const formattedDate = formatLocalDate(date);
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const updatedLines = [...form.serviceLines];
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if (updatedLines[index]) {
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updatedLines[index].procedureDate = formattedDate;
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}
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setForm({ ...form, serviceLines: updatedLines });
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};
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// for serviceLine rows, to auto scroll when it got updated by combo buttons and all.
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const rowRefs = useRef<(HTMLDivElement | null)[]>([]);
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const scrollToLine = (index: number) => {
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const el = rowRefs.current[index];
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if (el) {
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el.scrollIntoView({ behavior: "smooth", block: "start" });
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}
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};
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// Map Price function
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const onMapPrice = () => {
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setForm((prev) =>
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mapPricesForForm({
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form: prev,
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patientDOB: patient?.dateOfBirth ?? "",
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})
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);
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};
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// FILE UPLOAD ZONE
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const uploadZoneRef = useRef<MultipleFileUploadZoneHandle | null>(null);
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const [isUploading, setIsUploading] = useState(false);
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// NO validation here — the upload zone handles validation, toasts, max files, sizes, etc.
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const handleFilesChange = useCallback((files: File[]) => {
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setForm((prev) => ({ ...prev, uploadedFiles: files }));
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}, []);
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// 1st Button workflow - Mass Health Button Handler
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const handleMHSubmit = async (
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formToUse?: ClaimFormData & { uploadedFiles?: File[] }
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) => {
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// Use the passed form, or fallback to current state
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const f = formToUse ?? form;
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// 0. Validate required fields
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const missingFields: string[] = [];
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if (!f.memberId?.trim()) missingFields.push("Member ID");
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if (!f.dateOfBirth?.trim()) missingFields.push("Date of Birth");
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if (!patient?.firstName?.trim()) missingFields.push("First Name");
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if (missingFields.length > 0) {
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toast({
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title: "Missing Required Fields",
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description: `Please fill out the following field(s): ${missingFields.join(", ")}`,
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variant: "destructive",
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});
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return;
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}
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// 1. Create or update appointment
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const appointmentData = {
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patientId: patientId,
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date: f.serviceDate,
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staffId: staff?.id,
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};
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const appointmentId = await onHandleAppointmentSubmit(appointmentData);
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// 2. Update patient
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if (patient && typeof patient.id === "number") {
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const { id, createdAt, userId, ...sanitizedFields } = patient;
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const updatedPatientFields = {
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id,
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...sanitizedFields,
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insuranceProvider: "MassHealth",
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};
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onHandleUpdatePatient(updatedPatientFields);
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} else {
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toast({
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title: "Error",
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description: "Cannot update patient: Missing or invalid patient data",
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variant: "destructive",
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});
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}
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// 3. Create Claim(if not)
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// Filter out empty service lines (empty procedureCode)
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const filteredServiceLines = f.serviceLines.filter(
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(line) => line.procedureCode.trim() !== ""
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);
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const { uploadedFiles, insuranceSiteKey, ...formToCreateClaim } = f;
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// build claimFiles metadata from uploadedFiles (only filename + mimeType)
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const claimFilesMeta: ClaimFileMeta[] = (uploadedFiles || []).map((f) => ({
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filename: f.name,
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mimeType: f.type,
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}));
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const createdClaim = await onSubmit({
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...formToCreateClaim,
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serviceLines: filteredServiceLines,
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staffId: Number(staff?.id),
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patientId: patientId,
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insuranceProvider: "MassHealth",
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appointmentId: appointmentId!,
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claimFiles: claimFilesMeta,
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});
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// 4. sending form data to selenium service
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onHandleForMHSelenium({
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...f,
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serviceLines: filteredServiceLines,
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staffId: Number(staff?.id),
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patientId: patientId,
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insuranceProvider: "Mass Health",
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appointmentId: appointmentId!,
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insuranceSiteKey: "MH",
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claimId: createdClaim.id,
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});
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// 5. Close form
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onClose();
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};
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// 2nd Button workflow - Only Creates Data, patient, appointmetn, claim, payment, not actually submits claim to MH site.
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const handleAddService = async () => {
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// 0. Validate required fields
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const missingFields: string[] = [];
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if (!form.memberId?.trim()) missingFields.push("Member ID");
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if (!form.dateOfBirth?.trim()) missingFields.push("Date of Birth");
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if (!patient?.firstName?.trim()) missingFields.push("First Name");
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if (missingFields.length > 0) {
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toast({
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title: "Missing Required Fields",
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description: `Please fill out the following field(s): ${missingFields.join(", ")}`,
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variant: "destructive",
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});
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return;
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}
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// 1. Create or update appointment
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const appointmentData = {
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patientId: patientId,
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date: serviceDate,
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staffId: staff?.id,
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};
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const appointmentId = await onHandleAppointmentSubmit(appointmentData);
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// 2. Update patient
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if (patient && typeof patient.id === "number") {
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const { id, createdAt, userId, ...sanitizedFields } = patient;
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const updatedPatientFields = {
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id,
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...sanitizedFields,
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insuranceProvider: "MassHealth",
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};
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onHandleUpdatePatient(updatedPatientFields);
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} else {
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toast({
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title: "Error",
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description: "Cannot update patient: Missing or invalid patient data",
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variant: "destructive",
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});
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}
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// 3. Create Claim(if not)
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// Filter out empty service lines (empty procedureCode)
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const filteredServiceLines = form.serviceLines.filter(
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(line) => line.procedureCode.trim() !== ""
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);
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const { uploadedFiles, insuranceSiteKey, ...formToCreateClaim } = form;
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// build claimFiles metadata from uploadedFiles (only filename + mimeType)
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const claimFilesMeta: ClaimFileMeta[] = (uploadedFiles || []).map((f) => ({
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filename: f.name,
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mimeType: f.type,
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}));
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const createdClaim = await onSubmit({
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...formToCreateClaim,
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serviceLines: filteredServiceLines,
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staffId: Number(staff?.id),
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patientId: patientId,
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insuranceProvider: "MassHealth",
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appointmentId: appointmentId!,
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claimFiles: claimFilesMeta,
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});
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// 4. Close form
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onClose();
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};
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const applyComboAndThenMH = async (
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comboId: keyof typeof PROCEDURE_COMBOS
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) => {
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const nextForm = applyComboToForm(
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form,
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comboId,
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patient?.dateOfBirth ?? "",
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{ replaceAll: true, lineDate: form.serviceDate }
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);
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setForm(nextForm);
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setTimeout(() => scrollToLine(0), 0);
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await handleMHSubmit(nextForm);
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};
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return (
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<div className="fixed inset-0 bg-black/50 flex items-center justify-center z-50 p-4 overflow-y-auto">
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<Card className="w-full max-w-5xl max-h-[90vh] overflow-y-auto bg-white">
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<CardHeader className="flex flex-row items-center justify-between pb-2 border-b">
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<CardTitle className="text-xl font-bold">
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Insurance Claim Form
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</CardTitle>
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<Button variant="ghost" size="icon" onClick={onClose}>
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<X className="h-4 w-4" />
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</Button>
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</CardHeader>
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<CardContent className="pt-4">
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<div className="space-y-6">
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{/* Patient Information */}
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<div className="grid grid-cols-4 gap-4">
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<div>
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<Label htmlFor="memberId">Member ID</Label>
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<Input
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id="memberId"
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value={form.memberId}
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onChange={(e) =>
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setForm({ ...form, memberId: e.target.value })
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}
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/>
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</div>
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<div>
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<Label htmlFor="dateOfBirth">Date Of Birth</Label>
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<Input
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id="dateOfBirth"
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value={form.dateOfBirth}
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onChange={(e) => {
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updatePatientField("dateOfBirth", e.target.value);
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setForm((prev) => ({
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...prev,
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dateOfBirth: e.target.value,
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}));
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}}
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disabled={isLoading}
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/>
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</div>
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<div>
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<Label htmlFor="firstName">First Name</Label>
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<Input
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id="firstName"
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value={patient?.firstName || ""}
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onChange={(e) => {
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updatePatientField("firstName", e.target.value);
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setForm((prev) => ({
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...prev,
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patientName:
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`${e.target.value} ${patient?.lastName || ""}`.trim(),
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}));
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}}
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disabled={isLoading}
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/>
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</div>
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<div>
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<Label htmlFor="lastName">Last Name</Label>
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<Input
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id="lastName"
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value={patient?.lastName || ""}
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onChange={(e) => {
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updatePatientField("lastName", e.target.value);
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setForm((prev) => ({
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...prev,
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patientName:
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`${patient?.firstName || ""} ${e.target.value}`.trim(),
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}));
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}}
|
|
disabled={isLoading}
|
|
/>
|
|
</div>
|
|
</div>
|
|
|
|
{/* Clinical Notes Entry */}
|
|
<div className="mb-4 flex items-center gap-2">
|
|
<Label htmlFor="remarks" className="whitespace-nowrap">
|
|
Remarks:
|
|
</Label>
|
|
<Input
|
|
id="remarks"
|
|
className="flex-grow"
|
|
placeholder="Paste clinical notes here"
|
|
value={form.remarks}
|
|
onChange={(e) => setForm({ ...form, remarks: e.target.value })}
|
|
/>
|
|
</div>
|
|
|
|
{/* Service Lines */}
|
|
<div>
|
|
<h3 className="text-xl font-semibold mb-2 text-center">
|
|
Service Lines
|
|
</h3>
|
|
|
|
<div className="flex flex-col gap-2">
|
|
<div className="flex justify-end items-center mb-4">
|
|
{/* Service Date */}
|
|
<div className="flex gap-2">
|
|
<Label className="flex items-center">Service Date</Label>
|
|
<Popover
|
|
open={serviceDateOpen}
|
|
onOpenChange={setServiceDateOpen}
|
|
>
|
|
<PopoverTrigger asChild>
|
|
<Button
|
|
variant="outline"
|
|
className="w-[140px] justify-start text-left font-normal mr-4"
|
|
>
|
|
<CalendarIcon className="mr-2 h-4 w-4" />
|
|
{form.serviceDate}
|
|
</Button>
|
|
</PopoverTrigger>
|
|
<PopoverContent className="w-auto">
|
|
<Calendar
|
|
mode="single"
|
|
selected={serviceDateValue}
|
|
onSelect={(date) => {
|
|
onServiceDateChange(date);
|
|
}}
|
|
onClose={() => setServiceDateOpen(false)}
|
|
/>
|
|
</PopoverContent>
|
|
</Popover>
|
|
{/* Treating doctor */}
|
|
<Label className="flex items-center ml-2">
|
|
Treating Doctor
|
|
</Label>
|
|
<Select
|
|
value={staff?.id?.toString() || ""}
|
|
onValueChange={(id) => {
|
|
const selected = staffMembersRaw.find(
|
|
(member) => member.id?.toString() === id
|
|
);
|
|
if (selected) {
|
|
setStaff(selected);
|
|
setForm((prev) => ({
|
|
...prev,
|
|
staffId: Number(selected.id),
|
|
}));
|
|
}
|
|
}}
|
|
>
|
|
<SelectTrigger className="w-36">
|
|
<SelectValue
|
|
placeholder={staff ? staff.name : "Select Staff"}
|
|
/>
|
|
</SelectTrigger>
|
|
|
|
<SelectContent>
|
|
{staffMembersRaw.map((member) => {
|
|
if (member.id === undefined) return null;
|
|
|
|
return (
|
|
<SelectItem
|
|
key={member.id}
|
|
value={member.id.toString()}
|
|
>
|
|
{member.name}
|
|
</SelectItem>
|
|
);
|
|
})}
|
|
</SelectContent>
|
|
</Select>
|
|
|
|
{/* Map Price Button */}
|
|
<Button
|
|
className="ml-4"
|
|
variant="success"
|
|
onClick={onMapPrice}
|
|
>
|
|
Map Price
|
|
</Button>
|
|
</div>
|
|
</div>
|
|
|
|
<div className="space-y-4">
|
|
<div className="mb-3 text-sm font-semibold opacity-70">
|
|
Direct Claim Submittion Buttons
|
|
</div>
|
|
<div className="flex flex-wrap gap-1">
|
|
<Button
|
|
variant="secondary"
|
|
onClick={() => applyComboAndThenMH("childRecallDirect")}
|
|
>
|
|
Child Recall Direct
|
|
</Button>
|
|
<Button
|
|
variant="secondary"
|
|
onClick={() => applyComboAndThenMH("adultRecallDirect")}
|
|
>
|
|
Adult Recall Direct
|
|
</Button>
|
|
<Button
|
|
variant="secondary"
|
|
onClick={() =>
|
|
applyComboAndThenMH("adultRecallDirect4bw")
|
|
}
|
|
>
|
|
Adult Recall Direct 4BW
|
|
</Button>
|
|
<Button
|
|
variant="secondary"
|
|
onClick={() =>
|
|
applyComboAndThenMH("adultRecallDirect4bw2pa")
|
|
}
|
|
>
|
|
Adult Recall Direct 4BW2PA
|
|
</Button>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
|
|
{/* Header */}
|
|
<div className="grid grid-cols-[1.5fr,0.5fr,1fr,1fr,1fr,1fr,1fr] gap-1 mb-2 mt-10 font-medium text-sm text-gray-700 items-center">
|
|
<div className="grid grid-cols-[auto,1fr] items-center gap-2">
|
|
<span />
|
|
<span className="pl-8">Procedure Code</span>
|
|
</div>
|
|
<span className="justify-self-center">Info</span>
|
|
<span>Procedure Date</span>
|
|
<span>Oral Cavity Area</span>
|
|
<span>Tooth Number</span>
|
|
<span>Tooth Surface</span>
|
|
<span>Billed Amount</span>
|
|
</div>
|
|
|
|
{/* Dynamic Rows */}
|
|
{form.serviceLines.map((line, i) => {
|
|
const raw = line.procedureCode || "";
|
|
const code = raw.trim();
|
|
const desc = code
|
|
? getDescriptionForCode(code) || "No description available"
|
|
: "Enter a procedure code";
|
|
|
|
return (
|
|
<div
|
|
key={i}
|
|
ref={(el) => {
|
|
rowRefs.current[i] = el;
|
|
if (!el) rowRefs.current.splice(i, 1);
|
|
}}
|
|
className="scroll-mt-28 grid grid-cols-[1.5fr,0.5fr,1fr,1fr,1fr,1fr,1fr] gap-1 mb-2 items-center"
|
|
>
|
|
<div className="grid grid-cols-[auto,1fr] items-center gap-2">
|
|
<button
|
|
type="button"
|
|
onClick={() =>
|
|
setForm((prev) => {
|
|
const next = {
|
|
...prev,
|
|
serviceLines: [...prev.serviceLines],
|
|
};
|
|
next.serviceLines.splice(i, 1);
|
|
return next;
|
|
})
|
|
}
|
|
className="p-1 rounded hover:bg-red-50"
|
|
>
|
|
<Trash2 className="h-4 w-4 text-red-500 hover:text-red-700" />
|
|
</button>
|
|
<Input
|
|
placeholder="eg. D0120"
|
|
value={line.procedureCode}
|
|
onChange={(e) =>
|
|
updateServiceLine(
|
|
i,
|
|
"procedureCode",
|
|
e.target.value.toUpperCase()
|
|
)
|
|
}
|
|
/>
|
|
</div>
|
|
|
|
<div className="flex justify-center">
|
|
<Tooltip>
|
|
<TooltipTrigger asChild>
|
|
<HelpCircle className="h-4 w-4 text-gray-400 hover:text-gray-600 cursor-help" />
|
|
</TooltipTrigger>
|
|
<TooltipContent>
|
|
<div className="text-sm">{desc}</div>
|
|
</TooltipContent>
|
|
</Tooltip>
|
|
</div>
|
|
|
|
{/* Date Picker */}
|
|
<Popover
|
|
open={openProcedureDateIndex === i}
|
|
onOpenChange={(open) =>
|
|
setOpenProcedureDateIndex(open ? i : null)
|
|
}
|
|
>
|
|
<PopoverTrigger asChild>
|
|
<Button
|
|
variant="outline"
|
|
className="w-full text-left font-normal"
|
|
>
|
|
<CalendarIcon className="mr-2 h-4 w-4" />
|
|
{line.procedureDate || "Pick Date"}
|
|
</Button>
|
|
</PopoverTrigger>
|
|
<PopoverContent className="w-auto">
|
|
<Calendar
|
|
mode="single"
|
|
selected={
|
|
line.procedureDate
|
|
? new Date(line.procedureDate)
|
|
: undefined
|
|
}
|
|
onSelect={(date) => updateProcedureDate(i, date)}
|
|
onClose={() => setOpenProcedureDateIndex(null)}
|
|
/>
|
|
</PopoverContent>
|
|
</Popover>
|
|
|
|
<Input
|
|
placeholder="Oral Cavity Area"
|
|
value={line.oralCavityArea}
|
|
onChange={(e) =>
|
|
updateServiceLine(i, "oralCavityArea", e.target.value)
|
|
}
|
|
/>
|
|
<Input
|
|
placeholder="eg. 14"
|
|
value={line.toothNumber}
|
|
onChange={(e) =>
|
|
updateServiceLine(i, "toothNumber", e.target.value)
|
|
}
|
|
/>
|
|
<Input
|
|
placeholder="eg. 'B', 'D', 'F', 'I', 'L', 'M', 'O'"
|
|
value={line.toothSurface}
|
|
onChange={(e) =>
|
|
updateServiceLine(i, "toothSurface", e.target.value)
|
|
}
|
|
/>
|
|
<Input
|
|
type="number"
|
|
step="0.01"
|
|
placeholder="$0.00"
|
|
value={
|
|
line.totalBilled?.toNumber() === 0
|
|
? ""
|
|
: line.totalBilled?.toNumber()
|
|
}
|
|
onChange={(e) => {
|
|
updateServiceLine(i, "totalBilled", e.target.value);
|
|
}}
|
|
onBlur={(e) => {
|
|
const val = parseFloat(e.target.value);
|
|
const rounded = Math.round(val * 100) / 100;
|
|
updateServiceLine(
|
|
i,
|
|
"totalBilled",
|
|
isNaN(rounded) ? 0 : rounded
|
|
);
|
|
}}
|
|
/>
|
|
</div>
|
|
);
|
|
})}
|
|
|
|
<Button
|
|
className="mt-2"
|
|
variant="outline"
|
|
onClick={() =>
|
|
setForm((prev) => ({
|
|
...prev,
|
|
serviceLines: [
|
|
...prev.serviceLines,
|
|
{
|
|
procedureCode: "",
|
|
procedureDate: serviceDate,
|
|
oralCavityArea: "",
|
|
toothNumber: "",
|
|
toothSurface: "",
|
|
totalBilled: new Decimal(0),
|
|
totalAdjusted: new Decimal(0),
|
|
totalPaid: new Decimal(0),
|
|
},
|
|
],
|
|
}))
|
|
}
|
|
>
|
|
+ Add Service Line
|
|
</Button>
|
|
|
|
<div className="space-y-4 mt-8">
|
|
{Object.entries(COMBO_CATEGORIES).map(([section, ids]) => (
|
|
<div key={section}>
|
|
<div className="mb-3 text-sm font-semibold opacity-70">
|
|
{section}
|
|
</div>
|
|
<div className="flex flex-wrap gap-1">
|
|
{ids.map((id) => {
|
|
const b = PROCEDURE_COMBOS[id];
|
|
if (!b) {
|
|
return;
|
|
}
|
|
return (
|
|
<Button
|
|
key={b.id}
|
|
variant="secondary"
|
|
onClick={() =>
|
|
setForm((prev) => {
|
|
const next = applyComboToForm(
|
|
prev,
|
|
b.id as any,
|
|
patient?.dateOfBirth ?? "",
|
|
{
|
|
replaceAll: true,
|
|
lineDate: prev.serviceDate,
|
|
}
|
|
);
|
|
|
|
setTimeout(() => scrollToLine(0), 0);
|
|
|
|
return next;
|
|
})
|
|
}
|
|
>
|
|
{b.label}
|
|
</Button>
|
|
);
|
|
})}
|
|
</div>
|
|
</div>
|
|
))}
|
|
</div>
|
|
</div>
|
|
|
|
{/* File Upload Section */}
|
|
<div className="mt-4 bg-gray-100 p-4 rounded-md space-y-4">
|
|
<p className="text-sm text-gray-500">
|
|
You can upload up to 10 files. Allowed types: PDF, JPG, PNG,
|
|
WEBP.
|
|
</p>
|
|
|
|
<MultipleFileUploadZone
|
|
ref={uploadZoneRef}
|
|
onFilesChange={handleFilesChange}
|
|
isUploading={isUploading}
|
|
acceptedFileTypes="application/pdf,image/jpeg,image/jpg,image/png,image/webp"
|
|
maxFiles={10}
|
|
/>
|
|
|
|
{form.uploadedFiles.length > 0 && (
|
|
<ul className="text-sm text-gray-700 list-disc ml-6">
|
|
{form.uploadedFiles.map((file, index) => (
|
|
<li key={index}>{file.name}</li>
|
|
))}
|
|
</ul>
|
|
)}
|
|
</div>
|
|
|
|
{/* Insurance Carriers */}
|
|
<div>
|
|
<h3 className="text-xl font-semibold mb-4 text-center">
|
|
Insurance Carriers
|
|
</h3>
|
|
<div className="flex justify-between">
|
|
<Button
|
|
className="w-32"
|
|
variant="warning"
|
|
onClick={() => handleMHSubmit()}
|
|
>
|
|
MH
|
|
</Button>
|
|
<Button className="w-32" variant="warning">
|
|
MH PreAuth
|
|
</Button>
|
|
<Button
|
|
className="w-32"
|
|
variant="warning"
|
|
onClick={handleAddService}
|
|
>
|
|
Add Service
|
|
</Button>
|
|
<Button className="w-32" variant="outline">
|
|
Delta MA
|
|
</Button>
|
|
<Button className="w-32" variant="outline">
|
|
Others
|
|
</Button>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</CardContent>
|
|
</Card>
|
|
</div>
|
|
);
|
|
}
|