feat(sp14): 5-lane Inbox UI with Payer-Rejected acknowledge action

Closes the gap between the SP10 backend (5 lanes) and the SP6
frontend (4 lanes). The Payer-Rejected lane (277CA STC A4/A6/A7)
is now rendered alongside Rejected/Candidates/Unmatched/Done,
with an Acknowledge bulk action that drops claims from the
working surface without erasing the original 277CA rejection
event (audit log stays intact, SP11).

Backend:
* Migration 0010: add payer_rejected_acknowledged_at +
  payer_rejected_acknowledged_actor columns + partial index.
* db.py: surface the two new columns on the Claim model.
* inbox_lanes.py: filter acknowledged claims out of the
  payer_rejected lane; expose the new fields on the row payload
  for forward-compat (e.g. a future 'Recently acknowledged' view).
* api.py:
  - POST /api/inbox/payer-rejected/acknowledge
    Bulk-acknowledge. Idempotent. Returns transitioned /
    already_acked / not_found / not_rejected counts so the UI
    can show '3 of 5 were already acknowledged' on a noop bulk.
    Writes a 'claim.payer_rejected_acknowledged' event to the
    SP11 hash-chained audit log.
  - GET /api/inbox/export.csv: accept 'payer_rejected' lane.
* test_acks.py: bump user_version assertion to 10.
* test_lane_filter_acknowledged.py: 4 tests for the lane filter
  and forward-compat row payload.
* test_payer_rejected_acknowledge.py: 6 tests for the endpoint
  (happy path, idempotency, no-op on non-rejected, missing
  ids, 400 on empty, audit-log wiring + chain integrity).

Frontend:
* lib/inbox-api.ts: add payer_rejected to InboxLanes, add
  acknowledgePayerRejected(), update exportInboxCsvUrl union.
* hooks/useInboxLanes.ts: add payer_rejected to initial state.
* hooks/useInboxLanes.test.ts: add payer_rejected to mocks.
* components/inbox/BulkBar.tsx: add 'payer_rejected' lane with
  Acknowledge action (no Resubmit, no Dismiss — payer-rejected
  is not eligible for either).
* components/inbox/BulkBar.test.tsx: add payer_rejected test.
* pages/Inbox.tsx: render the 5th lane, hook up onAcknowledge,
  include payer_rejected in the needEyes count.
* pages/Inbox.test.tsx: 3 new tests (5-lane render, need-eyes
  count, acknowledge action hits the right endpoint).
* components/inbox/InboxHeader.tsx: doc comment now explains
  why payer_rejected rolls up into need-eyes.

Pre-existing typecheck warnings in BulkBar.test.tsx / InboxRow
.test.tsx / Lane.tsx / download.test.ts are unchanged from
main — not touched here.

Test counts: backend 724 -> 734 (+10). Frontend 350 -> 354 (+4).
This commit is contained in:
Tyler
2026-06-21 00:13:47 -06:00
parent fdfbde35c6
commit 5c9365ec33
15 changed files with 704 additions and 18 deletions
+73 -1
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@@ -1105,6 +1105,78 @@ def inbox_dismiss_candidates(body: dict):
return {"ok": True, "dismissed_count": len(pairs)}
# ---------------------------------------------------------------------------
# SP14: Payer-Rejected acknowledge
#
# Operator hits "Acknowledge" on the Payer-Rejected Inbox lane to clear
# the claim from the working surface. We don't delete the rejection
# (the original payer_rejected_* fields stay for SP11 audit), we just
# set payer_rejected_acknowledged_at so the lane query filters it out.
#
# Idempotent: re-acknowledging an already-acknowledged claim is a noop
# (the timestamp is not bumped). Returns the count actually transitioned
# so the UI can show "3 of 5 were already acknowledged".
# ---------------------------------------------------------------------------
@app.post("/api/inbox/payer-rejected/acknowledge")
def inbox_acknowledge_payer_rejected(body: dict):
"""Mark Payer-Rejected claims as acknowledged by the operator."""
claim_ids = body.get("claim_ids") or []
actor = body.get("actor") or "operator"
if not isinstance(claim_ids, list) or not claim_ids:
raise HTTPException(400, "claim_ids must be a non-empty list")
if not all(isinstance(c, str) for c in claim_ids):
raise HTTPException(400, "claim_ids must be a list of strings")
with db.SessionLocal()() as session:
from cyclone.db import Claim
now = datetime.now(timezone.utc)
transitioned = 0
already_acked = 0
not_found = 0
not_rejected = 0
for cid in claim_ids:
claim = session.get(Claim, cid)
if claim is None:
not_found += 1
continue
if claim.payer_rejected_at is None:
not_rejected += 1
continue
if claim.payer_rejected_acknowledged_at is not None:
already_acked += 1
continue
claim.payer_rejected_acknowledged_at = now
claim.payer_rejected_acknowledged_actor = actor
transitioned += 1
# SP11: audit event for the acknowledge action.
try:
from cyclone.audit_log import append_event, AuditEvent
append_event(session, AuditEvent(
event_type="claim.payer_rejected_acknowledged",
entity_type="claim",
entity_id=claim.id,
actor=actor,
payload={
"payer_rejected_status_code": claim.payer_rejected_status_code,
"payer_rejected_by_277ca_id": claim.payer_rejected_by_277ca_id,
},
))
except Exception: # noqa: BLE001
# Audit append is best-effort; don't block the operator's
# acknowledge action on an audit-log failure.
pass
if transitioned:
session.commit()
return {
"ok": True,
"transitioned": transitioned,
"already_acked": already_acked,
"not_found": not_found,
"not_rejected": not_rejected,
}
@app.post("/api/inbox/rejected/resubmit")
def inbox_resubmit_rejected(
request: Request,
@@ -1202,7 +1274,7 @@ def inbox_resubmit_rejected(
@app.get("/api/inbox/export.csv")
def inbox_export_csv(lane: str):
"""Stream a CSV for a single lane."""
if lane not in {"rejected", "candidates", "unmatched", "done_today"}:
if lane not in {"rejected", "candidates", "unmatched", "done_today", "payer_rejected"}:
raise HTTPException(400, f"unknown lane: {lane}")
dismissed_pairs = getattr(app.state, "dismissed_pairs", set())
with db.SessionLocal()() as session:
+10
View File
@@ -239,6 +239,16 @@ class Claim(Base):
payer_rejected_by_277ca_id: Mapped[Optional[str]] = mapped_column(
String(64), nullable=True
)
# SP14: when the operator hits "Acknowledge" on the Payer-Rejected
# lane, we set this timestamp. The lane query filters on it being
# NULL so acknowledged claims drop out of the working surface. The
# original payer_rejected_* fields stay intact for audit (SP11).
payer_rejected_acknowledged_at: Mapped[Optional[datetime]] = mapped_column(
DateTime(timezone=True), nullable=True
)
payer_rejected_acknowledged_actor: Mapped[Optional[str]] = mapped_column(
String(64), nullable=True
)
resubmit_count: Mapped[int] = mapped_column(
Integer, nullable=False, default=0, server_default=text("0")
)
+14 -1
View File
@@ -73,6 +73,12 @@ def _claim_to_row(
"payer_rejected_reason": c.payer_rejected_reason,
"payer_rejected_status_code": c.payer_rejected_status_code,
"payer_rejected_by_277ca_id": c.payer_rejected_by_277ca_id,
# SP14: acknowledgment tracking. Always null on the lane
# (we filter acknowledged claims out) but exposed for
# forward-compat if we later add a "Recently acknowledged"
# inspector view.
"payer_rejected_acknowledged_at": _isoformat(c.payer_rejected_acknowledged_at),
"payer_rejected_acknowledged_actor": c.payer_rejected_acknowledged_actor,
}
@@ -192,8 +198,15 @@ def compute_lanes(session: Session, *, dismissed_pairs: Iterable[frozenset]) ->
# by the payer after we submitted a syntactically-valid file).
# We don't filter by Claim.state here because the claim may still
# be in SUBMITTED state — the payer just hasn't paid it yet.
#
# SP14: filter out claims the operator has already acknowledged.
# The original payer_rejected_* fields stay intact for audit;
# only the working surface (this lane) is filtered.
payer_rejected_claims = (
session.query(Claim).filter(Claim.payer_rejected_at.is_not(None)).all()
session.query(Claim)
.filter(Claim.payer_rejected_at.is_not(None))
.filter(Claim.payer_rejected_acknowledged_at.is_(None))
.all()
)
pr_matched, pr_total = _line_count_lookup(session, payer_rejected_claims)
matched_counts.update(pr_matched)
@@ -0,0 +1,22 @@
-- version: 10
-- SP14: Payer-Rejected lane acknowledge
-- When the operator reviews a payer-rejected claim, they hit the
-- "Acknowledge" bulk action. We mark the claim with the timestamp so
-- the lane query can filter it out (it stays in the DB for audit but
-- doesn't show up in the operator's working surface).
--
-- Why a separate column instead of clearing payer_rejected_at:
-- * Audit trail: SP11's hash-chained audit_log needs the *original*
-- rejection event intact. Clearing the timestamp would erase the
-- evidence of the payer saying "no" — exactly what auditors want
-- to see.
-- * Reconciliation: future SPs that match payer-rejected claims
-- against appeals (e.g. SP17) can still see the original status
-- code and reason.
ALTER TABLE claims ADD COLUMN payer_rejected_acknowledged_at TEXT;
ALTER TABLE claims ADD COLUMN payer_rejected_acknowledged_actor TEXT;
CREATE INDEX idx_claims_payer_rejected_unack
ON claims(payer_rejected_at)
WHERE payer_rejected_acknowledged_at IS NULL;
+5 -5
View File
@@ -51,18 +51,18 @@ def test_migration_0002_creates_acks_table():
def test_migration_latest_idempotent_on_fresh_db():
"""Re-running the migration on the same DB must be a no-op (PRAGMA
user_version already at the latest version — currently 9 after
user_version already at the latest version — currently 10 after
0004-0006 line_reconciliation, 0005 ta1_acks, SP9's 0007
providers/payers/clearhouse, SP10's 0008 payer_rejected, and
SP11's 0009 audit_log)."""
providers/payers/clearhouse, SP10's 0008 payer_rejected,
SP11's 0009 audit_log, and SP14's 0010 payer_rejected_acknowledged)."""
with db.engine().begin() as c:
v1 = c.exec_driver_sql("PRAGMA user_version").scalar() or 0
assert v1 == 9
assert v1 == 10
# A second run should not raise and should not bump the version.
db_migrate.run(db.engine())
with db.engine().begin() as c:
v2 = c.exec_driver_sql("PRAGMA user_version").scalar() or 0
assert v2 == 9
assert v2 == 10
def test_add_ack_persists_row():
@@ -0,0 +1,105 @@
"""SP14 — Lane filter drops acknowledged payer-rejected claims.
The Payer-Rejected Inbox lane must not include claims the operator
has already acknowledged. This is the working-surface UX: acknowledged
claims drop out so the operator only sees new rejections.
"""
from __future__ import annotations
from datetime import datetime, timezone
import pytest
from cyclone import db
from cyclone.db import Batch, Claim, ClaimState
from cyclone.inbox_lanes import compute_lanes
@pytest.fixture(autouse=True)
def _setup(tmp_path, monkeypatch):
monkeypatch.setenv("CYCLONE_DB_URL", f"sqlite:///{tmp_path}/test.db")
db._reset_for_tests()
db.init_db()
def _seed(*, acked: bool = False) -> str:
now = datetime.now(timezone.utc)
cid = "C1"
with db.SessionLocal()() as session:
batch = Batch(
id="b-1", kind="837p",
input_filename="t.x12", parsed_at=now,
)
session.add(batch)
session.flush()
claim = Claim(
id=cid, batch_id=batch.id, patient_control_number=cid,
state=ClaimState.SUBMITTED, charge_amount=100,
payer_rejected_at=now,
payer_rejected_status_code="A7",
payer_rejected_reason="invalid dx",
)
if acked:
claim.payer_rejected_acknowledged_at = now
claim.payer_rejected_acknowledged_actor = "operator"
session.add(claim)
session.commit()
return cid
def test_unacknowledged_claim_appears_in_lane():
_seed(acked=False)
with db.SessionLocal()() as session:
lanes = compute_lanes(session, dismissed_pairs=set())
assert len(lanes.payer_rejected) == 1
assert lanes.payer_rejected[0]["id"] == "C1"
def test_acknowledged_claim_drops_out_of_lane():
_seed(acked=True)
with db.SessionLocal()() as session:
lanes = compute_lanes(session, dismissed_pairs=set())
assert lanes.payer_rejected == []
def test_mix_of_acked_and_unacked():
"""Only the unacknowledged one shows up."""
now = datetime.now(timezone.utc)
with db.SessionLocal()() as session:
batch = Batch(
id="b-1", kind="837p",
input_filename="t.x12", parsed_at=now,
)
session.add(batch)
session.flush()
for i, acked in enumerate([True, False, True, False]):
claim = Claim(
id=f"C{i}", batch_id=batch.id,
patient_control_number=f"PCN-{i}",
state=ClaimState.SUBMITTED, charge_amount=100,
payer_rejected_at=now,
payer_rejected_status_code="A7",
)
if acked:
claim.payer_rejected_acknowledged_at = now
session.add(claim)
session.commit()
with db.SessionLocal()() as session:
lanes = compute_lanes(session, dismissed_pairs=set())
ids = [r["id"] for r in lanes.payer_rejected]
assert sorted(ids) == ["C1", "C3"]
def test_lane_row_carries_ack_fields_for_forward_compat():
"""The row payload still carries the ack fields (all null on the lane)
so future views that want a 'Recently acknowledged' section don't need
a schema change."""
_seed(acked=False)
with db.SessionLocal()() as session:
lanes = compute_lanes(session, dismissed_pairs=set())
row = lanes.payer_rejected[0]
assert "payer_rejected_acknowledged_at" in row
assert row["payer_rejected_acknowledged_at"] is None
assert "payer_rejected_acknowledged_actor" in row
assert row["payer_rejected_acknowledged_actor"] is None
@@ -0,0 +1,168 @@
"""SP14 — Payer-Rejected acknowledge endpoint tests.
The endpoint marks payer-rejected claims as acknowledged so the
working-surface lane query filters them out. The original
payer_rejected_* fields stay intact (SP11 audit).
"""
from __future__ import annotations
import pytest
from cyclone import db
from cyclone.db import Claim, ClaimState
from cyclone.audit_log import verify_chain
@pytest.fixture(autouse=True)
def _setup(tmp_path, monkeypatch):
monkeypatch.setenv("CYCLONE_DB_URL", f"sqlite:///{tmp_path}/test.db")
db._reset_for_tests()
db.init_db()
def _make_claim(claim_id: str, *, payer_rejected: bool = True) -> None:
"""Insert a minimal claim with optional payer_rejected markers."""
from datetime import datetime, timezone
from cyclone.db import Batch
with db.SessionLocal()() as session:
batch = Batch(
id=f"b-{claim_id}",
kind="837p",
input_filename="t.x12",
parsed_at=datetime.now(timezone.utc),
)
session.add(batch)
session.flush()
claim = Claim(
id=claim_id,
batch_id=batch.id,
patient_control_number=claim_id,
state=ClaimState.SUBMITTED,
charge_amount=100,
)
if payer_rejected:
now = datetime.now(timezone.utc)
claim.payer_rejected_at = now
claim.payer_rejected_reason = "invalid diagnosis code"
claim.payer_rejected_status_code = "A7"
session.add(claim)
session.commit()
def test_acknowledge_marks_unacknowledged_claim():
_make_claim("C1", payer_rejected=True)
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"], "actor": "operator"},
)
assert r.status_code == 200, r.text
body = r.json()
assert body["ok"] is True
assert body["transitioned"] == 1
assert body["already_acked"] == 0
assert body["not_found"] == 0
assert body["not_rejected"] == 0
with db.SessionLocal()() as session:
c = session.get(Claim, "C1")
assert c.payer_rejected_acknowledged_at is not None
assert c.payer_rejected_acknowledged_actor == "operator"
# Original fields stay intact for audit.
assert c.payer_rejected_at is not None
assert c.payer_rejected_status_code == "A7"
assert c.payer_rejected_reason == "invalid diagnosis code"
def test_acknowledge_is_idempotent():
_make_claim("C1", payer_rejected=True)
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r1 = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"]},
)
assert r1.json()["transitioned"] == 1
r2 = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"]},
)
assert r2.json()["transitioned"] == 0
assert r2.json()["already_acked"] == 1
def test_acknowledge_skips_non_payer_rejected_claims():
_make_claim("C1", payer_rejected=False)
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"]},
)
assert r.status_code == 200
body = r.json()
assert body["transitioned"] == 0
assert body["not_rejected"] == 1
def test_acknowledge_counts_missing_ids():
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["nope"]},
)
assert r.status_code == 200
body = r.json()
assert body["transitioned"] == 0
assert body["not_found"] == 1
def test_acknowledge_empty_claim_ids_400():
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": []},
)
assert r.status_code == 400
def test_acknowledge_writes_audit_event():
_make_claim("C1", payer_rejected=True)
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"], "actor": "alice"},
)
assert r.status_code == 200
# SP11: the chain is intact and includes the new event.
with db.SessionLocal()() as session:
result = verify_chain(session)
assert result.ok, f"chain broken: {result.reason} at {result.first_bad_id}"
# And the event itself is queryable.
import json as _json
from cyclone.db import AuditLog
with db.SessionLocal()() as session:
events = (
session.query(AuditLog)
.filter(AuditLog.event_type == "claim.payer_rejected_acknowledged")
.all()
)
assert len(events) == 1
e = events[0]
assert e.entity_type == "claim"
assert e.entity_id == "C1"
assert e.actor == "alice"
payload = _json.loads(e.payload_json) if e.payload_json else {}
assert payload["payer_rejected_status_code"] == "A7"