I'm a senior web developer and I have an ongoing project for healthcare insurance company.
The project is really simple, just read the description carefully.
almost the whole system is already done, I need a hand in few pages, however, you need to get full understand of the system before anything else, let's start.
# Project Description
The system main entities is the following:
1- Healthcare providers: they are the clinics, pharmacies ...etc.
2- Customers: insured companies at the insurance company.
3- Subscribers: customer employees and their relations.
4- Operations: the daily work happens here.
5- Price List: it is a standard price list contains all medical operations without prices, because the prices is a matter of the healthcare provider.
## Healthcare Provider
Each healthcare provider have its own information and it includes the prices of their price list.
Each customer "who is in fact a company" have its own information of course, name and other standard information, and it contains the contract details and limitations.
The contract details is the max value of the insurance contract and the max values of the main insurance such as "in patient" and "out patient".
The Limitation is the contract limits of price list.
The contract details and the limitations are applied to all the subscribers of the customer.
**We can manually choose some subscribers as VIP, which they can override the contract LIMITATIONS
#Example: The customer insured for 1 million $ as a max insurance value. We define also that the max insurance on "In patient" is $700,000, and $500,000 for the "Out patient". this is applied to all the price list except what we will define in the limitations.
In limitations we limits the Dental care to only $3000 and we limits the diseases of tumors to fixed price $10,000 for "Out Patient" OR 10 Visits. the limits reached on one of the conditions goes true.
that means each subscriber in that customer will have an insurance of 1 million $ but he only can use maximum of $3k at dental care. and so forth so on for all the limitations.
they are the employees and their relations if any (wife, father, mother, son ...etc)
it separated on two parts
1- In Network: which is the operations on a in network (exists on the system) healthcare providers.
2- Cash Claim: which is the operations of unknown healthcare providers.
For In Network:
The data entry person will receive a patch from a healthcare provider contains a number of claims.
he/she must select the healthcare provider, then type in the path details, how many claims, total price of all claims, then he must start enter the claims one by one, selecting the subscriber and his/her company (which is saved as a customer in our system), then enter claim date, diagnostic, and select the services in the claim (which we already have in the system as a price list and we know its price which is defined in the healthcare provider) the system will fill the price in the field accepted or rejected or in both based on the customer limitation and the subscriber used limit. finally it should be saved as "processing state" until it is approved by the system admin.
For the Cash claim
The data entry person will receive a cash claim paper from the subscriber, he/she will select the subscriber, and then fill the healthcare provider information because its not in network and its unknown to the system then proceed as same as In network.
2- MongoDB (Mongoose)
Almost everything already done, I'm now workin on customers section.
I need you to do the operations and the system reports.
the complicated part is done, this is a two days work, should be delivered before Friday. Please submit separated milestones.
I've a contract for an entire ERP of 8 blocks I'm looking for a developer to work long term together on this system after deliver this block.
12 freelancer đang chào giá trung bình $257 cho công việc này
Hello Sir, We have checked your requirement and have some query. So please message us to discuss on it. So after understanding it well, we can start work. Thanks Stay tuned, I'm still working on this proposal.