@extends('layouts.vertical', ['title' => 'Modificar Reclamo - Gastos Médicos'])


@section('content')
<div class="card">
    <div class="card-body">
        <div class="col wrapper">
            <div class="row">
                <div class="col-12 mtop16 mb-5">
                    <div class="row">
                        <div class="col-12">
                            <div class="panel myshadow">
                                <div class="mypanel">
                                    <div class="title mb-3">
                                        <p><i class="bi bi-pencil-square"></i> Modificar Reclamo Gastos Médicos</p>
                                    </div>
                                    <form action="{{ url('/claims/1/edit/' . $claim->id) }}" method="POST" class="my-forms" enctype="multipart/form-data">
                                        @csrf
                                        <div class="row">
                                            <!-- Grupo: Información del Reclamo -->
                                            <small class="my-2">Información del Reclamo</small>

                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Estado del Reclamo</label>
                                                <select class="form-select"  name="status">
                                                    @foreach(medicalClaimsStatuses() as $key => $value)
                                                        <option value="{{ $key }}" @selected($claim->status == $key)>{{ $value }}</option>
                                                    @endforeach
                                                </select>
                                            </div>

                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Número de reclamo</label>
                                                <input type="text" class="form-control"  name="claim_number" value="{{ old('claim_number', $claim->claim_number) }}">
                                            </div>

                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Valor Total del Reclamo</label>
                                                <input type="text" class="form-control"  name="valor_total_reclamo" value="{{ old('valor_total_reclamo', $claim->valor_total_reclamo) }}">
                                            </div>

                                            <!-- Cliente, Póliza, Aseguradora -->
                                            <small class="my-2">Información del Cliente y Seguro</small>
                                            <div class="col-lg-3 col-md-6 mb-3">
                                                <label class="form-label">Cliente</label>
                                                <p> {{rvfj( json_encode(personIdentifier()), $claim->client_title)}} {{getClientName($claim->getClient)}}</p>
                                            </div>
                                            <div class="col-lg-3 col-md-6 mb-3">
                                                <label class="form-label">Póliza</label>
                                                <p> {{ $claim->policy?->policy_id }} </p>
                                            </div>
                                            <div class="col-lg-3 col-md-6 mb-3">
                                                <label class="form-label">Aseguradora</label>
                                                <p> {{ $claim->insurance?->name }} </p>
                                            </div>
                                            <div class="col-lg-3 col-md-6 mb-3">
                                                <label class="form-label">Ramo</label>
                                                <p> {{ $claim->insuranceInsurer?->name }} </p>
                                            </div>
                                            <div class="col-lg-3 col-md-6 mb-3">
                                                <label class="form-label">Asegurado</label>
                                                <p> {{rvfj( json_encode(personIdentifier()), $claim->client_title)}} {{$claim->policyInsurer?->name}}</p>
                                            </div>
                                            <div class="col-lg-3 col-md-6 mb-3">
                                                <label class="form-label">Dependiente</label>
                                                <p>{{$claim->policyInsurerDependient?->name ?? 'N/A'}}</p>
                                            </div>

                                            <!-- Fechas importantes -->
                                            <small class="my-2">Fechas</small>
                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Fecha de gasto <small>Cliente realiza el gasto médico.</small></label>
                                                <input type="date" class="form-control" name="date_claim_cost" value="{{ $claim->date_claim_cost }}">
                                            </div>
                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Fecha de reclamo <small>Infinity recibe la solicitud.</small></label>
                                                <input type="date" class="form-control" name="date_infinity_recive" value="{{ $claim->date_infinity_recive }}">
                                            </div>

                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Fecha de ingreso a compañía <small>Infinity envía el reclamo a la aseguradora.</small> </label>
                                                <input type="date" class="form-control" name="date_claim" value="{{ $claim->date_claim }}">
                                            </div>

                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Reingreso <small>Corrección y reenvío del reclamo.</small></label>
                                                <input type="date" class="form-control" name="date_cia_recived" value="{{ $claim->date_cia_recived }}">
                                            </div>

                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Fecha de liquidación <small>Aprobación y pago por parte de la aseguradora.</small></label>
                                                <input type="date" class="form-control" name="date_liquidacion_credito" value="{{ $claim->date_liquidacion_credito }}">
                                            </div>

                                            <div class="col-lg-4 col-md-6 mb-3">
                                                <label class="form-label">Fecha de crédito <small>Pago al cliente. {{ $claim->date_credito }}</small></label>
                                                <input type="date" class="form-control" name="date_credito" value="{{ $claim->date_credito }}">
                                            </div>
                                                @php
                                                    $hasReturn = !empty($claim->date_cia_recived);
                                                @endphp
                                            <div class="col-12 block-new-camps" id="return-fields" style="{{ $hasReturn ? '' : 'display: none;' }} ">
                                                <div class="row">
                                                <small>Obervaciones del reingreso</small>
                                                <div class="col-lg-3 col-md-3 mb-3">
                                                    <label class="form-label">Observación de devolución</label>
                                                    <textarea class="form-control" name="return_observation">{{ old('return_observation', $claim->return_observation) }}</textarea>
                                                </div>

                                                <div class="col-lg-3 col-md-3 mb-3">
                                                    <label class="form-label">Fecha de notificación al cliente</label>
                                                    <input type="date" class="form-control" name="return_notify_date" value="{{ old('return_notify_date', $claim->return_notify_date) }}">
                                                </div>

                                                <div class="col-lg-3 col-md-3 mb-3">
                                                    <label class="form-label">Encargado de reingreso</label>
                                                    <input type="text" class="form-control" name="reentry_responsible" value="{{ old('reentry_responsible', $claim->reentry_responsible) }}">
                                                </div>

                                                <div class="col-lg-3 col-md-3 mb-3">
                                                    <label class="form-label">Fecha de reingreso confirmada</label>
                                                    <input type="date" class="form-control" name="reentry_confirmed_date" value="{{ old('reentry_confirmed_date', $claim->reentry_confirmed_date) }}">
                                                </div>
                                                </div>
                                            </div>

                                            @php
                                                $hasLiquidation = !empty($claim->date_liquidacion_credito);
                                            @endphp
                                            <div class="col-12 mt-3 block-new-camps" id="liquidation-fields" style="{{ $hasLiquidation ? '' : 'display: none;' }} ">
                                                <div class="row">
                                                    <small>Observaciones de liquidación</small>

                                                    <div class="col-lg-4 col-md-4 mb-3">
                                                        <label class="form-label">Observación de liquidación</label>
                                                        <textarea class="form-control" name="liquidation_observation">{{ old('liquidation_observation', $claim->liquidation_observation) }}</textarea>
                                                    </div>
                                                </div>
                                            </div>


                                            <!-- Diagnósticos -->
                                            <small class="my-2">Diagnósticos</small>
                                            <div class="col-lg-6 mb-3">
                                                <label class="form-label">Diagnóstico Principal</label>
                                                <textarea class="form-control" name="principal_diagnost">{{ $claim->principal_diagnost }}</textarea>
                                            </div>
                                            <div class="col-lg-6 mb-3">
                                                <label class="form-label">Diagnóstico Secundario</label>
                                                <textarea class="form-control" name="second_diagnost">{{ $claim->second_diagnost }}</textarea>
                                            </div>

                                            <!-- Medicamentos -->
                                            <small class="my-2">Medicamentos de Uso Continuo</small>
                                            @for ($i = 1; $i <= 3; $i++)
                                                @if ($i == 1)
                                                    <div class="col-lg-4 mb-3">
                                                        <label class="form-label">Medicamento {{ $i }}</label>
                                                        <input type="text" class="form-control" name="medicament_continual_{{ $i }}" value="{{ $claim['medicament_continual_'.$i] }}">
                                                    </div>
                                                @endif

                                                <div class="col-lg-4 mb-3">
                                                    <label class="form-label">Detalle Medicamento {{ $i }}</label>
                                                    <input type="text" class="form-control" name="detail_medicament_continual_{{ $i }}" value="{{ $claim['detail_medicament_continual_'.$i] }}">
                                                </div>

                                                <div class="col-lg-4 mb-3">
                                                    <label class="form-label">Fecha Final Medicamento {{ $i }}</label>
                                                    <input type="date" class="form-control" name="date_final_medicament_continual_{{ $i }}" value="{{ $claim['date_final_medicament_continual_'.$i] }}">
                                                </div>
                                            @endfor


                                            <div class="row">
                                                <small class="my-2" >Agregar Documentos</small>

                                                <!-- Contenedor dinámico para los documentos -->
                                                <div id="document-container" class="col-lg-12 col-md-12 col-sm-12 col-12 mb-2">
                                                    <div class="row document-entry">
                                                        <!-- Tipo de Documento -->
                                                        <div class="col-lg-3 col-md-3 col-sm-4 col-12 mb-2">
                                                            <div class="form-floating">
                                                                <select class="form-select" name="document_type[]" aria-label="Tipo de Documento">
                                                                <option value=""> Seleccionar tipo de documento</option>
                                                                    @foreach (ClaimDocumentTypeList() as $cdtl_id => $cdtl_name)
                                                                    <option @if(old('ticket_id') == $cdtl_id) selected @endif value="{{$cdtl_id}}"> {{$cdtl_name}} </option>
                                                                    @endforeach
                                                                </select>
                                                                <label for="document_type">Tipo de Documento</label>
                                                            </div>
                                                        </div>

                                                        <!-- Selección de Archivo -->
                                                        <div class="col-lg-3 col-md-3 col-sm-4 col-12 mb-2">
                                                            <div class="form-floating">
                                                                <input type="file" class="form-control" name="document_file[]">
                                                                <label for="document_file">Subir Documento</label>
                                                            </div>
                                                        </div>

                                                        <!-- Input de valor -->
                                                        <div class="col-lg-3 col-md-3 col-sm-4 col-12 mb-2">
                                                            <div class="form-floating">
                                                                <input type="number" step="0.01" class="form-control document-value" name="document_value[]" placeholder="Valor">
                                                                <label for="document_value">Valor</label>
                                                            </div>
                                                        </div>

                                                        <!-- Botón de Eliminar Documento -->
                                                        <div class="col-lg-3 col-md-3 col-sm-4 col-12 mb-2 d-flex align-items-center">
                                                            <button type="button" class="btn btn-danger remove-document">Eliminar</button>
                                                        </div>
                                                    </div>
                                                </div>

                                                <!-- Botón para añadir más documentos -->
                                                <div class="col-lg-12 col-md-12 col-sm-12 col-12 mb-2">
                                                    <button type="button" class="btn btn-primary" id="add-document">Agregar más documentos</button>
                                                </div>

                                                <!-- Variable JSON para almacenar los documentos -->
                                                <div class="col-lg-12 col-md-12 col-sm-12 col-12 mb-2">
                                                    <input type="hidden" id="documents_json" name="documents_json">
                                                </div>

                                            </div>

                                            <!-- Input oculto para guardar el JSON -->
                                            <input type="hidden" id="documents_json" name="documents_json">

                                            <!-- Documentos existentes -->
                                            <small class="my-2">Documentación Adjunta</small>
                                            <div class="col-12 mb-3">
                                                <table class="table table-bordered">
                                                    <thead>
                                                        <tr><th>Tipo de Documento</th><th>Valor</th></tr>
                                                    </thead>
                                                    <tbody>
                                                        @foreach ($claim->ClaimDocs as $doc)
                                                            <tr>
                                                                <td>
                                                                    @if($doc->path)
                                                                        <a href="{{ getFileUrl($doc->path) }}" target="_blank">{{ ClaimDocumentTypeList()[$doc->type] ?? 'Documento' }}</a>
                                                                    @else
                                                                        {{ ClaimDocumentTypeList()[$doc->type] ?? 'Documento' }}
                                                                    @endif
                                                                </td>
                                                                <td>{{ $doc->value }}</td>
                                                            </tr>
                                                        @endforeach
                                                    </tbody>
                                                </table>
                                            </div>

                                            <!-- Botón enviar -->
                                            <div class="col-12 mt-4">
                                                <button class="btn btn-success" type="submit">Actualizar Reclamo</button>
                                            </div>
                                        </div>
                                    </form>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
</div>
@endsection

@section('script')
    @vite([
        'resources/js/pages/form-advanced.init.js',
        'resources/js/pages/form-validation.init.js'
    ])
    <script src="{{url('/static/js/claim_creation.js?v='.time())}}"></script>
    <script>
        document.addEventListener("DOMContentLoaded", function () {
            const reingresoInput = document.querySelector('input[name="date_cia_recived"]');
            const returnFields = document.getElementById('return-fields');
            const liquidationInput = document.querySelector('input[name="date_liquidacion_credito"]');
            const liquidationFields = document.getElementById('liquidation-fields');

            if (reingresoInput && returnFields) {
                function toggleReturnFields() {
                    if (reingresoInput.value) {
                        returnFields.style.display = 'block';
                    } else {
                        returnFields.style.display = 'none';
                    }
                }

                // Inicial
                toggleReturnFields();

                // On change
                reingresoInput.addEventListener('change', toggleReturnFields);
            }

            if (liquidationInput && liquidationFields) {
                function toggleLiquidationFields() {
                    if (liquidationInput.value) {
                        liquidationFields.style.display = 'block';
                    } else {
                        liquidationFields.style.display = 'none';
                    }
                }

                // Inicial
                toggleLiquidationFields();

                // On change
                liquidationInput.addEventListener('change', toggleLiquidationFields);
            }
        });
    </script>

@endsection