feat(backend): add store mappers (claim, remittance, provider, activity)

2026-06-19 19:05:42 -06:00
parent 112c08fe14
commit 2a78d129ca
2 changed files with 212 additions and 2 deletions
@@ -14,8 +14,8 @@ from typing import Iterable, Literal

 from pydantic import BaseModel, ConfigDict, Field

-from cyclone.parsers.models import ParseResult
-from cyclone.parsers.models_835 import ParseResult835
+from cyclone.parsers.models import ClaimOutput, ParseResult
+from cyclone.parsers.models_835 import ClaimPayment, ParseResult835


 BatchKind = Literal["837p", "835"]
@@ -66,3 +66,132 @@ store = InMemoryStore()
 def utcnow_iso() -> str:
    """ISO 8601 UTC timestamp, second precision, suffixed with 'Z'."""
    return datetime.now(timezone.utc).strftime("%Y-%m-%dT%H:%M:%SZ")
+
+
+# ---------------------------------------------------------------------------
+# Mappers: rich backend models → simpler UI types.
+# The shape of the returned dicts must match the TypeScript interfaces in
+# `src/types/index.ts`. Keep both sides in sync.
+# ---------------------------------------------------------------------------
+
+
+def to_ui_claim(
+    claim: ClaimOutput,
+    *,
+    batch_id: str,
+    parsed_at: str,
+) -> dict:
+    """Map a 837P ClaimOutput to the UI's `Claim` shape.
+
+    Status rules (per spec section 6.2, evaluated in priority order):
+      - !passed                        → denied
+      - passed and any warnings        → pending
+      - passed and frequency_code == "1" → submitted
+      - otherwise                      → draft
+    """
+    v = claim.validation
+    if not v.passed:
+        status = "denied"
+    elif v.warnings:
+        status = "pending"
+    elif claim.claim.frequency_code == "1":
+        status = "submitted"
+    else:
+        status = "draft"
+
+    return {
+        "id": claim.claim_id,
+        "patientName": f"{claim.subscriber.first_name} {claim.subscriber.last_name}".strip(),
+        "providerNpi": claim.billing_provider.npi,
+        "payerName": claim.payer.name,
+        "cptCode": (
+            claim.service_lines[0].procedure.code
+            if claim.service_lines
+            else ""
+        ),
+        "billedAmount": float(claim.claim.total_charge or 0.0),
+        "receivedAmount": 0.0,
+        "status": status,
+        "denialReason": None,
+        "submissionDate": parsed_at,
+        "batchId": batch_id,
+        "parsedAt": parsed_at,
+    }
+
+
+def to_ui_remittance(
+    cp: ClaimPayment,
+    *,
+    batch_id: str,
+    parsed_at: str,
+) -> dict:
+    """Map an 835 ClaimPayment to the UI's `Remittance` shape.
+
+    Status mapping (per spec section 6.3):
+      - status_code 21/22 → reconciled (reversal/correction)
+      - otherwise         → received
+    """
+    code = cp.status_code
+    if code in {"21", "22"}:
+        status = "reconciled"
+    else:
+        status = "received"
+
+    return {
+        "id": cp.payer_claim_control_number,
+        "claimId": cp.original_claim_id or "",
+        "payerName": "",
+        "paidAmount": float(cp.total_paid or 0.0),
+        "adjustmentAmount": 0.0,
+        "status": status,
+        "denialReason": None,
+        "receivedDate": parsed_at,
+        "batchId": batch_id,
+        "parsedAt": parsed_at,
+    }
+
+
+def to_ui_provider(
+    *,
+    npi: str,
+    name: str,
+    tax_id: str | None = None,
+    address: str | None = None,
+    city: str | None = None,
+    state: str | None = None,
+    zip: str | None = None,
+    phone: str | None = None,
+    claim_count: int = 0,
+    outstanding_ar: float = 0.0,
+) -> dict:
+    return {
+        "npi": npi,
+        "name": name,
+        "taxId": tax_id or "",
+        "address": address or "",
+        "city": city or "",
+        "state": state or "",
+        "zip": zip or "",
+        "phone": phone or "",
+        "claimCount": claim_count,
+        "outstandingAr": float(outstanding_ar),
+    }
+
+
+def to_activity_event(
+    *,
+    id: str,
+    kind: str,
+    message: str,
+    timestamp: str,
+    npi: str | None = None,
+    amount: float | None = None,
+) -> dict:
+    return {
+        "id": id,
+        "kind": kind,
+        "message": message,
+        "timestamp": timestamp,
+        "npi": npi,
+        "amount": amount,
+    }
@@ -122,3 +122,84 @@ def test_add_and_get_round_trip():
 def test_get_missing_returns_none():
    s = InMemoryStore()
    assert s.get("does-not-exist") is None
+
+
+# ---------------------------------------------------------------------------
+# Task 2: Mappers
+# ---------------------------------------------------------------------------
+
+
+def test_to_ui_claim_maps_status_submitted():
+    from cyclone.store import to_ui_claim
+    claim = _make_claim("CLM-1")
+    out = to_ui_claim(claim, batch_id="b1", parsed_at="2026-06-19T12:00:00Z")
+    assert out["id"] == "CLM-1"
+    assert out["status"] == "submitted"  # passed=True, frequency_code="1"
+    assert out["providerNpi"] == "1234567890"
+    assert out["batchId"] == "b1"
+
+
+def test_to_ui_claim_maps_status_pending_when_warnings():
+    from cyclone.store import to_ui_claim
+    claim = _make_claim("CLM-2")
+    claim.validation = ValidationReport(
+        passed=True, errors=[],
+        warnings=[ValidationIssue(rule="W001", severity="warning", message="soft")],
+    )
+    out = to_ui_claim(claim, batch_id="b1", parsed_at="2026-06-19T12:00:00Z")
+    assert out["status"] == "pending"
+
+
+def test_to_ui_claim_maps_status_denied_when_failed():
+    from cyclone.store import to_ui_claim
+    claim = _make_claim("CLM-3")
+    claim.validation = ValidationReport(
+        passed=False,
+        errors=[ValidationIssue(rule="E001", severity="error", message="hard")],
+        warnings=[],
+    )
+    out = to_ui_claim(claim, batch_id="b1", parsed_at="2026-06-19T12:00:00Z")
+    assert out["status"] == "denied"
+
+
+def test_to_ui_remittance_maps_status_received_for_paid():
+    from cyclone.store import to_ui_remittance
+    cp = ClaimPayment(
+        payer_claim_control_number="PCN-1",
+        status_code="1",
+        status_label="Processed as Primary",
+        total_charge=Decimal("100.00"),
+        total_paid=Decimal("80.00"),
+        patient_responsibility=Decimal("0.00"),
+        claim_filing_indicator="MC",
+        original_claim_id=None,
+        frequency_code=None,
+        facility_type=None,
+        service_payments=[],
+    )
+    out = to_ui_remittance(cp, batch_id="b1", parsed_at="2026-06-19T12:00:00Z")
+    assert out["status"] == "received"
+
+
+def test_to_ui_provider_aggregates_claims():
+    from cyclone.store import to_ui_provider
+    out = to_ui_provider(
+        npi="1234567890", name="Acme Clinic", tax_id="99-9999999",
+        address="1 Main", city="Denver", state="CO", zip="80202", phone="303-555-0100",
+        claim_count=5, outstanding_ar=250.0,
+    )
+    assert out["npi"] == "1234567890"
+    assert out["claimCount"] == 5
+
+
+def test_to_activity_event_uses_iso_timestamp():
+    from cyclone.store import to_activity_event
+    out = to_activity_event(
+        id="a1", kind="claim_submitted",
+        message="Claim CLM-1 submitted",
+        timestamp="2026-06-19T12:00:00Z",
+        npi="1234567890", amount=100.0,
+    )
+    assert out["id"] == "a1"
+    assert out["kind"] == "claim_submitted"
+    assert out["amount"] == 100.0