clear general tool

2025-08-28 18:03:38 +07:00
parent f060a01b98
commit af9d04de07
22 changed files with 5349 additions and 2154 deletions
--- a/internal/models/reference/eclaim.go
+++ b/internal/models/reference/eclaim.go
@@ -0,0 +1,148 @@
+package reference
+
+// === KLAIM MODELS ===
+
+// KlaimRequest represents klaim submission request
+type KlaimRequest struct {
+	BaseRequest
+	NoSep        string    `json:"nomor_sep" validate:"required"`
+	NoKartu      string    `json:"nomor_kartu" validate:"required"`
+	NoMR         string    `json:"nomor_mr" validate:"required"`
+	TglPulang    string    `json:"tgl_pulang" validate:"required"`
+	TglMasuk     string    `json:"tgl_masuk" validate:"required"`
+	JnsPelayanan string    `json:"jenis_pelayanan" validate:"required,oneof=1 2"`
+	CaraPulang   string    `json:"cara_pulang" validate:"required"`
+	Data         KlaimData `json:"data" validate:"required"`
+}
+
+// KlaimData represents detailed klaim information
+type KlaimData struct {
+	Diagnosa    []DiagnosaKlaim    `json:"diagnosa" validate:"required,dive"`
+	Procedure   []ProcedureKlaim   `json:"procedure,omitempty"`
+	Investigasi []InvestigasiKlaim `json:"investigasi,omitempty"`
+	ObatAlkes   []ObatKlaim        `json:"obat_alkes,omitempty"`
+	TarifRS     []TarifKlaim       `json:"tarif_rs,omitempty"`
+	DRG         *DRGInfo           `json:"drg,omitempty"`
+	SpecialCMG  *SpecialCMGInfo    `json:"special_cmg,omitempty"`
+}
+
+// DiagnosaKlaim represents diagnosis in klaim
+type DiagnosaKlaim struct {
+	KodeDiagnosa string `json:"kode_diagnosa" validate:"required"`
+	NamaDiagnosa string `json:"nama_diagnosa"`
+	TipeDiagnosa string `json:"tipe_diagnosa" validate:"required,oneof=1 2"`
+}
+
+// ProcedureKlaim represents procedure in klaim
+type ProcedureKlaim struct {
+	KodeTindakan    string `json:"kode_tindakan" validate:"required"`
+	NamaTindakan    string `json:"nama_tindakan"`
+	TanggalTindakan string `json:"tanggal_tindakan" validate:"required"`
+	Keterangan      string `json:"keterangan,omitempty"`
+}
+
+// InvestigasiKlaim represents investigation/lab results
+type InvestigasiKlaim struct {
+	KodeInvestigasi string `json:"kode_investigasi" validate:"required"`
+	NamaInvestigasi string `json:"nama_investigasi"`
+	Hasil           string `json:"hasil,omitempty"`
+	Satuan          string `json:"satuan,omitempty"`
+	NilaiNormal     string `json:"nilai_normal,omitempty"`
+}
+
+// ObatKlaim represents medication in klaim
+type ObatKlaim struct {
+	KodeObat  string  `json:"kode_obat" validate:"required"`
+	NamaObat  string  `json:"nama_obat"`
+	Dosis     string  `json:"dosis,omitempty"`
+	Frekuensi string  `json:"frekuensi,omitempty"`
+	Jumlah    float64 `json:"jumlah" validate:"min=0"`
+	Harga     float64 `json:"harga" validate:"min=0"`
+}
+
+// TarifKlaim represents hospital tariff
+type TarifKlaim struct {
+	KodeTarif string  `json:"kode_tarif" validate:"required"`
+	NamaTarif string  `json:"nama_tarif"`
+	Jumlah    int     `json:"jumlah" validate:"min=0"`
+	Tarif     float64 `json:"tarif" validate:"min=0"`
+	Total     float64 `json:"total"`
+}
+
+// DRGInfo represents DRG information
+type DRGInfo struct {
+	KodeDRG  string  `json:"kode_drg"`
+	NamaDRG  string  `json:"nama_drg"`
+	TarifDRG float64 `json:"tarif_drg"`
+	Severity string  `json:"severity,omitempty"`
+}
+
+// SpecialCMGInfo represents Special CMG information
+type SpecialCMGInfo struct {
+	KodeCMG  string  `json:"kode_cmg"`
+	NamaCMG  string  `json:"nama_cmg"`
+	TarifCMG float64 `json:"tarif_cmg"`
+	SubAcute string  `json:"sub_acute,omitempty"`
+}
+
+// KlaimResponse represents klaim API response
+type KlaimResponse struct {
+	BaseResponse
+	Data *KlaimResponseData `json:"data,omitempty"`
+}
+
+// KlaimResponseData represents processed klaim data
+type KlaimResponseData struct {
+	NoKlaim       string         `json:"nomor_klaim"`
+	NoSep         string         `json:"nomor_sep"`
+	StatusKlaim   string         `json:"status_klaim"`
+	TarifAktual   float64        `json:"tarif_aktual"`
+	TarifRS       float64        `json:"tarif_rs"`
+	TarifApproved float64        `json:"tarif_approved"`
+	Grouper       *GrouperResult `json:"grouper,omitempty"`
+}
+
+// === GROUPER MODELS ===
+
+// GrouperRequest represents grouper processing request
+type GrouperRequest struct {
+	BaseRequest
+	NoSep           string   `json:"nomor_sep" validate:"required"`
+	NoKartu         string   `json:"nomor_kartu" validate:"required"`
+	TglMasuk        string   `json:"tgl_masuk" validate:"required"`
+	TglPulang       string   `json:"tgl_pulang" validate:"required"`
+	JnsPelayanan    string   `json:"jenis_pelayanan" validate:"required,oneof=1 2"`
+	CaraPulang      string   `json:"cara_pulang" validate:"required"`
+	DiagnosaPrimer  string   `json:"diagnosa_primer" validate:"required"`
+	DiagnosaSkunder []string `json:"diagnosa_skunder,omitempty"`
+	Procedure       []string `json:"procedure,omitempty"`
+	AdlScore        int      `json:"adl_score,omitempty"`
+	AgeAtAdmission  int      `json:"age_at_admission" validate:"min=0"`
+}
+
+// GrouperResult represents grouper processing result
+type GrouperResult struct {
+	KodeDRG  string     `json:"kode_drg"`
+	NamaDRG  string     `json:"nama_drg"`
+	TarifDRG float64    `json:"tarif_drg"`
+	KodeCMG  string     `json:"kode_cmg,omitempty"`
+	NamaCMG  string     `json:"nama_cmg,omitempty"`
+	TarifCMG float64    `json:"tarif_cmg,omitempty"`
+	Severity string     `json:"severity"`
+	SubAcute bool       `json:"sub_acute"`
+	Chronic  bool       `json:"chronic"`
+	TopUp    *TopUpInfo `json:"top_up,omitempty"`
+}
+
+// TopUpInfo represents top-up information
+type TopUpInfo struct {
+	Eligible   bool    `json:"eligible"`
+	Percentage float64 `json:"percentage"`
+	Amount     float64 `json:"amount"`
+}
+
+// GrouperResponse represents grouper API response
+type GrouperResponse struct {
+	BaseResponse
+	Data *GrouperResult `json:"data,omitempty"`
+}