taskGNU Health - Tasks: task #14067, New module Health Insurance Policy

 
 

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task #14067: New module Health Insurance Policy

Submitted by:  Luis Falcon <meanmicio>
Submitted on:  Thu 30 Jun 2016 02:58:23 PM UTC  
 
Should Start On:  Thu 30 Jun 2016 12:00:00 AM UTC Should be Finished on:  Wed 05 Oct 2016 12:00:00 AM UTC
Category:  Data model Priority:  8
Status:  Done Privacy:  Public
Percent Complete:  100% Assigned to:  Luis Falcon <meanmicio>
Open/Closed:  Closed Release:  3.1.0
Module:  health_insurance

( Jump to the original submission)

Wed 12 Oct 2016 12:08:17 PM UTC, comment #9: 

Add better validation and set required fields
Use plan as rec_name. This will be default on 3.2

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Sat 08 Oct 2016 03:31:53 PM UTC, comment #8: 

Dear all
Main, basic functionality is now in place :)

Please test it on AIR32, at the community development instance.

I have created an insurance policy, with two lines. The person Ana Betz has the "Nova Plan" from Insurator company.

You can now test different scenarios, products, services, percentages, invoicing, product categories...

Besides the bugs that you will find, there are some cosmetic things I would like to work, such as moving to the Health root menu the Insurance. It will be much easier for the administrative personnel to work at that level.

Bests

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Fri 07 Oct 2016 01:26:49 PM UTC, comment #7: 

Update :
Traverse the list and give precedence to the product policy, before the the generic category.

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Fri 07 Oct 2016 01:00:31 PM UTC, comment #6: 

Check and apply discount on service related products belonging to an specific category that are contained in the insurance policy.

In terms of applying a discount, category and product are mutually exclusive. GNU Health first checks for matching categories on the insurance policy and related service document line. If there is none, then it checks for the product.

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Fri 07 Oct 2016 11:13:55 AM UTC, comment #5: 

Apply discount on service lines that have been marked as to invoice, and they match the product from the insurance product policy.

Include the discount percentage on the description.

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Wed 05 Oct 2016 06:39:03 PM UTC, comment #4: 

Match the service line with the insurance policy.

  • The service line has to be invoiceable
  • There is an insurance plan associate to the insurance policy holder

GNU Health traverse the insurance plan policies and checks for a match on the service line.

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Mon 03 Oct 2016 04:07:42 PM UTC, comment #3: 

Include Insurance plan product policies in party view

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Sat 01 Oct 2016 06:09:44 PM UTC, comment #2: 

Include insurance policy holder on the health service document

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Sat 01 Oct 2016 12:00:36 PM UTC, comment #1: 

Created basic structure, views and Insurance Plan Product policy.

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.
Thu 30 Jun 2016 02:58:23 PM UTC, original submission:  

The new module will set up the base for an individual insurance policy.

The insurance policy will have the main components :

- Insurer :Insurance company (already at GNU Health core)
- Insured : The person. Already links the insurance plan in the core module.

- Plan : The insurance plan will have contain lines with the services / products coverage level, deductibles, ....

- Health Service document : We will include a M2O field to choose the insurance that the person wants to use if she or he has more than one insurance. The health core module already has a "default" plan. This includes prescriptions.

Health Services and Insurance :
When including the person insurance plan in the health service document, it will traverse each service document line (product and / or product categories) that has been mark to be invoiced, and apply the rule set on the insurance plan.

It's quite basic but generic enough to be enhanced and customized to different institutions / country needs.

Luis Falcon <meanmicio>
Project AdministratorIn charge of this item.

 

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Depends on the following items: None found

Items that depend on this one: None found

 

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    Follow 15 latest changes.

    Date Changed by Updated Field Previous Value => Replaced by
    2017-11-12 meanmicio StatusReady For Test => Done
    2016-11-15 meanmicio Open/ClosedOpen => Closed
    2016-10-08 meanmicio StatusIn Progress => Ready For Test
        Percent Complete90% => 100%
    2016-10-07 meanmicio Percent Complete80% => 90%
    2016-10-05 meanmicio Percent Complete40% => 80%
    2016-10-03 meanmicio Percent Complete20% => 40%
    2016-10-01 meanmicio Should be Finished on2016-08-30 => 2016-10-05
        Percent Complete0% => 20%
        Modulehealth_insurance_policy => health_insurance
    2016-08-12 meanmicio Should be Finished on2017-07-07 => 2016-08-30
        Priority5 - Normal => 8
    2016-07-17 meanmicio CategoryNone => Data model
        StatusNone => In Progress
        ReleaseNone => 3.1.0

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