feat(backend): add Remittance + CasAdjustment ORM models

This commit is contained in:
Tyler
2026-06-19 21:47:18 -06:00
parent 2019a651ed
commit 0cc74dc173
2 changed files with 108 additions and 6 deletions
+46 -5
View File
@@ -20,11 +20,13 @@ from typing import Optional
import sqlalchemy as sa
from sqlalchemy import (
Boolean,
Date,
DateTime,
Enum,
ForeignKey,
Index,
Integer,
Numeric,
String,
Text,
@@ -223,11 +225,6 @@ class Claim(Base):
)
# Minimal stub for forward relationship/FK resolution. The full Remittance
# model (with payer_claim_control_number, status_code, total_charge, etc.)
# is defined in Task 5 and will replace this stub. The stub declares only
# the columns needed for `Batch.remittances` relationship resolution and
# `Claim.matched_remittance_id` FK metadata resolution.
class Remittance(Base):
__tablename__ = "remittances"
@@ -235,4 +232,48 @@ class Remittance(Base):
batch_id: Mapped[str] = mapped_column(
String(32), ForeignKey("batches.id", ondelete="CASCADE"), nullable=False
)
payer_claim_control_number: Mapped[str] = mapped_column(String(64), nullable=False)
claim_id: Mapped[Optional[str]] = mapped_column(
String(64), ForeignKey("claims.id"), nullable=True
)
status_code: Mapped[str] = mapped_column(String(4), nullable=False)
status_label: Mapped[Optional[str]] = mapped_column(String(32), nullable=True)
total_charge: Mapped[Decimal] = mapped_column(Numeric(12, 2), nullable=False, default=Decimal("0"))
total_paid: Mapped[Decimal] = mapped_column(Numeric(12, 2), nullable=False, default=Decimal("0"))
patient_responsibility: Mapped[Optional[Decimal]] = mapped_column(Numeric(12, 2), nullable=True)
adjustment_amount: Mapped[Decimal] = mapped_column(Numeric(12, 2), nullable=False, default=Decimal("0"))
received_at: Mapped[datetime] = mapped_column(DateTime(timezone=True), nullable=False)
service_date: Mapped[Optional[date]] = mapped_column(Date, nullable=True)
is_reversal: Mapped[bool] = mapped_column(Boolean, nullable=False, default=False)
raw_json: Mapped[Optional[dict]] = mapped_column(JSONText, nullable=True)
batch: Mapped["Batch"] = relationship(back_populates="remittances")
cas_adjustments: Mapped[list["CasAdjustment"]] = relationship(
back_populates="remittance", cascade="all, delete-orphan"
)
__table_args__ = (
UniqueConstraint("batch_id", "payer_claim_control_number", name="uq_remits_batch_pcn"),
Index("ix_remittances_claim_id", "claim_id"),
Index("ix_remittances_payer_claim_control_number", "payer_claim_control_number"),
Index("ix_remittances_status_code", "status_code"),
)
class CasAdjustment(Base):
__tablename__ = "cas_adjustments"
id: Mapped[int] = mapped_column(Integer, primary_key=True, autoincrement=True)
remittance_id: Mapped[str] = mapped_column(
String(64), ForeignKey("remittances.id", ondelete="CASCADE"), nullable=False
)
group_code: Mapped[str] = mapped_column(String(4), nullable=False)
reason_code: Mapped[str] = mapped_column(String(8), nullable=False)
amount: Mapped[Decimal] = mapped_column(Numeric(12, 2), nullable=False)
quantity: Mapped[Optional[Decimal]] = mapped_column(Numeric(10, 2), nullable=True)
remittance: Mapped["Remittance"] = relationship(back_populates="cas_adjustments")
__table_args__ = (
Index("ix_cas_adjustments_remittance_id", "remittance_id"),
)
+62 -1
View File
@@ -9,7 +9,7 @@ from decimal import Decimal
import pytest
from cyclone import db
from cyclone.db import Base, Batch, Claim, ClaimState
from cyclone.db import Base, Batch, CasAdjustment, Claim, ClaimState, Remittance
@pytest.fixture(autouse=True)
@@ -155,3 +155,64 @@ def test_batch_cascade_delete_drops_claims():
with db.SessionLocal()() as s:
assert s.get(Batch, "b1") is None
assert s.get(Claim, "CLM-1") is None
def test_create_and_query_remittance():
with db.SessionLocal()() as s:
s.add(Batch(
id="b1", kind="835", input_filename="x",
parsed_at=datetime(2026, 6, 19, tzinfo=timezone.utc),
))
r = Remittance(
id="CLP-1",
batch_id="b1",
payer_claim_control_number="CLP-1",
status_code="1",
total_charge=Decimal("124.00"),
total_paid=Decimal("124.00"),
received_at=datetime(2026, 6, 19, tzinfo=timezone.utc),
service_date=date(2026, 6, 1),
is_reversal=False,
)
s.add(r)
s.commit()
with db.SessionLocal()() as s:
loaded = s.get(Remittance, "CLP-1")
assert loaded is not None
assert loaded.status_code == "1"
assert loaded.total_paid == Decimal("124.00")
assert loaded.is_reversal is False
assert loaded.adjustment_amount == Decimal("0") # default
def test_cas_adjustment_aggregation():
"""Sum of CAS rows for a Remittance equals expected total."""
with db.SessionLocal()() as s:
s.add(Batch(
id="b1", kind="835", input_filename="x",
parsed_at=datetime(2026, 6, 19, tzinfo=timezone.utc),
))
r = Remittance(
id="CLP-1", batch_id="b1",
payer_claim_control_number="CLP-1", status_code="1",
total_charge=Decimal("124.00"), total_paid=Decimal("62.00"),
received_at=datetime(2026, 6, 19, tzinfo=timezone.utc),
)
s.add(r)
s.flush()
s.add_all([
CasAdjustment(remittance_id="CLP-1", group_code="CO", reason_code="45",
amount=Decimal("30.00")),
CasAdjustment(remittance_id="CLP-1", group_code="PR", reason_code="1",
amount=Decimal("32.00")),
])
s.commit()
from sqlalchemy import select, func
with db.SessionLocal()() as s:
total = s.execute(
select(func.sum(CasAdjustment.amount))
.where(CasAdjustment.remittance_id == "CLP-1")
).scalar_one()
assert total == Decimal("62.00")