feat: wire copayment/adjustment into balance and collected calculations

Balance = totalBilled - mhPaidAmount - copayment - adjustment
Collected = mhPaidAmount + copayment (adjustment is a write-off)

- Frontend breakdown now shows Collected, Adjustment (if >0), and Balance
- Reports: totalCollected and totalOutstanding use the new formula
- Both date-range and staff summary queries updated

Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
This commit is contained in:
Gitead
2026-05-06 21:36:04 -04:00
parent 4bd501250d
commit 49415bcfc4
2 changed files with 62 additions and 46 deletions

View File

@@ -175,18 +175,19 @@ export const paymentsReportsStorage: IPaymentsReportsStorage = {
)) as { cnt: number }[];
const totalPatients = patientsCntRows?.[0]?.cnt ?? 0;
// totalOutstanding: sum of (charges - paid - adjusted) across patients, using payments in range
// totalOutstanding: totalBilled - mhPaidAmount - copayment - adjustment
let outstandingSql = "";
if (hasFrom && hasTo) {
outstandingSql = `
SELECT COALESCE(SUM(
COALESCE(pm.total_charges,0) - COALESCE(pm.total_paid,0) - COALESCE(pm.total_adjusted,0)
GREATEST(COALESCE(pm.total_charges,0) - COALESCE(pm.mh_paid,0) - COALESCE(pm.copayment,0) - COALESCE(pm.adjustment,0), 0)
),0)::numeric(14,2) AS outstanding
FROM (
SELECT pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
WHERE pay."createdAt" >= ${fromStart} AND pay."createdAt" <= ${toNextStart}
GROUP BY pay."patientId"
@@ -195,13 +196,14 @@ export const paymentsReportsStorage: IPaymentsReportsStorage = {
} else if (hasFrom) {
outstandingSql = `
SELECT COALESCE(SUM(
COALESCE(pm.total_charges,0) - COALESCE(pm.total_paid,0) - COALESCE(pm.total_adjusted,0)
GREATEST(COALESCE(pm.total_charges,0) - COALESCE(pm.mh_paid,0) - COALESCE(pm.copayment,0) - COALESCE(pm.adjustment,0), 0)
),0)::numeric(14,2) AS outstanding
FROM (
SELECT pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
WHERE pay."createdAt" >= ${fromStart}
GROUP BY pay."patientId"
@@ -210,13 +212,14 @@ export const paymentsReportsStorage: IPaymentsReportsStorage = {
} else if (hasTo) {
outstandingSql = `
SELECT COALESCE(SUM(
COALESCE(pm.total_charges,0) - COALESCE(pm.total_paid,0) - COALESCE(pm.total_adjusted,0)
GREATEST(COALESCE(pm.total_charges,0) - COALESCE(pm.mh_paid,0) - COALESCE(pm.copayment,0) - COALESCE(pm.adjustment,0), 0)
),0)::numeric(14,2) AS outstanding
FROM (
SELECT pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
WHERE pay."createdAt" <= ${toNextStart}
GROUP BY pay."patientId"
@@ -225,13 +228,14 @@ export const paymentsReportsStorage: IPaymentsReportsStorage = {
} else {
outstandingSql = `
SELECT COALESCE(SUM(
COALESCE(pm.total_charges,0) - COALESCE(pm.total_paid,0) - COALESCE(pm.total_adjusted,0)
GREATEST(COALESCE(pm.total_charges,0) - COALESCE(pm.mh_paid,0) - COALESCE(pm.copayment,0) - COALESCE(pm.adjustment,0), 0)
),0)::numeric(14,2) AS outstanding
FROM (
SELECT pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
GROUP BY pay."patientId"
) pm
@@ -242,74 +246,78 @@ export const paymentsReportsStorage: IPaymentsReportsStorage = {
)) as { outstanding: string }[];
const totalOutstanding = Number(outstandingRows?.[0]?.outstanding ?? 0);
// totalCollected: sum(totalPaid) in the range
// totalCollected: mhPaidAmount + copayment (adjustment is write-off, not collected)
let collSql = "";
if (hasFrom && hasTo) {
collSql = `SELECT COALESCE(SUM("totalPaid"),0)::numeric(14,2) AS collected FROM "Payment" WHERE "createdAt" >= ${fromStart} AND "createdAt" <= ${toNextStart}`;
collSql = `SELECT COALESCE(SUM(COALESCE("mhPaidAmount",0) + "copayment"),0)::numeric(14,2) AS collected FROM "Payment" WHERE "createdAt" >= ${fromStart} AND "createdAt" <= ${toNextStart}`;
} else if (hasFrom) {
collSql = `SELECT COALESCE(SUM("totalPaid"),0)::numeric(14,2) AS collected FROM "Payment" WHERE "createdAt" >= ${fromStart}`;
collSql = `SELECT COALESCE(SUM(COALESCE("mhPaidAmount",0) + "copayment"),0)::numeric(14,2) AS collected FROM "Payment" WHERE "createdAt" >= ${fromStart}`;
} else if (hasTo) {
collSql = `SELECT COALESCE(SUM("totalPaid"),0)::numeric(14,2) AS collected FROM "Payment" WHERE "createdAt" <= ${toNextStart}`;
collSql = `SELECT COALESCE(SUM(COALESCE("mhPaidAmount",0) + "copayment"),0)::numeric(14,2) AS collected FROM "Payment" WHERE "createdAt" <= ${toNextStart}`;
} else {
collSql = `SELECT COALESCE(SUM("totalPaid"),0)::numeric(14,2) AS collected FROM "Payment"`;
collSql = `SELECT COALESCE(SUM(COALESCE("mhPaidAmount",0) + "copayment"),0)::numeric(14,2) AS collected FROM "Payment"`;
}
const collRows = (await prisma.$queryRawUnsafe(collSql)) as {
collected: string;
}[];
const totalCollected = Number(collRows?.[0]?.collected ?? 0);
// NEW: patientsWithBalance: number of patients whose (charges - paid - adjusted) > 0, within the date range
// patientsWithBalance: patients where (billed - mhPaid - copayment - adjustment) > 0
let patientsWithBalanceSql = "";
if (hasFrom && hasTo) {
patientsWithBalanceSql = `
SELECT COUNT(*)::int AS cnt FROM (
SELECT pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
WHERE pay."createdAt" >= ${fromStart} AND pay."createdAt" <= ${toNextStart}
GROUP BY pay."patientId"
) t
WHERE (COALESCE(t.total_charges,0) - COALESCE(t.total_paid,0) - COALESCE(t.total_adjusted,0)) > 0
WHERE (COALESCE(t.total_charges,0) - COALESCE(t.mh_paid,0) - COALESCE(t.copayment,0) - COALESCE(t.adjustment,0)) > 0
`;
} else if (hasFrom) {
patientsWithBalanceSql = `
SELECT COUNT(*)::int AS cnt FROM (
SELECT pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
WHERE pay."createdAt" >= ${fromStart}
GROUP BY pay."patientId"
) t
WHERE (COALESCE(t.total_charges,0) - COALESCE(t.total_paid,0) - COALESCE(t.total_adjusted,0)) > 0
WHERE (COALESCE(t.total_charges,0) - COALESCE(t.mh_paid,0) - COALESCE(t.copayment,0) - COALESCE(t.adjustment,0)) > 0
`;
} else if (hasTo) {
patientsWithBalanceSql = `
SELECT COUNT(*)::int AS cnt FROM (
SELECT pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
WHERE pay."createdAt" <= ${toNextStart}
GROUP BY pay."patientId"
) t
WHERE (COALESCE(t.total_charges,0) - COALESCE(t.total_paid,0) - COALESCE(t.total_adjusted,0)) > 0
WHERE (COALESCE(t.total_charges,0) - COALESCE(t.mh_paid,0) - COALESCE(t.copayment,0) - COALESCE(t.adjustment,0)) > 0
`;
} else {
patientsWithBalanceSql = `
SELECT COUNT(*)::int AS cnt FROM (
SELECT pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
GROUP BY pay."patientId"
) t
WHERE (COALESCE(t.total_charges,0) - COALESCE(t.total_paid,0) - COALESCE(t.total_adjusted,0)) > 0
WHERE (COALESCE(t.total_charges,0) - COALESCE(t.mh_paid,0) - COALESCE(t.copayment,0) - COALESCE(t.adjustment,0)) > 0
`;
}
const pwbRows = (await prisma.$queryRawUnsafe(
@@ -824,9 +832,10 @@ export const paymentsReportsStorage: IPaymentsReportsStorage = {
payments_agg AS (
SELECT
pay."patientId" AS patient_id,
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(pay."totalPaid")::numeric(14,2) AS total_paid,
SUM(pay."totalAdjusted")::numeric(14,2) AS total_adjusted
SUM(pay."totalBilled")::numeric(14,2) AS total_charges,
SUM(COALESCE(pay."mhPaidAmount",0))::numeric(14,2) AS mh_paid,
SUM(pay."copayment")::numeric(14,2) AS copayment,
SUM(pay."adjustment")::numeric(14,2) AS adjustment
FROM "Payment" pay
JOIN "Claim" c ON pay."claimId" = c.id
WHERE c."staffId" = ${Number(staffId)}
@@ -835,9 +844,9 @@ export const paymentsReportsStorage: IPaymentsReportsStorage = {
)
SELECT json_build_object(
'totalPatients', COALESCE(COUNT(DISTINCT pa.patient_id),0),
'totalOutstanding', COALESCE(SUM(COALESCE(pa.total_charges,0) - COALESCE(pa.total_paid,0) - COALESCE(pa.total_adjusted,0)),0)::text,
'totalCollected', COALESCE(SUM(COALESCE(pa.total_paid,0)),0)::text,
'patientsWithBalance', COALESCE(SUM(CASE WHEN (COALESCE(pa.total_charges,0) - COALESCE(pa.total_paid,0) - COALESCE(pa.total_adjusted,0)) > 0 THEN 1 ELSE 0 END),0)
'totalOutstanding', COALESCE(SUM(GREATEST(COALESCE(pa.total_charges,0) - COALESCE(pa.mh_paid,0) - COALESCE(pa.copayment,0) - COALESCE(pa.adjustment,0), 0)),0)::text,
'totalCollected', COALESCE(SUM(COALESCE(pa.mh_paid,0) + COALESCE(pa.copayment,0)),0)::text,
'patientsWithBalance', COALESCE(SUM(CASE WHEN (COALESCE(pa.total_charges,0) - COALESCE(pa.mh_paid,0) - COALESCE(pa.copayment,0) - COALESCE(pa.adjustment,0)) > 0 THEN 1 ELSE 0 END),0)
) AS summary_json
FROM payments_agg pa;
`;