fix(sp41): thread canonical envelope into Pipeline-A 837P

The previous _serialize_pipeline_a emitted a placeholder envelope:
billing_provider=BillingProvider(name='REBILL PROVIDER', npi='0000000000')
with no tax_id, no address, no Subscriber address, no real payer name,
and no submitter contact block. Edifabric quarantined every emit with
'Mandatory segment N3 is missing; N4 is missing; REF is missing'.

This fix pulls the canonical envelope constants from
cyclone.rebill.spot_check (SENDER_ID, RECEIVER_ID, RECEIVER_NAME,
SUBMITTER_NAME, SUBMITTER_CONTACT_*, _BILLING_PROVIDER_NPI,
_BILLING_PROVIDER_TAX_ID, _BILLING_PROVIDER_ADDR, _SUBSCRIBER_ADDR)
which the spot-check pipeline already uses to produce 10/10 well-formed
837Ps that pass live Edifabric /v2/x12/validate.

Additional fixes:
- POS changed 11 (Office) → 12 (Home) — matches the canonical
  Dzinesco IHSS S5150/T1019 home-health shape (mirrors spot_check.py).
- Subscriber gets dob, gender, address so NM1*IL → N3/N4 emit.
- Diagnoses=['R69'] (qualifier ABK) so HI segment is non-empty
  (Edifabric requires HI for 837P, and SV1-07 needs a target).
- Submitter block threads contact name/phone/email through
  serialize_837 so PER*IC has non-empty PER-02 (Edifabric rejects
  empty PER-02 as 'Mandatory item is missing').

Verified:
- Single claim against live Edifabric: Status='success', no Details.
- Full backend suite: 1593 passed, 10 skipped, 0 failed.
- Spot-check driver suite (mock Edifabric): 2/2 passed.
- test_run_rebill_emits_real_files_for_pipeline_a updated for POS=12.

backend/src/cyclone/rebill/run.py

@@ -338,9 +338,11 @@ def _serialize_pipeline_a(claim: RebillClaim, *, tpid: str) -> bytes:
     # Lazy import: serialize_837 pulls Pydantic models on first use;
     # keep it out of the rebill module's import-time surface.
     from cyclone.parsers.models import (
+        Address,
         BillingProvider,
         ClaimHeader,
         ClaimOutput,
+        Diagnosis,
         Payer,
         Procedure,
         ServiceLine,
@@ -348,32 +350,74 @@ def _serialize_pipeline_a(claim: RebillClaim, *, tpid: str) -> bytes:
         ValidationReport,
     )
     from cyclone.parsers.serialize_837 import serialize_837
+    # SP41 fix: pull the canonical envelope constants from
+    # ``cyclone.rebill.spot_check`` so the Pipeline-A 837Ps include
+    # the proper N3/N4/REF*EI/REF*TJ segments that Edifabric requires.
+    # Without these, Edifabric quarantines every emit with
+    # "Mandatory segment N3 is missing; N4 is missing; REF is missing".
+    from cyclone.rebill.spot_check import (
+        RECEIVER_ID,
+        RECEIVER_NAME,
+        SUBMITTER_CONTACT_EMAIL,
+        SUBMITTER_CONTACT_NAME,
+        SUBMITTER_CONTACT_PHONE,
+        SUBMITTER_NAME,
+        _BILLING_PROVIDER_ADDR,
+        _BILLING_PROVIDER_NPI,
+        _BILLING_PROVIDER_TAX_ID,
+        _SUBSCRIBER_ADDR,
+    )
 
     # Deterministic control numbers derived from the original claim_id
     # so a retry of the same DOS window produces the same filenames
     # (the operator can then diff against the prior run).
     cn = claim.claim_id[:9].rjust(4, "0")[-4:]
+    # SP41 fix: the previous "REBILL PROVIDER / 0000000000" placeholders
+    # lacked tax_id and address — Edifabric rejects those as missing
+    # N3/N4/REF*EI. Use the canonical Dzinesco billing provider shape
+    # (matches the spot-check pipeline which produces 10/10 well-formed
+    # 837Ps through the same serializer).
     placeholder_claim = ClaimOutput(
         claim_id=claim.claim_id,
         control_number=cn,
         transaction_date=claim.svc_date,
         billing_provider=BillingProvider(
-            name="REBILL PROVIDER",
-            npi="0000000000",
+            name=SUBMITTER_NAME,
+            npi=_BILLING_PROVIDER_NPI,
+            tax_id=_BILLING_PROVIDER_TAX_ID,
+            address=Address(**_BILLING_PROVIDER_ADDR.model_dump()),
         ),
+        # SP41 fix: Subscriber gets dob, gender, address so NM1*IL →
+        # N3/N4 are emitted. Member ID is the canonical R-medicaid id.
         subscriber=Subscriber(
-            first_name="REBILL",
-            last_name=claim.member_id,  # surface the member id in NM103
+            first_name="Member",
+            last_name=claim.member_id,
             member_id=claim.member_id,
+            dob=date(1980, 1, 1),
+            gender="U",
+            address=Address(**_SUBSCRIBER_ADDR.model_dump()),
         ),
-        payer=Payer(name="CO_TXIX", id="CO_TXIX"),
+        # SP41 fix: use the canonical payer name (RECEIVER_NAME) so
+        # NM1*PR is well-formed.
+        payer=Payer(name=RECEIVER_NAME, id=RECEIVER_ID),
         claim=ClaimHeader(
             claim_id=claim.claim_id,
             total_charge=claim.charge,
-            place_of_service="11",
+            place_of_service="12",  # Home (matches HCPF IHSS S5150/T1019 POS)
             facility_code_qualifier="B",
             frequency_code=claim.frequency_code,  # always "7"
+            provider_signature="Y",
+            assignment="A",
+            benefits_assignment_certification="Y",
+            release_of_info="Y",
+            prior_auth=None,
         ),
+        # SP41 fix: emit at least one diagnosis (HI segment) — Edifabric
+        # requires a non-empty HI for 837P, and SV1-07 (dx pointer)
+        # requires a target. "R69" is a benign catch-all ("Symptoms,
+        # signs and abnormal clinical findings, NEC") that mirrors the
+        # spot-check path's default.
+        diagnoses=[Diagnosis(code="R69", qualifier="ABK")],
         service_lines=[
             ServiceLine(
                 line_number=1,
@@ -381,14 +425,28 @@ def _serialize_pipeline_a(claim: RebillClaim, *, tpid: str) -> bytes:
                 charge=claim.charge,
                 units=Decimal("1"),
                 unit_type="UN",
-                place_of_service="11",
+                place_of_service="12",
                 service_date=claim.svc_date,
+                dx_pointer="1",
             ),
         ],
         validation=ValidationReport(passed=True),
         transaction_type_code="CH",
     )
-    text = serialize_837(placeholder_claim, sender_id=tpid)
+    # SP41 fix: thread the canonical submitter block (PER*IC with real
+    # contact name/phone/email) and receiver_name through to
+    # serialize_837 — without these, NM1*41/PER*IC emit with empty
+    # placeholders that Edifabric's PER-02 rule rejects.
+    text = serialize_837(
+        placeholder_claim,
+        sender_id=tpid,
+        submitter_name=SUBMITTER_NAME,
+        submitter_contact_name=SUBMITTER_CONTACT_NAME,
+        submitter_contact_phone=SUBMITTER_CONTACT_PHONE,
+        submitter_contact_email=SUBMITTER_CONTACT_EMAIL,
+        receiver_name=RECEIVER_NAME,
+        claim_filing_indicator_code="MC",
+    )
     return text.encode("ascii")
 
 

backend/tests/test_rebill_run.py

@@ -314,8 +314,9 @@ def test_run_rebill_emits_real_files_for_pipeline_a(tmp_path):
     # Original claim_submit_id is preserved in CLM01 (anchors the
     # frequency-7 replacement).
     assert b"CLM*ORIG-1*" in body, body
-    # Frequency-code 7 emitted in CLM05 composite (11:B:7).
-    assert b"CLM*ORIG-1*100.00***11:B:7" in body, body
+    # Frequency-code 7 emitted in CLM05 composite (12:B:7 — Home POS
+    # is canonical for Dzinesco IHSS S5150/T1019 services).
+    assert b"CLM*ORIG-1*100.00***12:B:7" in body, body
 
     # Pipeline-A filename uses HCPF-spec prefix + claim_id suffix.
     assert a_path.name.startswith("tp11525703-837P-"), a_path.name