@ampath/esm-dha-workflow-app 4.0.0-next.44 → 4.0.0-next.448

package/src/billing/dashboard/v3/preauth/elective/elective-preauth.resource.ts

@@ -0,0 +1,1378 @@
+import { openmrsFetch, restBaseUrl } from '@openmrs/esm-framework';
+import dayjs from 'dayjs';
+import {
+  createPreauthRequest,
+  extractPreauthStatusForIntervention,
+  fetchShaInterventionByCode,
+  getPreauthPreview,
+  getServiceType,
+  listPreAuthRequests,
+  patchPreAuthRequest,
+  type ListPreAuthRequestsParams,
+} from '../../../../../claims/claims.resource';
+import {
+  fetchPatientDiagnosesForBilling,
+  preferredDiagnosisForPreauth,
+} from '../../../../billing-claims.resource';
+import type { Intervention, PreAuthRequestRecord, PreauthRequest } from '../../../../../claims/index';
+import type { AmrsVisitDiagnosis } from '../../../../types';
+import { IdentifierTypesUuids } from '../../../../../resources/identifier-types';
+import { createOrderEncounter, getOrder } from '../../../../../shared/services/encounters.resource';
+import type { CreateOrderEncounterDto } from '../../../../../shared/types';
+import {
+  CLINICAL_INDICATIONS_CONCEPT_UUID,
+  fetchPreauthFormValues,
+  PREAUTH_ENCOUNTER_TYPE_UUID,
+  PREAUTH_FORM_CONCEPTS,
+  PREAUTH_INTERVENTION_TYPE,
+  searchDiagnosisConcepts,
+  type DiagnosisConceptHit,
+} from '../preauth.resource';
+
+type ConceptMappingLike = {
+  display?: string;
+  conceptReferenceTerm?: {
+    code?: string;
+    name?: string;
+    conceptSource?: { uuid?: string; name?: string; hl7Code?: string };
+  };
+};
+
+export type ElectiveConceptOption = {
+  uuid: string;
+  display: string;
+  /** Mappings from dictionary search — SHA code is resolved only after selection. */
+  mappings?: ConceptMappingLike[];
+};
+
+/** SHA concept source name in OpenMRS (reference term source). */
+export const SHA_CONCEPT_SOURCE = 'SHA';
+
+/** Extract intervention code from mappings whose concept source is SHA. */
+export function extractShaCodeFromConcept(concept: {
+  mappings?: ConceptMappingLike[];
+}): string {
+  for (const m of concept.mappings ?? []) {
+    const term = m.conceptReferenceTerm;
+    if (!term) continue;
+    const sourceName = String(term.conceptSource?.name ?? '').trim();
+    if (sourceName.toUpperCase() !== SHA_CONCEPT_SOURCE) continue;
+    const code = String(term.code ?? '').trim().toUpperCase();
+    if (code) return code.startsWith('SHA') ? code : `SHA-${code}`;
+  }
+  for (const m of concept.mappings ?? []) {
+    const display = String(m.display ?? '');
+    // e.g. "SHA: SHA-06-031" or "SHA: 06-031"
+    if (!/^SHA\s*:/i.test(display) && !display.toUpperCase().startsWith('SHA:')) continue;
+    const match = display.match(/SHA-\d[\w-]*/i) ?? display.split(':').pop()?.trim();
+    if (match) {
+      const code = String(match).trim().toUpperCase();
+      return code.startsWith('SHA') ? code : `SHA-${code}`;
+    }
+  }
+  return '';
+}
+
+const CONCEPT_SEARCH_REPR =
+  'custom:(uuid,display,mappings:(display,conceptReferenceTerm:(uuid,code,name,conceptSource:(uuid,name,hl7Code))))';
+
+/**
+ * Search the OpenMRS concept dictionary (name / code).
+ * Results are concepts with mappings attached; SHA code is read on select.
+ */
+export async function searchElectiveConcepts(q: string): Promise<ElectiveConceptOption[]> {
+  const term = (q ?? '').trim();
+  if (term.length < 2) {
+    return [];
+  }
+
+  const params = new URLSearchParams({
+    q: term,
+    limit: '25',
+    v: CONCEPT_SEARCH_REPR,
+  });
+
+  try {
+    const response = await openmrsFetch(`${restBaseUrl}/concept?${params.toString()}`);
+    const results =
+      (response?.data?.results as Array<{
+        uuid: string;
+        display: string;
+        mappings?: ConceptMappingLike[];
+      }>) ?? [];
+
+    const out: ElectiveConceptOption[] = [];
+    const seen = new Set<string>();
+    for (const c of results) {
+      if (!c?.uuid || seen.has(c.uuid)) continue;
+      seen.add(c.uuid);
+      out.push({
+        uuid: c.uuid,
+        display: c.display || c.uuid,
+        mappings: c.mappings ?? [],
+      });
+    }
+    return out;
+  } catch {
+    return [];
+  }
+}
+
+export async function fetchPatientCrNumber(
+  patientUuid: string,
+  identifierTypeUuid: string,
+): Promise<string> {
+  if (!patientUuid || !identifierTypeUuid) return '';
+  try {
+    const res = await openmrsFetch(
+      `${restBaseUrl}/patient/${patientUuid}?v=custom:(uuid,identifiers:(identifier,identifierType:(uuid)))`,
+    );
+    const identifiers = (res?.data?.identifiers ?? []) as Array<{
+      identifier?: string;
+      identifierType?: { uuid?: string };
+    }>;
+    const hit = identifiers.find((i) => i.identifierType?.uuid === identifierTypeUuid);
+    return String(hit?.identifier ?? '').trim();
+  } catch {
+    return '';
+  }
+}
+
+export type ElectiveDiagnosisOption = {
+  key: string;
+  conceptUuid: string;
+  display: string;
+  icd11Code: string;
+  rank?: number | null;
+  source: 'visit' | 'search';
+};
+
+export type ElectiveCaptureInput = {
+  patientUuid: string;
+  locationUuid: string;
+  encounterTypeUuid: string;
+  concept: ElectiveConceptOption;
+  intervention: Intervention;
+  clinicalIndications: string;
+  expectedServiceStartDate: string;
+  chiefComplaint?: string;
+  hpi?: string;
+  physicalExam?: string;
+  investigations?: string;
+  anaesthesia?: string;
+  surgeryDate?: string;
+  relatedToEmployment?: boolean;
+  relatedToAccident?: boolean;
+  isCoInsured?: boolean;
+  coInsuranceDetails?: string;
+  sessionsRequired?: string;
+  frequency?: string;
+  startDate?: string;
+  necessity?: string;
+  lensPrescription?: string;
+  newOrReplacement?: string;
+  lensAmount?: string;
+  eyeExamAmount?: string;
+  frameAmount?: string;
+  /** Primary diagnosis on the preauth encounter (UI field; preferably prefilled from today’s visit) */
+  diagnosis?: ElectiveDiagnosisOption | null;
+  /** Session / selected provider — stored on the encounter for Accounting Raise */
+  providerUuid?: string;
+  /** Optional override; otherwise Clinician/Unknown role is resolved from OpenMRS */
+  encounterRoleUuid?: string;
+  /** ISO datetime for encounter */
+  encounterDatetime?: string;
+};
+
+/** OpenMRS core default "Unknown" encounter role — fallback if lookup fails. */
+const DEFAULT_ENCOUNTER_ROLE_UUID = 'a0b03050-c99b-11e0-9572-0800200c9a66';
+
+const HIE_ANAESTHESIA_TO_CONCEPT: Record<string, string> = {
+  GENERAL: '7a69a31a-d88f-4ebd-a00b-cb5b4581de00',
+  LOCAL: '074225d4-b1be-56e9-93f6-255ebf106df3',
+  SEDATION: '3fa5c3a8-41e5-493a-9ab7-7177fc6f8c82',
+  SPINAL: 'f45ac884-e73e-4b02-9d8b-49c4e3ce5a15',
+};
+
+const HIE_FREQUENCY_TO_CONCEPT: Record<string, string> = {
+  ONCE_A_WEEK: '5dcfe297-2ef7-4f1c-97e3-a519c18fcc84',
+  TWICE_A_WEEK: '6f4a4c5b-34d4-4577-b1f2-c0e5d5a61374',
+  ONCE_EVERY_2_WEEKS: '690b2ab2-4cbc-4df4-be19-64b8a93981ab',
+  ONCE_EVERY_3_WEEKS: '72ec1de0-4bf0-4c40-9329-b8f574a64132',
+  ONCE_A_MONTH: 'a899d7f6-1350-11df-a1f1-0026b9348838',
+};
+
+const LENS_TO_CONCEPT: Record<string, string> = {
+  FRAMES_LENSES: '51fc8b51-c35d-4025-9d25-fef5d0d44b47',
+  FRAMED: '51fc8b51-c35d-4025-9d25-fef5d0d44b47',
+  CONTACT: 'da45c81a-e0fc-4589-8094-cb6fb7a7a285',
+};
+
+const NEW_OR_REPL_TO_CONCEPT: Record<string, string> = {
+  NEW: 'a8a48066-1350-11df-a1f1-0026b9348838',
+  REPLACEMENT: 'f021d384-65cd-47b5-b96c-6dc738a00452',
+};
+
+function interventionTypeConcept(intervention: Intervention): string {
+  const flags = {
+    requiresSurgicalPreauth: Boolean(intervention.requiresSurgicalPreauth),
+    requiresRenalPreauth: Boolean(intervention.requiresRenalPreauth),
+    requiresOncologyPreauth: Boolean(intervention.requiresOncologyPreauth),
+    requiresRadiologyPreauth: Boolean(intervention.requiresRadiologyPreauth),
+    requiresOpticalPreauth: Boolean(intervention.requiresOpticalPreauth),
+  };
+  if (flags.requiresSurgicalPreauth) return PREAUTH_INTERVENTION_TYPE.surgical;
+  if (flags.requiresRenalPreauth) return PREAUTH_INTERVENTION_TYPE.renal;
+  if (flags.requiresOncologyPreauth) return PREAUTH_INTERVENTION_TYPE.oncology;
+  if (flags.requiresRadiologyPreauth) return PREAUTH_INTERVENTION_TYPE.imaging;
+  if (flags.requiresOpticalPreauth) return PREAUTH_INTERVENTION_TYPE.optical;
+  return PREAUTH_INTERVENTION_TYPE.normal;
+}
+
+let cachedEncounterRoleUuid: string | null = null;
+
+async function resolveEncounterRoleUuid(configured?: string): Promise<string> {
+  const fromConfig = (configured ?? '').trim();
+  if (fromConfig) return fromConfig;
+  if (cachedEncounterRoleUuid) return cachedEncounterRoleUuid;
+
+  try {
+    const res = await openmrsFetch(
+      `${restBaseUrl}/encounterrole?v=custom:(uuid,display,retired)&limit=50`,
+    );
+    const results = (res?.data?.results ?? []) as Array<{
+      uuid?: string;
+      display?: string;
+      retired?: boolean;
+    }>;
+    const active = results.filter((r) => r.uuid && !r.retired);
+    const preferred =
+      active.find((r) => /clinician/i.test(String(r.display ?? ''))) ||
+      active.find((r) => /unknown/i.test(String(r.display ?? ''))) ||
+      active[0];
+    if (preferred?.uuid) {
+      cachedEncounterRoleUuid = preferred.uuid;
+      return preferred.uuid;
+    }
+  } catch {
+    // fall through to default
+  }
+
+  cachedEncounterRoleUuid = DEFAULT_ENCOUNTER_ROLE_UUID;
+  return DEFAULT_ENCOUNTER_ROLE_UUID;
+}
+
+function plannedServiceObsConcept(configured?: string): string {
+  const fromConfig = (configured ?? '').trim();
+  // Only persist as encounter obs when a real Text concept UUID is configured.
+  return fromConfig;
+}
+
+function buildObs(
+  input: ElectiveCaptureInput,
+  plannedServiceObsConceptUuid?: string,
+): Array<Record<string, unknown>> {
+  const C = PREAUTH_FORM_CONCEPTS;
+  const obs: Array<Record<string, unknown>> = [];
+  const text = (concept: string, value?: string) => {
+    const v = (value ?? '').trim();
+    if (!v || !concept) return;
+    obs.push({ concept, value: v });
+  };
+  const coded = (concept: string, valueConcept?: string) => {
+    const v = (valueConcept ?? '').trim();
+    if (!v || !concept) return;
+    obs.push({ concept, value: v });
+  };
+  const boolCoded = (concept: string, value?: boolean) => {
+    if (value === undefined) return;
+    coded(concept, value ? C.yes : C.no);
+  };
+  const dateObs = (concept: string, iso?: string) => {
+    if (!iso) return;
+    const d = dayjs(iso);
+    if (!d.isValid()) return;
+    obs.push({ concept, value: d.format('YYYY-MM-DDTHH:mm:ss.SSSZZ') });
+  };
+
+  obs.push({
+    concept: C.typeOfIntervention,
+    value: interventionTypeConcept(input.intervention),
+  });
+
+  text(C.clinicalIndication || CLINICAL_INDICATIONS_CONCEPT_UUID, input.clinicalIndications);
+  dateObs(C.expectedServiceStartDate || C.startDate, input.expectedServiceStartDate);
+  // Free-text chief complaint → "Specify other complaints" concept.
+  text(C.otherComplaint, input.chiefComplaint);
+  text(C.hpi, input.hpi);
+  text(C.generalExam, input.physicalExam);
+  text(C.investigation, input.investigations);
+
+  if (input.anaesthesia) {
+    coded(C.anaesthesia, HIE_ANAESTHESIA_TO_CONCEPT[input.anaesthesia] || input.anaesthesia);
+  }
+  // Surgery date is not a dedicated form concept — reuse startDate when surgical.
+  dateObs(C.startDate, input.surgeryDate || input.startDate);
+
+  boolCoded(C.employmentRelated, input.relatedToEmployment);
+  boolCoded(C.accidentRelated, input.relatedToAccident);
+  boolCoded(C.coInsured, input.isCoInsured);
+  text(C.coInsuredDetails, input.coInsuranceDetails);
+
+  if (input.sessionsRequired?.trim()) {
+    obs.push({ concept: C.sessionNumber, value: Number(input.sessionsRequired) });
+  }
+  if (input.frequency) {
+    coded(C.frequencyOfSessions, HIE_FREQUENCY_TO_CONCEPT[input.frequency] || input.frequency);
+  }
+
+  if (input.lensPrescription) {
+    coded(C.lens, LENS_TO_CONCEPT[input.lensPrescription] || input.lensPrescription);
+  }
+  if (input.newOrReplacement) {
+    coded(C.newRequest, NEW_OR_REPL_TO_CONCEPT[input.newOrReplacement] || input.newOrReplacement);
+  }
+  if (input.lensAmount?.trim()) {
+    obs.push({ concept: C.lensAmount, value: Number(input.lensAmount) });
+  }
+  if (input.eyeExamAmount?.trim()) {
+    obs.push({ concept: C.eyeExaminationAmount, value: Number(input.eyeExamAmount) });
+  }
+  if (input.frameAmount?.trim()) {
+    obs.push({ concept: C.frameAmount, value: Number(input.frameAmount) });
+  }
+
+  // Planned orderable concept UUID (text) — used later by Create Order.
+  const orderableUuid = (input.concept?.uuid ?? '').trim();
+  if (orderableUuid) {
+    text(plannedServiceObsConcept(plannedServiceObsConceptUuid), orderableUuid);
+  }
+
+  return obs;
+}
+
+/** Form question concept UUIDs we manage on elective capture (void these on edit). */
+function electiveManagedConceptUuids(plannedServiceObsConceptUuid?: string): Set<string> {
+  const C = PREAUTH_FORM_CONCEPTS;
+  return new Set(
+    [
+      C.typeOfIntervention,
+      C.clinicalIndication,
+      CLINICAL_INDICATIONS_CONCEPT_UUID,
+      C.startDate,
+      C.expectedServiceStartDate,
+      C.otherComplaint,
+      C.hpi,
+      C.generalExam,
+      C.investigation,
+      C.anaesthesia,
+      C.employmentRelated,
+      C.accidentRelated,
+      C.coInsured,
+      C.coInsuredDetails,
+      C.sessionNumber,
+      C.frequencyOfSessions,
+      C.lens,
+      C.newRequest,
+      C.lensAmount,
+      C.eyeExaminationAmount,
+      C.frameAmount,
+      C.plannedServiceConcept,
+      plannedServiceObsConcept(plannedServiceObsConceptUuid),
+    ].filter(Boolean),
+  );
+}
+
+export async function createElectivePreauthEncounter(
+  input: ElectiveCaptureInput & { plannedServiceObsConceptUuid?: string },
+): Promise<{ uuid: string }> {
+  const encounterType = input.encounterTypeUuid || PREAUTH_ENCOUNTER_TYPE_UUID;
+  const providerUuid = (input.providerUuid ?? '').trim();
+  if (!providerUuid) {
+    throw new Error('A provider is required to save the elective preauth encounter');
+  }
+
+  const encounterRole = await resolveEncounterRoleUuid(input.encounterRoleUuid);
+  const diagnosisConceptUuid = (input.diagnosis?.conceptUuid ?? '').trim();
+  const body: Record<string, unknown> = {
+    patient: input.patientUuid,
+    encounterType,
+    location: input.locationUuid,
+    encounterDatetime: input.encounterDatetime || dayjs().format('YYYY-MM-DDTHH:mm:ss.SSSZZ'),
+    encounterProviders: [
+      {
+        provider: providerUuid,
+        encounterRole,
+      },
+    ],
+    obs: buildObs(input, input.plannedServiceObsConceptUuid),
+    // OpenMRS 2.2+ encounter resource — same shape as GET encounter.diagnoses
+    diagnoses: diagnosisConceptUuid
+      ? [
+          {
+            patient: input.patientUuid,
+            rank: Number(input.diagnosis?.rank) > 0 ? Number(input.diagnosis?.rank) : 1,
+            certainty: 'CONFIRMED',
+            diagnosis: {
+              coded: diagnosisConceptUuid,
+            },
+          },
+        ]
+      : [],
+  };
+  const res = await openmrsFetch(`${restBaseUrl}/encounter`, {
+    method: 'POST',
+    headers: { 'Content-Type': 'application/json' },
+    body,
+  });
+  const uuid = String(res?.data?.uuid ?? '');
+  if (!uuid) {
+    throw new Error('Failed to create preauth encounter');
+  }
+
+  return { uuid };
+}
+
+export type ElectiveEncounterObsProps = {
+  uuid: string;
+  conceptUuid: string;
+};
+
+export type ElectiveEncounterEditModel = {
+  encounterUuid: string;
+  hold: PreAuthRequestRecord | null;
+  formValues: Awaited<ReturnType<typeof fetchPreauthFormValues>>;
+  plannedConcept: ElectiveConceptOption | null;
+  existingObs: ElectiveEncounterObsProps[];
+  diagnoses: ElectiveDiagnosisOption[];
+};
+
+/**
+ * Load an elective preauth encounter for edit — form obs, planned orderable concept, hold.
+ */
+export async function loadElectiveEncounterForEdit(
+  encounterUuid: string,
+  patientUuid: string,
+  plannedServiceObsConceptUuid?: string,
+): Promise<ElectiveEncounterEditModel> {
+  const encUuid = (encounterUuid ?? '').trim();
+  if (!encUuid) {
+    throw new Error('Missing encounter UUID');
+  }
+
+  const res = await openmrsFetch(
+    `${restBaseUrl}/encounter/${encUuid}?v=custom:(uuid,encounterDatetime,diagnoses:(uuid,display,rank,certainty,diagnosis:(coded:(uuid,display))),obs:(uuid,voided,concept:(uuid,display),value,valueText,valueCodedName))`,
+  );
+  const enc = res?.data as Record<string, unknown> | undefined;
+  if (!enc?.uuid) {
+    throw new Error('Encounter not found');
+  }
+
+  const obsList = (Array.isArray(enc.obs) ? enc.obs : []) as Array<Record<string, unknown>>;
+  const existingObs: ElectiveEncounterObsProps[] = [];
+  for (const o of obsList) {
+    if (o.voided) continue;
+    const ou = String(o.uuid ?? '').trim();
+    const cu = conceptUuid(o);
+    if (ou && cu) existingObs.push({ uuid: ou, conceptUuid: cu });
+  }
+
+  const plannedQ = plannedServiceObsConcept(plannedServiceObsConceptUuid);
+  let plannedConceptUuid =
+    obsText(obsList.find((o) => !o.voided && conceptUuid(o) === plannedQ)) || '';
+
+  let hold: PreAuthRequestRecord | null = null;
+  try {
+    const holds = await fetchElectiveHolds({ encounterUuid: encUuid });
+    hold = holds[0] ?? null;
+  } catch {
+    hold = null;
+  }
+  if (!plannedConceptUuid) {
+    plannedConceptUuid = plannedConceptUuidFromOrderNo(hold?.orderNo);
+  }
+
+  let plannedConcept: ElectiveConceptOption | null = null;
+  if (plannedConceptUuid) {
+    try {
+      const conceptRes = await openmrsFetch(
+        `${restBaseUrl}/concept/${plannedConceptUuid}?v=${encodeURIComponent(CONCEPT_SEARCH_REPR)}`,
+      );
+      const c = conceptRes?.data as ElectiveConceptOption | undefined;
+      if (c?.uuid) {
+        plannedConcept = {
+          uuid: c.uuid,
+          display: String(c.display ?? c.uuid),
+          mappings: c.mappings,
+        };
+      }
+    } catch {
+      plannedConcept = {
+        uuid: plannedConceptUuid,
+        display: plannedConceptUuid,
+        mappings: [],
+      };
+    }
+  }
+
+  const formValues = await fetchPreauthFormValues(patientUuid, encUuid);
+
+  const diagnoses: ElectiveDiagnosisOption[] = [];
+  const dxList = (Array.isArray(enc.diagnoses) ? enc.diagnoses : []) as Array<Record<string, unknown>>;
+  for (const dx of dxList) {
+    const diagnosis = (dx.diagnosis ?? {}) as Record<string, unknown>;
+    const coded = diagnosis.coded as { uuid?: string; display?: string } | string | undefined;
+    const conceptUuidDx =
+      typeof coded === 'object' ? String(coded?.uuid ?? '').trim() : String(coded ?? '').trim();
+    const display =
+      (typeof coded === 'object' ? String(coded?.display ?? '').trim() : '') ||
+      String(dx.display ?? '').trim() ||
+      conceptUuidDx;
+    if (!conceptUuidDx) continue;
+    diagnoses.push({
+      key: `enc-dx-${conceptUuidDx}`,
+      conceptUuid: conceptUuidDx,
+      display,
+      icd11Code: '',
+      rank: typeof dx.rank === 'number' ? dx.rank : Number(dx.rank) || 1,
+      source: 'visit',
+    });
+  }
+
+  return {
+    encounterUuid: encUuid,
+    hold,
+    formValues,
+    plannedConcept,
+    existingObs,
+    diagnoses,
+  };
+}
+
+/**
+ * Update elective preauth encounter obs via OpenMRS void-and-replace:
+ * same `obs` array includes `{ uuid, voided: true }` for current rows and new obs without uuid.
+ */
+export async function updateElectivePreauthEncounter(
+  encounterUuid: string,
+  input: ElectiveCaptureInput & { plannedServiceObsConceptUuid?: string },
+  existingObs: ElectiveEncounterObsProps[],
+): Promise<{ uuid: string }> {
+  const encUuid = (encounterUuid ?? '').trim();
+  if (!encUuid) {
+    throw new Error('Missing encounter UUID');
+  }
+
+  const newObs = buildObs(input, input.plannedServiceObsConceptUuid);
+  const managed = electiveManagedConceptUuids(input.plannedServiceObsConceptUuid);
+  const voided = existingObs
+    .filter((o) => managed.has(o.conceptUuid))
+    .map((o) => ({ uuid: o.uuid, voided: true as const }));
+
+  const body = {
+    obs: [...voided, ...newObs],
+  };
+
+  const res = await openmrsFetch(`${restBaseUrl}/encounter/${encUuid}`, {
+    method: 'POST',
+    headers: { 'Content-Type': 'application/json' },
+    body,
+  });
+  const uuid = String(res?.data?.uuid ?? encUuid);
+  if (!uuid) {
+    throw new Error('Failed to update preauth encounter');
+  }
+  return { uuid };
+}
+
+/** Update hold orderNo concept encoding when the orderable concept changes (before a real order #). */
+export async function syncElectiveHoldOrderConcept(opts: {
+  holdId: number;
+  encounterUuid: string;
+  conceptUuid: string;
+  currentOrderNo?: string | null;
+}): Promise<void> {
+  const current = String(opts.currentOrderNo ?? '').trim();
+  // Do not overwrite a real OpenMRS order number.
+  if (current && !current.startsWith('ELECTIVE-')) {
+    return;
+  }
+  const next = opts.conceptUuid
+    ? `ELECTIVE-${opts.encounterUuid}::${opts.conceptUuid}`
+    : `ELECTIVE-${opts.encounterUuid}`;
+  if (next === current) return;
+  await patchPreAuthRequest(opts.holdId, { orderNo: next });
+}
+
+function diagnosisOptionFromConcept(hit: DiagnosisConceptHit): ElectiveDiagnosisOption {
+  return {
+    key: `search-${hit.uuid}`,
+    conceptUuid: hit.uuid,
+    display: hit.display,
+    icd11Code: hit.icd11Code,
+    rank: 1,
+    source: 'search',
+  };
+}
+
+function diagnosisOptionFromVisitDx(dx: AmrsVisitDiagnosis): ElectiveDiagnosisOption | null {
+  const icd11Code = String(dx.icd11_code ?? '').trim();
+  const conceptUuid = String(dx.uuid ?? '').trim();
+  // ETL uuid is usually the coded concept uuid for encounter-diagnosis rows.
+  if (!conceptUuid && !icd11Code) return null;
+  const display = icd11Code
+    ? `${icd11Code} · ${dx.concept_source_name || dx.encounter_type || 'Visit diagnosis'}`
+    : dx.concept_source_name || dx.encounter_type || conceptUuid;
+  return {
+    key: `visit-${dx.encounter_id}-${icd11Code || conceptUuid}`,
+    conceptUuid,
+    display,
+    icd11Code,
+    rank: dx.dx_rank ?? null,
+    source: 'visit',
+  };
+}
+
+async function ensureDiagnosisConceptUuid(
+  option: ElectiveDiagnosisOption,
+): Promise<ElectiveDiagnosisOption> {
+  if (option.conceptUuid) return option;
+  const code = (option.icd11Code ?? '').trim();
+  if (!code) return option;
+  try {
+    const hits = await searchDiagnosisConcepts(code);
+    const match =
+      hits.find((h) => h.icd11Code.toUpperCase() === code.toUpperCase()) || hits[0];
+    if (match?.uuid) {
+      return {
+        ...option,
+        conceptUuid: match.uuid,
+        display: option.display || match.display,
+        icd11Code: option.icd11Code || match.icd11Code,
+      };
+    }
+  } catch {
+    // keep unresolved
+  }
+  return option;
+}
+
+/**
+ * Diagnoses from today's active visit encounters (OpenMRS) plus today's ETL diagnosis rows.
+ * Prefers rank-1 ICD-11 coded rows for prefill.
+ */
+export async function fetchTodaysVisitDiagnoses(
+  patientUuid: string,
+  locationUuid: string,
+): Promise<{ options: ElectiveDiagnosisOption[]; preferred: ElectiveDiagnosisOption | null }> {
+  if (!patientUuid || !locationUuid) {
+    return { options: [], preferred: null };
+  }
+
+  const today = dayjs().format('YYYY-MM-DD');
+  const options: ElectiveDiagnosisOption[] = [];
+  const seen = new Set<string>();
+
+  const addOption = (opt: ElectiveDiagnosisOption | null) => {
+    if (!opt) return;
+    const key = `${opt.conceptUuid}|${opt.icd11Code}`.toUpperCase();
+    if (!opt.conceptUuid && !opt.icd11Code) return;
+    if (seen.has(key)) return;
+    seen.add(key);
+    options.push(opt);
+  };
+
+  // 1) Diagnoses already on encounters in today's active visit
+  try {
+    const params = new URLSearchParams({
+      patient: patientUuid,
+      includeInactive: 'false',
+      fromStartDate: dayjs().startOf('day').toISOString(),
+      location: locationUuid,
+      v: 'custom:(uuid,startDatetime,stopDatetime,encounters:(uuid,encounterDatetime,diagnoses:(uuid,display,rank,certainty,diagnosis:(coded:(uuid,display),nonCoded))))',
+      limit: '1',
+    });
+    const visitRes = await openmrsFetch(`${restBaseUrl}/visit?${params.toString()}`);
+    const visit = (visitRes?.data?.results ?? [])[0] as
+      | { encounters?: Array<Record<string, unknown>> }
+      | undefined;
+    const encounters = visit?.encounters ?? [];
+    for (const enc of encounters) {
+      const diagnoses = (Array.isArray(enc.diagnoses) ? enc.diagnoses : []) as Array<
+        Record<string, unknown>
+      >;
+      for (const dx of diagnoses) {
+        const diagnosis = (dx.diagnosis ?? dx.condition ?? {}) as Record<string, unknown>;
+        const coded = diagnosis.coded as { uuid?: string; display?: string } | string | undefined;
+        const conceptUuid =
+          typeof coded === 'object' ? String(coded?.uuid ?? '').trim() : String(coded ?? '').trim();
+        const display =
+          (typeof coded === 'object' ? String(coded?.display ?? '').trim() : '') ||
+          String(dx.display ?? '').trim() ||
+          conceptUuid;
+        if (!conceptUuid) continue;
+        addOption({
+          key: `visit-enc-${String(enc.uuid ?? '')}-${conceptUuid}`,
+          conceptUuid,
+          display,
+          icd11Code: '',
+          rank: typeof dx.rank === 'number' ? dx.rank : Number(dx.rank) || null,
+          source: 'visit',
+        });
+      }
+    }
+  } catch {
+    // continue with ETL
+  }
+
+  // 2) ETL visit / encounter / maternity diagnoses for today (adds ICD-11 codes)
+  let etlPreferred: AmrsVisitDiagnosis | null = null;
+  try {
+    const etlRows = await fetchPatientDiagnosesForBilling({
+      visitDate: today,
+      billingDate: today,
+      patientUuid,
+      locationUuid,
+    });
+    etlPreferred = preferredDiagnosisForPreauth(etlRows);
+    for (const row of etlRows) {
+      addOption(diagnosisOptionFromVisitDx(row));
+    }
+  } catch {
+    // keep OpenMRS-only options
+  }
+
+  // Resolve missing concept UUIDs via ICD-11 dictionary search
+  const resolved = await Promise.all(options.map((o) => ensureDiagnosisConceptUuid(o)));
+  const usable = resolved.filter((o) => o.conceptUuid);
+
+  let preferred: ElectiveDiagnosisOption | null = null;
+  if (etlPreferred) {
+    const fromEtl = diagnosisOptionFromVisitDx(etlPreferred);
+    if (fromEtl) {
+      const resolvedPreferred = await ensureDiagnosisConceptUuid(fromEtl);
+      if (resolvedPreferred.conceptUuid) {
+        preferred = resolvedPreferred;
+      }
+    }
+  }
+  if (!preferred) {
+    preferred =
+      usable.find((o) => Number(o.rank) === 1) ||
+      usable[0] ||
+      null;
+  }
+
+  return { options: usable, preferred };
+}
+
+export async function searchElectiveDiagnoses(q: string): Promise<ElectiveDiagnosisOption[]> {
+  const hits = await searchDiagnosisConcepts(q);
+  return hits.map(diagnosisOptionFromConcept);
+}
+
+export async function holdElectivePreauthRequest(opts: {
+  patientUuid: string;
+  locationUuid: string;
+  encounterUuid: string;
+  intervention: Intervention;
+  expectedServiceStartDate: string;
+  conceptUuid?: string;
+}): Promise<unknown> {
+  const code = (opts.intervention.code ?? '').trim();
+  const subBenefit =
+    (opts.intervention as Intervention & { packageCode?: string }).packageCode ||
+    code.split('-').slice(0, 2).join('-') ||
+    code;
+
+  const docs = (opts.intervention.applicableDocumentTypes ?? []).filter(Boolean).join(',');
+  const requiredDocs = (opts.intervention.requiredPreauthDocumentTypes ?? []).filter(Boolean).join(',');
+
+  const payload: PreauthRequest = {
+    patientUuid: opts.patientUuid,
+    locationUuid: opts.locationUuid,
+    encounterUuid: opts.encounterUuid,
+    expectedServiceStartDate: dayjs(opts.expectedServiceStartDate).toISOString(),
+    // Encode planned OpenMRS concept UUID for later Create Order (replaced by real order #).
+    orderNo: opts.conceptUuid
+      ? `ELECTIVE-${opts.encounterUuid}::${opts.conceptUuid}`
+      : `ELECTIVE-${opts.encounterUuid}`,
+    subBenefitCode: subBenefit,
+    interventionCode: code,
+    serviceType: getServiceType(opts.intervention, 'OUTPATIENT'),
+    requiresPreauth: Boolean(opts.intervention.needsPreauth),
+    normalPreauth: Boolean(opts.intervention.needsPreauth) && !Boolean(opts.intervention.needsManualPreauthApproval),
+    electivePreauth: true,
+    applicableDocumentTypes: docs,
+    requiredPreauthDocumentTypes: requiredDocs,
+  };
+
+  return createPreauthRequest(payload);
+}
+
+/** Parse planned service concept UUID from elective hold orderNo (`ELECTIVE-{enc}::{conceptUuid}`). */
+export function plannedConceptUuidFromOrderNo(orderNo: string | null | undefined): string {
+  const raw = String(orderNo ?? '').trim();
+  const marker = '::';
+  const idx = raw.indexOf(marker);
+  if (idx < 0) return '';
+  return raw.slice(idx + marker.length).trim();
+}
+
+/** Resolve OpenMRS concept UUID for an elective hold (orderNo encoding, then SHA dictionary match). */
+export async function resolveElectiveServiceConceptUuid(opts: {
+  orderNo?: string | null;
+  interventionCode?: string | null;
+}): Promise<string> {
+  const fromOrderNo = plannedConceptUuidFromOrderNo(opts.orderNo);
+  if (fromOrderNo) return fromOrderNo;
+
+  const code = String(opts.interventionCode ?? '').trim().toUpperCase();
+  if (!code) return '';
+
+  const searchTerms = [code, code.replace(/^SHA-/, ''), code.replace(/^SHA-/i, '')].filter(
+    (t, i, arr) => t.length >= 2 && arr.indexOf(t) === i,
+  );
+  for (const term of searchTerms) {
+    try {
+      const hits = await searchElectiveConcepts(term);
+      const exact = hits.find((h) => extractShaCodeFromConcept(h) === code);
+      if (exact?.uuid) return exact.uuid;
+      const fuzzy = hits.find((h) => extractShaCodeFromConcept(h).includes(code.replace(/^SHA-/, '')));
+      if (fuzzy?.uuid) return fuzzy.uuid;
+    } catch {
+      // try next term
+    }
+  }
+  return '';
+}
+
+export async function resolveCoverageForConcept(
+  patientCr: string,
+  locationUuid: string,
+  shaCode: string,
+): Promise<Intervention | null> {
+  return fetchShaInterventionByCode(patientCr, locationUuid, shaCode);
+}
+
+export async function fetchElectiveHolds(
+  params: ListPreAuthRequestsParams,
+): Promise<PreAuthRequestRecord[]> {
+  return listPreAuthRequests({
+    ...params,
+    electivePreauth: true,
+  });
+}
+
+type ElectiveHoldStatusSource = Pick<
+  PreAuthRequestRecord,
+  'id' | 'patientUuid' | 'interventionCode' | 'consentToken' | 'status' | 'locationUuid'
+> & {
+  crNo?: string;
+};
+
+/**
+ * Refresh HIE statuses for elective holds that already have a consent token.
+ * Holds without a token are ignored — callers must filter to raised rows only.
+ */
+export async function syncElectiveHoldStatusesFromPreview(
+  holds: ElectiveHoldStatusSource[],
+  fallbackLocationUuid: string,
+): Promise<Record<number, string>> {
+  const statusMap: Record<number, string> = {};
+  if (!holds.length || !fallbackLocationUuid?.trim()) {
+    return statusMap;
+  }
+
+  // One preview per unique consent token, then match interventions locally.
+  const tokenLocations = new Map<string, string>();
+  for (const hold of holds) {
+    const token = String(hold.consentToken ?? '').trim();
+    if (!token || tokenLocations.has(token)) continue;
+    tokenLocations.set(token, String(hold.locationUuid ?? '').trim() || fallbackLocationUuid);
+  }
+  if (!tokenLocations.size) {
+    return statusMap;
+  }
+
+  const previewByToken = new Map<string, unknown>();
+  await Promise.all(
+    [...tokenLocations.entries()].map(async ([token, loc]) => {
+      try {
+        previewByToken.set(token, await getPreauthPreview(token, loc));
+      } catch {
+        previewByToken.set(token, null);
+      }
+    }),
+  );
+
+  await Promise.all(
+    holds.map(async (hold) => {
+      if (hold.id == null) return;
+      const token = String(hold.consentToken ?? '').trim();
+      if (!token) return;
+
+      const preview = previewByToken.get(token);
+      if (!preview) return;
+
+      // Intervention-specific status only — never visit-wide overallPreauthFinalised.
+      const hieStatus = extractPreauthStatusForIntervention(preview, hold.interventionCode);
+      if (!hieStatus) {
+        // Token exists but this intervention is not on the preview — do not keep a
+        // stale FINALISED/ACTIVE from an earlier bad sync.
+        return;
+      }
+
+      statusMap[hold.id] = hieStatus;
+
+      const holdStatus = String(hold.status ?? '')
+        .trim()
+        .toUpperCase();
+      const normalizedHie = hieStatus.trim().toUpperCase();
+      if (normalizedHie && normalizedHie !== holdStatus) {
+        try {
+          await patchPreAuthRequest(hold.id, { status: hieStatus });
+        } catch {
+          // non-blocking — UI still shows live HIE status via statusMap
+        }
+      }
+    }),
+  );
+
+  return statusMap;
+}
+
+export type ElectiveHoldRow = PreAuthRequestRecord & {
+  patientName: string;
+  crNo: string;
+  providerDisplay: string;
+  providerUuid: string;
+  providerNationalId: string;
+  encounterDatetime: string;
+  clinicalIndications: string;
+};
+
+function patientDisplayName(patient: Record<string, unknown> | null | undefined): string {
+  if (!patient) return '';
+  const display = String(patient.display ?? '').trim();
+  if (display) {
+    // OpenMRS often returns "Name - identifier"
+    return display.split(' - ')[0]?.trim() || display;
+  }
+  const person = patient.person as { display?: string } | undefined;
+  return String(person?.display ?? '').trim();
+}
+
+function identifierOfType(
+  patient: Record<string, unknown> | null | undefined,
+  typeUuid: string,
+): string {
+  const ids = (patient?.identifiers ?? []) as Array<{
+    identifier?: string;
+    identifierType?: { uuid?: string };
+  }>;
+  const hit = ids.find((i) => i.identifierType?.uuid === typeUuid);
+  return String(hit?.identifier ?? '').trim();
+}
+
+function providerNationalIdFromAttrs(
+  attributes?: Array<{ value?: string; voided?: boolean; attributeType?: { uuid?: string } }>,
+): string {
+  const hit = (attributes ?? []).find(
+    (a) =>
+      !a.voided &&
+      a.attributeType?.uuid === IdentifierTypesUuids.PROVIDER_NATIONAL_ID_UUID &&
+      a.value,
+  );
+  return hit?.value ? String(hit.value).trim() : '';
+}
+
+async function fetchPatientSummary(patientUuid: string): Promise<{
+  name: string;
+  crNo: string;
+}> {
+  try {
+    const res = await openmrsFetch(
+      `${restBaseUrl}/patient/${patientUuid}?v=custom:(uuid,display,person:(display),identifiers:(identifier,identifierType:(uuid)))`,
+    );
+    const patient = res?.data as Record<string, unknown> | undefined;
+    return {
+      name: patientDisplayName(patient),
+      crNo: identifierOfType(patient, IdentifierTypesUuids.CLIENT_REGISTRY_NO_UUID),
+    };
+  } catch {
+    return { name: '', crNo: '' };
+  }
+}
+
+async function fetchEncounterSummary(encounterUuid: string): Promise<{
+  encounterDatetime: string;
+  providerDisplay: string;
+  providerUuid: string;
+  providerNationalId: string;
+  clinicalIndications: string;
+}> {
+  const empty = {
+    encounterDatetime: '',
+    providerDisplay: '',
+    providerUuid: '',
+    providerNationalId: '',
+    clinicalIndications: '',
+  };
+  if (!encounterUuid) return empty;
+  try {
+    const res = await openmrsFetch(
+      `${restBaseUrl}/encounter/${encounterUuid}?v=custom:(uuid,encounterDatetime,encounterProviders:(display,provider:(uuid,display,attributes:(value,voided,attributeType:(uuid)))),obs:(uuid,concept:(uuid),value,valueText))`,
+    );
+    const enc = res?.data as Record<string, unknown> | undefined;
+    if (!enc) return empty;
+
+    const providers = (Array.isArray(enc.encounterProviders) ? enc.encounterProviders : []) as Array<{
+      display?: string;
+      provider?: {
+        uuid?: string;
+        display?: string;
+        attributes?: Array<{ value?: string; voided?: boolean; attributeType?: { uuid?: string } }>;
+      };
+    }>;
+    const primary = providers[0];
+    const provider = primary?.provider;
+    const providerDisplay =
+      String(provider?.display ?? '').trim() ||
+      String(primary?.display ?? '')
+        .replace(/\s*:\s*.*$/, '')
+        .trim();
+    const providerUuid = String(provider?.uuid ?? '').trim();
+    const providerNationalId = providerNationalIdFromAttrs(provider?.attributes);
+
+    const obsList = (Array.isArray(enc.obs) ? enc.obs : []) as Record<string, unknown>[];
+    let clinicalIndications = '';
+    for (const o of obsList) {
+      const cu = conceptUuid(o);
+      if (cu === PREAUTH_FORM_CONCEPTS.clinicalIndication || cu === CLINICAL_INDICATIONS_CONCEPT_UUID) {
+        clinicalIndications = obsText(o);
+        break;
+      }
+    }
+
+    return {
+      encounterDatetime: String(enc.encounterDatetime ?? ''),
+      providerDisplay,
+      providerUuid,
+      providerNationalId,
+      clinicalIndications,
+    };
+  } catch {
+    return empty;
+  }
+}
+
+/** Resolve patient name, CR, and encounter provider for Accounting elective list / Raise. */
+export async function enrichElectiveHolds(
+  holds: PreAuthRequestRecord[],
+  clientRegistryIdentifierTypeUuid?: string,
+): Promise<ElectiveHoldRow[]> {
+  const crType = clientRegistryIdentifierTypeUuid || IdentifierTypesUuids.CLIENT_REGISTRY_NO_UUID;
+
+  return Promise.all(
+    holds.map(async (hold) => {
+      const [patient, encounter] = await Promise.all([
+        fetchPatientSummary(hold.patientUuid),
+        fetchEncounterSummary(hold.encounterUuid ?? ''),
+      ]);
+      // Prefer configured CR type when it differs from default
+      let crNo = patient.crNo;
+      if (crType !== IdentifierTypesUuids.CLIENT_REGISTRY_NO_UUID && hold.patientUuid) {
+        try {
+          crNo = (await fetchPatientCrNumber(hold.patientUuid, crType)) || crNo;
+        } catch {
+          // keep patient.crNo
+        }
+      }
+      return {
+        ...hold,
+        patientName: patient.name || hold.patientUuid,
+        crNo,
+        providerDisplay: encounter.providerDisplay,
+        providerUuid: encounter.providerUuid,
+        providerNationalId: encounter.providerNationalId,
+        encounterDatetime: encounter.encounterDatetime,
+        clinicalIndications: encounter.clinicalIndications,
+      };
+    }),
+  );
+}
+
+export type PreauthEncounterCard = {
+  uuid: string;
+  encounterDatetime: string;
+  clinicalIndications: string;
+  expectedServiceStartDate: string;
+  locationDisplay: string;
+  hold?: PreAuthRequestRecord | null;
+  /** Planned service concept UUID when encoded on the hold orderNo */
+  plannedServiceConceptUuid: string;
+};
+
+function obsText(obs: Record<string, unknown> | undefined): string {
+  if (!obs) return '';
+  if (typeof obs.valueText === 'string' && obs.valueText.trim()) return obs.valueText.trim();
+  if (typeof obs.value === 'string' && obs.value.trim()) return obs.value.trim();
+  if (obs.value && typeof obs.value === 'object' && 'display' in (obs.value as object)) {
+    return String((obs.value as { display?: string }).display ?? '').trim();
+  }
+  return '';
+}
+
+function obsDate(obs: Record<string, unknown> | undefined): string {
+  if (!obs) return '';
+  const raw =
+    (typeof obs.valueDate === 'string' && obs.valueDate) ||
+    (typeof obs.valueDatetime === 'string' && obs.valueDatetime) ||
+    (typeof obs.value === 'string' && obs.value) ||
+    '';
+  const d = dayjs(raw);
+  return d.isValid() ? d.format('YYYY-MM-DD') : '';
+}
+
+function conceptUuid(obs: Record<string, unknown>): string {
+  const c = obs.concept;
+  if (c && typeof c === 'object' && 'uuid' in (c as object)) {
+    return String((c as { uuid?: string }).uuid ?? '');
+  }
+  return typeof c === 'string' ? c : '';
+}
+
+/** List PREAUTHORIZATION encounters for the patient chart elective page. */
+export async function fetchPreauthEncounterCards(
+  patientUuid: string,
+  encounterTypeUuid?: string,
+  locationUuid?: string,
+): Promise<PreauthEncounterCard[]> {
+  if (!patientUuid) return [];
+  const typeUuid = encounterTypeUuid || PREAUTH_ENCOUNTER_TYPE_UUID;
+  try {
+    const qs = new URLSearchParams({
+      patient: patientUuid,
+      encounterType: typeUuid,
+      v: 'custom:(uuid,encounterDatetime,location:(display),obs:(uuid,concept:(uuid),value,valueText,valueDate,valueDatetime))',
+      limit: '50',
+    });
+    const res = await openmrsFetch(`${restBaseUrl}/encounter?${qs.toString()}`);
+    const results = (res?.data?.results ?? []) as Array<Record<string, unknown>>;
+
+    // Chart view: load holds by patient only so a session location mismatch does not
+    // hide ACTIVE / raised rows (location filter still applies to Accounting lists).
+    let holds: PreAuthRequestRecord[] = [];
+    try {
+      holds = await fetchElectiveHolds({ patientUuid });
+    } catch {
+      holds = [];
+    }
+
+    const holdByEncounter = new Map<string, PreAuthRequestRecord>();
+    for (const h of holds) {
+      const encUuid = String(h.encounterUuid ?? '').trim();
+      if (encUuid) {
+        holdByEncounter.set(encUuid, h);
+        continue;
+      }
+      // Fallback: ELECTIVE-{encounterUuid} or ELECTIVE-{encounterUuid}::{conceptUuid}
+      const orderNo = String(h.orderNo ?? '').trim();
+      const m = orderNo.match(/^ELECTIVE-([0-9a-f-]{36})(?:::|$)/i);
+      if (m?.[1]) {
+        holdByEncounter.set(m[1], h);
+      }
+    }
+
+    const cards: PreauthEncounterCard[] = results.map((enc) => {
+      const uuid = String(enc.uuid ?? '');
+      const obsList = (Array.isArray(enc.obs) ? enc.obs : []) as Record<string, unknown>[];
+      const byConcept = new Map<string, Record<string, unknown>>();
+      for (const o of obsList) {
+        const cu = conceptUuid(o);
+        if (cu) byConcept.set(cu, o);
+      }
+      const clinical = obsText(byConcept.get(PREAUTH_FORM_CONCEPTS.clinicalIndication));
+      const expected = obsDate(byConcept.get(PREAUTH_FORM_CONCEPTS.expectedServiceStartDate || PREAUTH_FORM_CONCEPTS.startDate));
+      const loc = enc.location as { display?: string } | undefined;
+      const hold = holdByEncounter.get(uuid) ?? null;
+      const plannedFromObs = (() => {
+        const configured = plannedServiceObsConcept();
+        if (configured) {
+          const t = obsText(byConcept.get(configured));
+          if (t) return t;
+        }
+        return (
+          obsText(byConcept.get(PREAUTH_FORM_CONCEPTS.plannedServiceConcept)) || ''
+        );
+      })();
+      return {
+        uuid,
+        encounterDatetime: String(enc.encounterDatetime ?? ''),
+        clinicalIndications: clinical,
+        expectedServiceStartDate: expected,
+        locationDisplay: String(loc?.display ?? ''),
+        hold,
+        plannedServiceConceptUuid:
+          plannedFromObs || plannedConceptUuidFromOrderNo(hold?.orderNo),
+      };
+    });
+
+    // Also surface holds whose encounter is missing from the OpenMRS list (wrong encounter
+    // type config, etc.) so ACTIVE preauths are not invisible.
+    const seenEncounters = new Set(cards.map((c) => c.uuid));
+    for (const h of holds) {
+      const encUuid = String(h.encounterUuid ?? '').trim();
+      const fromOrder = String(h.orderNo ?? '').match(/^ELECTIVE-([0-9a-f-]{36})(?:::|$)/i)?.[1];
+      const key = encUuid || fromOrder || '';
+      if (!key || seenEncounters.has(key)) continue;
+      seenEncounters.add(key);
+      cards.push({
+        uuid: key,
+        encounterDatetime: h.dateCreated || '',
+        clinicalIndications: '',
+        expectedServiceStartDate: h.expectedServiceStartDate
+          ? dayjs(h.expectedServiceStartDate).format('YYYY-MM-DD')
+          : '',
+        locationDisplay: '',
+        hold: h,
+        plannedServiceConceptUuid: plannedConceptUuidFromOrderNo(h.orderNo),
+      });
+    }
+
+    return cards.sort((a, b) => {
+      const ta = dayjs(a.encounterDatetime).valueOf() || 0;
+      const tb = dayjs(b.encounterDatetime).valueOf() || 0;
+      return tb - ta;
+    });
+  } catch {
+    return [];
+  }
+}
+
+/** REST order subclass for POST /encounter orders (must match OrderType.javaClassName). */
+export type RestOrderType = 'order' | 'testorder' | 'drugorder';
+
+function restTypeFromJavaClassName(javaClassName: string | null | undefined): RestOrderType | null {
+  const name = String(javaClassName ?? '').trim();
+  if (!name) return null;
+  if (name.endsWith('TestOrder') || name === 'org.openmrs.TestOrder') return 'testorder';
+  if (name.endsWith('DrugOrder') || name === 'org.openmrs.DrugOrder') return 'drugorder';
+  if (name.endsWith('.Order') || name === 'org.openmrs.Order') return 'order';
+  return null;
+}
+
+function restTypeFromConceptClassName(className: string | null | undefined): RestOrderType {
+  const n = String(className ?? '')
+    .trim()
+    .toLowerCase();
+  if (!n) return 'order';
+  if (n.includes('drug')) return 'drugorder';
+  // LabTest, Test, LabSet, etc. map to TestOrder via order_type_class_map in most AMRS installs.
+  if (n.includes('test') || n.includes('lab')) return 'testorder';
+  return 'order';
+}
+
+/**
+ * Resolve the REST `type` for an orderable concept so OpenMRS does not reject
+ * the payload (e.g. TestOrder order type vs plain Order instance).
+ */
+export async function resolveRestOrderTypeForConcept(conceptUuid: string): Promise<RestOrderType> {
+  const uuid = (conceptUuid ?? '').trim();
+  if (!uuid) return 'order';
+
+  let conceptClassUuid = '';
+  let conceptClassName = '';
+  try {
+    const conceptRes = await openmrsFetch(
+      `${restBaseUrl}/concept/${uuid}?v=custom:(uuid,conceptClass:(uuid,display,name))`,
+    );
+    const cc = conceptRes?.data?.conceptClass as
+      | { uuid?: string; display?: string; name?: string }
+      | undefined;
+    conceptClassUuid = String(cc?.uuid ?? '').trim();
+    conceptClassName = String(cc?.display ?? cc?.name ?? '').trim();
+  } catch {
+    return 'order';
+  }
+
+  try {
+    const otRes = await openmrsFetch(
+      `${restBaseUrl}/ordertype?v=custom:(uuid,display,javaClassName,conceptClasses:(uuid,display))&limit=100`,
+    );
+    const types = (otRes?.data?.results ?? []) as Array<{
+      javaClassName?: string;
+      conceptClasses?: Array<{ uuid?: string; display?: string }>;
+    }>;
+
+    if (conceptClassUuid) {
+      const matched = types.find((t) =>
+        (t.conceptClasses ?? []).some((c) => c?.uuid === conceptClassUuid),
+      );
+      const fromMap = restTypeFromJavaClassName(matched?.javaClassName);
+      if (fromMap) return fromMap;
+    }
+  } catch {
+    // fall through to class-name heuristic
+  }
+
+  return restTypeFromConceptClassName(conceptClassName);
+}
+
+/** Create an OpenMRS order for an ACTIVE/FINALISED elective preauth using the planned service concept. */
+export async function createElectiveServiceOrder(opts: {
+  patientUuid: string;
+  visitUuid: string;
+  locationUuid: string;
+  providerUuid: string;
+  conceptUuid: string;
+  orderEncounterTypeUuid: string;
+  outPatientCareSettingUuid: string;
+}): Promise<{ orderUuid: string; orderNumber: string }> {
+  const conceptUuid = (opts.conceptUuid ?? '').trim();
+  if (!conceptUuid) {
+    throw new Error('Missing planned service concept for order');
+  }
+  if (!opts.providerUuid?.trim()) {
+    throw new Error('A provider is required to create the order');
+  }
+  if (!opts.orderEncounterTypeUuid?.trim() || !opts.outPatientCareSettingUuid?.trim()) {
+    throw new Error('Order encounter type and outpatient care setting must be configured');
+  }
+
+  const orderRestType = await resolveRestOrderTypeForConcept(conceptUuid);
+
+  const dto: CreateOrderEncounterDto = {
+    patient: opts.patientUuid,
+    location: opts.locationUuid,
+    encounterType: opts.orderEncounterTypeUuid,
+    encounterDatetime: new Date().toISOString(),
+    visit: opts.visitUuid,
+    obs: [],
+    orders: [
+      {
+        action: 'NEW',
+        type: orderRestType,
+        patient: opts.patientUuid,
+        careSetting: opts.outPatientCareSettingUuid,
+        orderer: opts.providerUuid,
+        concept: conceptUuid,
+        urgency: 'ROUTINE',
+      },
+    ],
+  };
+
+  const encounter = await createOrderEncounter(dto);
+  const createdOrder = encounter?.orders?.[0];
+  if (!createdOrder?.uuid) {
+    throw new Error('Order encounter was created without an order');
+  }
+
+  const order = await getOrder(createdOrder.uuid);
+  const orderNumber = String(order?.orderNumber ?? '').trim();
+  if (!orderNumber) {
+    throw new Error('Order was created but order number is missing');
+  }
+  return { orderUuid: createdOrder.uuid, orderNumber };
+}