Update

app/Http/Controllers/PatientController.php

@@ -41,6 +41,7 @@ use App\Models\Measurement;
 use App\Models\ClientReviewRequest;
 use App\Models\Point;
 use App\Models\Survey;
+use App\Models\InsuranceCard;
 use Illuminate\Support\Facades\Http;
 use PDF;
 use Illuminate\Support\Facades\Validator;
@@ -761,6 +762,15 @@ class PatientController extends Controller
         return get_doc_templates();
     }
 
+    public function insuranceCards(Request $request, Client $patient){
+        $insuranceCards = InsuranceCard::where('client_id', $patient->id)->orderBy('created_at', 'DESC')->get();
+        return view('app.patient.insurance-cards', compact('patient', 'insuranceCards'));
+    }
+
+    public function insuranceCard(Request $request, Client $patient, InsuranceCard $card){
+        return view('app.patient.insurance-card', compact('patient', 'card'));
+    }
+
     public function insuranceCoverageHistory(Request $request, Client $patient){
         $insuranceCoverageHistory = ClientPrimaryCoverage::where('client_id', $patient->id)->orderBy('created_at', 'DESC')->get();
         return view('app.patient.insurance-coverage-history', compact('patient', 'insuranceCoverageHistory'));

app/Models/EligibilityCheck.php

@@ -0,0 +1,15 @@
+<?php
+
+namespace App\Models;
+
+use Illuminate\Database\Eloquent\Factories\HasFactory;
+use Illuminate\Database\Eloquent\Model;
+
+class EligibilityCheck extends Model
+{    
+    protected $table = 'eligibility_check';
+
+    public function insuranceCard(){
+        return $this->hasOne(InsuranceCard::class, 'id', 'insurance_card_id');
+    }
+}

app/Models/InsuranceCard.php

@@ -0,0 +1,19 @@
+<?php
+
+namespace App\Models;
+
+use Illuminate\Database\Eloquent\Factories\HasFactory;
+use Illuminate\Database\Eloquent\Model;
+
+class InsuranceCard extends Model
+{    
+    protected $table = 'insurance_card';
+
+    public function client(){
+        return $this->hasOne(Client::class, 'id', 'client_id');
+    }
+
+    public function eligibilityChecks(){
+        return $this->hasMany(EligibilityCheck::class, 'insurance_card_id', 'id');
+    }
+}

resources/views/app/patient/insurance-card.blade.php

@@ -0,0 +1,90 @@
+@extends ('layouts.patient')
+
+@section('inner-content')
+    <style>
+        .eligible-table td {
+            white-space: nowrap;
+        }
+    </style>
+
+    <div>
+        <div class="d-flex align-items-center" style="gap:15px;">
+            <h4 class="font-weight-bold m-0 font-size-16">Insurance Card</h4>
+            <div class="d-flex align-items-center">
+                @include('app.patient.partials.insurance-cards.forms.put-coverage-order')
+                <span class="text-muted mx-1">|</span>
+                @include('app.patient.partials.insurance-cards.forms.put-card-info')
+                <span class="text-muted mx-1">|</span>
+                @include('app.patient.partials.insurance-cards.forms.put-benefit-meter')
+            </div>
+        </div>
+        <div class="row">
+            <div class="col-md-6">
+                <div class="card">
+                    <div class="card-header">
+                        Details
+                    </div>
+                    <div class="card-body">
+                        <div class="table-responsive">
+                            <?php parseRender($card->toArray()); ?>
+                        </div>
+                    </div>
+                </div>
+            </div>
+            <div class="col-md-6">
+                <div class="card">
+                    <div class="card-header">
+                        <div class="d-flex align-items-center justify-content-between">
+                            <span>Eligibility Checks</span>
+                            <div>
+                                @include('app.patient.partials.insurance-cards.forms.eligility-check-create')
+                            </div>
+                        </div>
+
+
+                    </div>
+                    <div class="card-body">
+                        <div class="">
+                            <table class="table table-sm table-striped table-bordered mt-3 mb-0">
+                                <thead>
+                                    <tr>
+                                        <th class="border-0">Created At</th>
+                                        <th class="border-0">Is Valid</th>
+                                        <th class="border-0">Source</th>
+                                        <th class="border-0">Effective Date</th>
+                                        <th class="border-0">Termination Date</th>
+                                        <th class="border-0"></th>
+                                    </tr>
+                                </thead>
+                                <tbody>
+                                    @foreach ($card->eligibilityChecks as $eligibilityCheck)
+                                        <tr>
+                                            <td>{{ friendly_date($eligibilityCheck->created_at) }}</td>
+                                            <td>{{ $eligibilityCheck->is_valid ? 'YES' : 'NO' }}</td>
+                                            <td>{{ $eligibilityCheck->source }}</td>
+                                            <td>{{ friendly_date($eligibilityCheck->effective_date) }}</td>
+                                            <td>{{ friendly_date($eligibilityCheck->termination_date) }}</td>
+                                            <td>
+                                                <div moe relative wide class="ml-2 hide-inside-popup">
+                                                    <a start show>
+                                                        <i class="fa fa-info-circle on-hover-opaque"></i>
+                                                    </a>
+                                                    <form url="" class="mcp-theme-1" right>
+                                                        @include(
+                                                            'app.patient.partials.display-coverage-details',
+                                                            ['displayCoverage' => $eligibilityCheck]
+                                                        )
+                                                    </form>
+                                                </div>
+                                            </td>
+                                        </tr>
+                                    @endforeach
+                                </tbody>
+                            </table>
+                        </div>
+                    </div>
+                </div>
+            </div>
+        </div>
+    </div>
+@endsection

resources/views/app/patient/insurance-cards.blade.php

@@ -0,0 +1,55 @@
+@extends ('layouts.patient')
+
+@section('inner-content')
+
+<style>
+    .eligible-table td {
+        white-space: nowrap;
+    }
+</style>
+
+<div>
+    <div class="d-flex align-items-center" style="gap:15px;">
+        <h4 class="font-weight-bold m-0 font-size-16">Insurance Cards</h4>
+        <div>
+            @include('app.patient.partials.insurance-cards.forms.create')
+        </div>
+    </div>
+
+    <table class="table table-sm table-striped table-bordered mt-3 mb-0">
+        <thead>
+            <tr>
+                <th class="border-0">Created At</th>
+                <th class="border-0">Coverage Order</th>
+                <th class="border-0">Plan Type</th>
+                <th class="border-0">Plan Name</th>
+                <th class="border-0">Carrier Category</th>
+                <th class="border-0">Carrier Name</th>
+                <th class="border-0"></th>
+            </tr>
+        </thead>
+        <tbody>
+            @foreach($insuranceCards as $card)
+            <tr>
+                <td><a href="{{ route('patients.view.insurance-card', ['patient' => $patient, 'card' => $card]) }}">{{ friendly_date($card->created_at) }}</a></td>
+                <td>{{ $card->coverage_order }}</td>
+                <td>{{ $card->plan_type }}</td>
+                <td>{{ $card->plan_name }}</td>
+                <td>{{ $card->carrier_category }}</td>
+                <td>{{ $card->carrier_name }}</td>
+                <td>
+                    <div moe relative wide class="ml-2 hide-inside-popup">
+                        <a start show>
+                        <i class="fa fa-info-circle on-hover-opaque"></i>
+                        </a>
+                        <form url="" class="mcp-theme-1" right>
+                        @include('app.patient.partials.display-coverage-details', ['displayCoverage' => $card ])
+                        </form>
+                    </div>
+                </td>
+            </tr>
+            @endforeach
+        </tbody>
+    </table>
+</div>
+@endsection

resources/views/app/patient/partials/insurance-cards/forms/create.blade.php

@@ -0,0 +1,221 @@
+<div moe>
+    <a class="text-nowrap" href="" show start>+Create</a>
+    <form url="/api/insuranceCard/create" style="min-width: 600px;">
+        <input type="hidden" name="clientUid" value="{{ $patient->uid }}">
+        <div class="bg-light">
+            <div class="col-md-12">
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Coverage Order</label>
+                            <select name="coverageOrder" class="form-control">
+                                <option value="PRIMARY">PRIMARY</option>
+                                <option value="SECONDARY">SECONDARY</option>
+                                <option value="TERTIARY">TERTIARY</option>
+                            </select>
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Payer Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Carrier Category</label>
+                            <select name="carrierCategory" class="form-control">
+                                <option value="MEDICARE">MEDICARE</option>
+                                <option value="MEDICAID">MEDICAID</option>
+                                <option value="COMMERCIAL">COMMERCIAL</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Carrier Name</label>
+                            <input name="carrierName" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Carrier Memo</label>
+                            <input name="carrierMemo" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Contact Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Phone Number For Provider</label>
+                            <input name="phoneNumberForProvider" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Phone Number For Members</label>
+                            <input name="phoneNumberForMembers" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Patient Informtion</h6>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient First Name</label>
+                            <input name="patientFirstName" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Middle Name</label>
+                            <input name="patientMiddleName" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Last Name</label>
+                            <input name="patientLastName" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Suffix</label>
+                            <input name="patientSuffix" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Sex</label>
+                            <select name="patientSex" class="form-control">
+                                <option value="MALE">MALE</option>
+                                <option value="FEMALE">FEMALE</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Birth Date</label>
+                            <input type="date" name="patientBirthDate" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="">
+                            <label><input type="checkbox" name="isPatientSubscriber" class="" /> Is Patient
+                                Subscriber?</label>
+
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Relationship To Subscriber</label>
+                            <input type="text" name="relationshipToSubscriber" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Subscriber Informtion</h6>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber First Name</label>
+                            <input name="subscriberFirstName" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Middle Name</label>
+                            <input name="subscriberMiddleName" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Last Name</label>
+                            <input name="subscriberLastName" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Suffix</label>
+                            <input name="subscriberSuffix" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Sex</label>
+                            <select name="subscriberSex" class="form-control">
+                                <option value="MALE">MALE</option>
+                                <option value="FEMALE">FEMALE</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Birth Date</label>
+                            <input type="date" name="subscriberBirthDate" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Identifier Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Member ID</label>
+                            <input name="memberId" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Group ID</label>
+                            <input name="groupId" class="form-control" />
+                        </div>
+                    </div>
+
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Plan Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Plan Name</label>
+                            <input name="planName" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Plan Type</label>
+                            <select name="planType" class="form-control">
+                                <option value="HMO">HMO</option>
+                                <option value="PPO">PPO</option>
+                                <option value="EPO">EPO</option>
+                                <option value="POS">POS</option>
+                                <option value="HDHP">HDHP</option>
+                                <option value="MCO">MCO</option>
+                                <option value="FFS">FFS</option>
+                                <option value="OTHER">OTHER</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Plan Effective Date</label>
+                            <input type="date" name="planEffectiveDate" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+            </div>
+        </div>
+        <div class="mb-0">
+            <button class="btn btn-primary btn-sm" submit>Submit</button>
+            <button class="btn btn-default border btn-sm" cancel>Cancel</button>
+        </div>
+    </form>
+</div>

resources/views/app/patient/partials/insurance-cards/forms/eligility-check-create.blade.php

@@ -0,0 +1,44 @@
+<div moe>
+    <a class="text-nowrap" href="" show start>+Create</a>
+    <form url="/api/eligibilityCheck/create" style="min-width: 300px;" right>
+        <input type="hidden" name="insuranceCardUid" value="{{ $card->uid }}">
+        <div class="bg-light">
+            <div class="col-md-12">
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Source</label>
+                            <select name="source" class="form-control">
+                                <option value="MANUAL">MANUAL</option>
+                                <option value="AUTO">AUTO</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="">
+                            <label><input type="checkbox" name="isValid" class="" /> Is Valid?</label>
+
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Effective Date</label>
+                            <input type="date" name="effectiveDate" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Termination Date</label>
+                            <input type="date" name="terminationDate" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                
+            </div>
+        </div>
+        <div class="mb-0">
+            <button class="btn btn-primary btn-sm" submit>Submit</button>
+            <button class="btn btn-default border btn-sm" cancel>Cancel</button>
+        </div>
+    </form>
+</div>

resources/views/app/patient/partials/insurance-cards/forms/eligility-check-update.blade.php

@@ -0,0 +1,44 @@
+<div moe>
+    <a class="text-nowrap" href="" show start>Edit</a>
+    <form url="/api/eligibilityCheck/updateInfo" style="min-width: 300px;" right>
+        <input type="hidden" name="uid" value="{{ $eligibilityCheck->uid }}">
+        <div class="bg-light">
+            <div class="col-md-12">
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Source</label>
+                            <select name="source" class="form-control">
+                                <option value="MANUAL" {{ $eligibilityCheck->source === 'MANUAL' ? 'selected':'' }}>MANUAL</option>
+                                <option value="AUTO" {{ $eligibilityCheck->source === 'AUTO' ? 'selected':'' }}>AUTO</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="">
+                            <label><input type="checkbox" name="isValid" class="" {{ $eligibilityCheck->is_valid ? 'checked':'' }} /> Is Valid?</label>
+
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Effective Date</label>
+                            <input type="date" name="effectiveDate" value="{{ $eligibilityCheck->effective_date }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Termination Date</label>
+                            <input type="date" name="terminationDate" value="{{ $eligibilityCheck->termination_date }}" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                
+            </div>
+        </div>
+        <div class="mb-0">
+            <button class="btn btn-primary btn-sm" submit>Submit</button>
+            <button class="btn btn-default border btn-sm" cancel>Cancel</button>
+        </div>
+    </form>
+</div>

resources/views/app/patient/partials/insurance-cards/forms/put-benefit-meter.blade.php

@@ -0,0 +1,73 @@
+<div moe>
+    <a class="text-nowrap" href="" show start>Put Card Info</a>
+    <form url="/api/insuranceCard/putBenefitMeter" style="min-width: 600px;">
+        <input type="hidden" name="uid" value="{{ $card->uid }}">
+        <div class="bg-light">
+            <div class="col-md-12">
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Plan Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Benefit Meter Effective Date</label>
+                            <input type="date" name="benefitMeterEffectiveDate" value="{{ $card->benefit_meter_effective_date }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Benefit Period Start</label>
+                            <input type="date" name="benefitPeriodStart" value="{{ $card->benefit_period_start }}" class="form-control" />
+                        </div>
+                    </div>
+
+                     <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Deductible Total</label>
+                            <input type="number" name="deductibleTotal" value="{{ $card->deductible_total }}" class="form-control" />
+                        </div>
+                    </div>
+
+                     <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Deductible Met</label>
+                            <input type="number" name="deductibleMet" value="{{ $card->deductible_met }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Deductible Remaining</label>
+                            <input type="number" name="deductibleRemaining" value="{{ $card->deductible_remaining }}" class="form-control" />
+                        </div>
+                    </div>
+
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>OOP Max Total</label>
+                            <input type="number" name="oopMaxTotal" value="{{ $card->oop_max_total }}" class="form-control" />
+                        </div>
+                    </div>
+
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>OOP Max Met</label>
+                            <input type="number" name="oopMaxMet" value="{{ $card->oop_max_met }}" class="form-control" />
+                        </div>
+                    </div>
+
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>OOP Max Remaining</label>
+                            <input type="number" name="oopMaxRemaining" value="{{ $card->oop_max_remaining }}" class="form-control" />
+                        </div>
+                    </div>
+
+                </div>
+            </div>
+        </div>
+        <div class="mb-0">
+            <button class="btn btn-primary btn-sm" submit>Submit</button>
+            <button class="btn btn-default border btn-sm" cancel>Cancel</button>
+        </div>
+    </form>
+</div>

resources/views/app/patient/partials/insurance-cards/forms/put-card-info.blade.php

@@ -0,0 +1,221 @@
+<div moe>
+    <a class="text-nowrap" href="" show start>Put Card Info</a>
+    <form url="/api/insuranceCard/putCardInfo" style="min-width: 600px;">
+        <input type="hidden" name="uid" value="{{ $card->uid }}">
+        <div class="bg-light">
+            <div class="col-md-12">
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Coverage Order</label>
+                            <select name="coverageOrder" class="form-control">
+                                <option value="PRIMARY" {{ $card->coverage_order === 'PRIMARY' ? 'selected':'' }}>PRIMARY</option>
+                                <option value="SECONDARY" {{ $card->coverage_order === 'SECONDARY' ? 'selected':'' }}>SECONDARY</option>
+                                <option value="TERTIARY" {{ $card->coverage_order === 'TERTIARY' ? 'selected':'' }}>TERTIARY</option>
+                            </select>
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Payer Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Carrier Category</label>
+                            <select name="carrierCategory" class="form-control">
+                                <option value="MEDICARE" {{ $card->carrier_category === 'MEDICARE' ? 'selected':'' }}>MEDICARE</option>
+                                <option value="MEDICAID" {{ $card->carrier_category === 'MEDICAID' ? 'selected':'' }}>MEDICAID</option>
+                                <option value="COMMERCIAL" {{ $card->carrier_category === 'COMMERCIAL' ? 'selected':'' }}>COMMERCIAL</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Carrier Name</label>
+                            <input name="carrierName" value="{{ $card->carrier_name }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Carrier Memo</label>
+                            <input name="carrierMemo" value="{{ $card->carrier_memo }}" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Contact Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Phone Number For Provider</label>
+                            <input name="phoneNumberForProvider" value="{{ $card->phone_number_for_provider }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Phone Number For Members</label>
+                            <input name="phoneNumberForMembers" value="{{ $card->phone_number_for_members }}" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Patient Informtion</h6>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient First Name</label>
+                            <input name="patientFirstName" value="{{ $card->patient_first_name }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Middle Name</label>
+                            <input name="patientMiddleName" value="{{ $card->patient_middle_name }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Last Name</label>
+                            <input name="patientLastName" value="{{ $card->patient_last_name }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Suffix</label>
+                            <input name="patientSuffix" value="{{ $card->patient_suffix }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Sex</label>
+                            <select name="patientSex" class="form-control">
+                                <option value="MALE" {{ $card->patient_sex === 'MALE' ? 'selected':'' }}>MALE</option>
+                                <option value="FEMALE" {{ $card->patient_sex === 'FEMALE' ? 'selected':'' }}>FEMALE</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Patient Birth Date</label>
+                            <input type="date" name="patientBirthDate" value="{{ $card->patient_birth_date }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="">
+                            <label><input type="checkbox" name="isPatientSubscriber" class="" {{ $card->is_patient_subscriber ? 'checked':'' }} /> Is Patient
+                                Subscriber?</label>
+
+                        </div>
+                    </div>
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Relationship To Subscriber</label>
+                            <input type="text" name="relationshipToSubscriber" value="{{ $card->relationship_to_subscriber }}" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Subscriber Informtion</h6>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber First Name</label>
+                            <input name="subscriberFirstName" value="{{ $card->subscriber_first_name }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Middle Name</label>
+                            <input name="subscriberMiddleName" value="{{ $card->subscriber_middle_name }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Last Name</label>
+                            <input name="subscriberLastName" value="{{ $card->subscriber_last_name }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Suffix</label>
+                            <input name="subscriberSuffix" value="{{ $card->subscriber_suffix }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Sex</label>
+                            <select name="subscriberSex" class="form-control">
+                                <option value="MALE" {{ $card->subscriber_sex === 'MALE' ? 'selected':'' }}>MALE</option>
+                                <option value="FEMALE" {{ $card->subscriber_sex === 'FEMALE' ? 'selected':'' }}>FEMALE</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-4">
+                        <div class="form-group">
+                            <label>Subscriber Birth Date</label>
+                            <input type="date" name="subscriberBirthDate" value="{{ $card->subscriber_birth_date }}" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Identifier Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Member ID</label>
+                            <input name="memberId" value="{{ $card->member_id }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Group ID</label>
+                            <input name="groupId" value="{{ $card->group_id }}" class="form-control" />
+                        </div>
+                    </div>
+
+                </div>
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <h6 class="font-weight-bold">Plan Informtion</h6>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Plan Name</label>
+                            <input name="planName" value="{{ $card->plan_name }}" class="form-control" />
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Plan Type</label>
+                            <select name="planType" class="form-control">
+                                <option value="HMO" {{ $card->plan_type === 'HMO' ? 'selected':'' }}>HMO</option>
+                                <option value="PPO" {{ $card->plan_type === 'PPO' ? 'selected':'' }}>PPO</option>
+                                <option value="EPO" {{ $card->plan_type === 'EPO' ? 'selected':'' }}>EPO</option>
+                                <option value="POS" {{ $card->plan_type === 'POS' ? 'selected':'' }}>POS</option>
+                                <option value="HDHP" {{ $card->plan_type === 'HDHP' ? 'selected':'' }}>HDHP</option>
+                                <option value="MCO" {{ $card->plan_type === 'MCO' ? 'selected':'' }}>MCO</option>
+                                <option value="FFS" {{ $card->plan_type === 'FFS' ? 'selected':'' }}>FFS</option>
+                                <option value="OTHER" {{ $card->plan_type === 'OTHER' ? 'selected':'' }}>OTHER</option>
+                            </select>
+                        </div>
+                    </div>
+                    <div class="col-md-6">
+                        <div class="form-group">
+                            <label>Plan Effective Date</label>
+                            <input type="date" name="planEffectiveDate" value="{{ $card->plan_effective_date }}" class="form-control" />
+                        </div>
+                    </div>
+                </div>
+            </div>
+        </div>
+        <div class="mb-0">
+            <button class="btn btn-primary btn-sm" submit>Submit</button>
+            <button class="btn btn-default border btn-sm" cancel>Cancel</button>
+        </div>
+    </form>
+</div>

resources/views/app/patient/partials/insurance-cards/forms/put-coverage-order.blade.php

@@ -0,0 +1,26 @@
+<div moe>
+    <a class="text-nowrap" href="" show start>Put Coverage Order</a>
+    <form url="/api/insuranceCard/putCoverageOrder" style="min-width: 300px;">
+        <input type="hidden" name="uid" value="{{ $card->uid }}">
+        <div class="bg-light">
+            <div class="col-md-12">
+                <div class="row border rounded pt-3 mb-3 bg-white">
+                    <div class="col-md-12">
+                        <div class="form-group">
+                            <label>Coverage Order</label>
+                            <select name="coverageOrder" class="form-control">
+                                <option value="PRIMARY" {{ $card->coverage_order === 'PRIMARY' ? 'selected':'' }}>PRIMARY</option>
+                                <option value="SECONDARY" {{ $card->coverage_order === 'SECONDARY' ? 'selected':'' }}>SECONDARY</option>
+                                <option value="TERTIARY" {{ $card->coverage_order === 'TERTIARY' ? 'selected':'' }}>TERTIARY</option>
+                            </select>
+                        </div>
+                    </div>
+                </div>
+            </div>
+        </div>
+        <div class="mb-0">
+            <button class="btn btn-primary btn-sm" submit>Submit</button>
+            <button class="btn btn-default border btn-sm" cancel>Cancel</button>
+        </div>
+    </form>
+</div>

resources/views/layouts/patient.blade.php

@@ -36,6 +36,9 @@ $patientCompanyClients = $patient->companyClients;
 							<li class="nav-item">
 								<a class="nav-link {{ strpos($routeName, 'patients.view.primary-coverage') === 0 ? 'active' : '' }}" href="{{ route('patients.view.primary-coverage', $patient) }}">Primary Coverage</a>
 							</li>
+							<li class="nav-item">
+								<a class="nav-link {{ strpos($routeName, 'patients.view.insurance-cards') === 0 ? 'active' : '' }}" href="{{ route('patients.view.insurance-cards', $patient) }}">Insurance Cards</a>
+							</li>
 							@if($pro->pro_type == 'ADMIN' || $pro->id == $patient->default_na_pro_id)
 							<li class="nav-item">
 								<a class="nav-link {{ strpos($routeName, 'patients.view.insurance-coverage') === 0 ? 'active' : '' }}" href="{{ route('patients.view.insurance-coverage-history', $patient) }}">Insurance Coverage History</a>

routes/web.php

@@ -633,6 +633,8 @@ Route::middleware('pro.auth')->group(function () {
             Route::get('documents', 'PatientController@documents')->name('documents');
             Route::get('incoming-reports/{currentReport?}', 'PatientController@incomingReports')->name('incoming-reports');
             Route::get('education', 'PatientController@education')->name('education');
+            Route::get('insurance-cards', 'PatientController@insuranceCards')->name('insurance-cards');
+            Route::get('insurance-cards/view/{card}', 'PatientController@insuranceCard')->name('insurance-card');
             Route::get('insurance-coverage-history', 'PatientController@insuranceCoverageHistory')->name('insurance-coverage-history');
             Route::get('messaging', 'PatientController@messaging')->name('messaging');
             Route::get('duplicate', 'PatientController@duplicate')->name('duplicate');