feat(sp7): inbox lanes matched_remittance includes matched/total line counts

2026-06-20 19:43:43 -06:00
parent 6ef59b5d1d
commit b7bda0662f
2 changed files with 234 additions and 8 deletions
@@ -0,0 +1,144 @@
+"""SP7 — inbox lanes expose matched_remittance line counts.
+
+For each claim row in the rejected / done_today lanes that has a
+matched remittance, the row must include a ``matched_remittance`` block
+with ``id``, ``matched_lines``, and ``total_lines``. These power the
+``MatchedRemitCard`` badge in T17.
+
+Architecture note: 837 service lines live in ``Claim.raw_json``, so
+``total_lines`` is read from the JSON blob.
+"""
+from datetime import date, datetime, timezone
+from decimal import Decimal
+import uuid
+
+import pytest
+from fastapi.testclient import TestClient
+
+from cyclone import db
+from cyclone.api import app
+from cyclone.parsers.models_835 import ClaimPayment, ServicePayment
+from cyclone.reconcile import run as reconcile_run
+from cyclone.store import _persist_835_remit, _remittance_835_row
+
+
+@pytest.fixture(autouse=True)
+def _clear_app_state():
+    yield
+    if hasattr(app.state, "dismissed_pairs"):
+        app.state.dismissed_pairs = set()
+
+
+@pytest.fixture
+def client() -> TestClient:
+    return TestClient(app)
+
+
+def _seed_pair_with_two_lines():
+    """One 837 claim (2 service lines) + one 835 remit (1 svc composite
+    matching line 1). After reconcile: 1 matched, 1 unmatched_837_only.
+    Returns the claim_id (and the remittance_id via matched_remittance).
+    """
+    bid_837 = str(uuid.uuid4())
+    bid_835 = str(uuid.uuid4())
+    claim_id = "CLM-INBOX-1"
+
+    svc_lines_json = [
+        {
+            "line_number": 1,
+            "procedure": {"qualifier": "HC", "code": "99213", "modifiers": []},
+            "charge": "100.00",
+            "unit_type": "UN",
+            "units": "1",
+            "place_of_service": "11",
+            "service_date": "2026-06-01",
+            "provider_reference": None,
+        },
+        {
+            "line_number": 2,
+            "procedure": {"qualifier": "HC", "code": "99214", "modifiers": []},
+            "charge": "100.00",
+            "unit_type": "UN",
+            "units": "1",
+            "place_of_service": "11",
+            "service_date": "2026-06-01",
+            "provider_reference": None,
+        },
+    ]
+
+    with db.SessionLocal()() as s:
+        # 837 batch + claim
+        s.add(db.Batch(
+            id=bid_837, kind="837p", input_filename="x.837",
+            parsed_at=datetime.now(timezone.utc),
+            totals_json={}, validation_json={}, raw_result_json={},
+        ))
+        s.add(db.Claim(
+            id=claim_id,
+            patient_control_number="PCN-INBOX",
+            charge_amount=Decimal("200.00"),
+            provider_npi="1234567890",
+            payer_id="SKCO0",
+            service_date_from=date(2026, 6, 1),
+            service_date_to=date(2026, 6, 1),
+            state=db.ClaimState.SUBMITTED,
+            batch_id=bid_837,
+            raw_json={"service_lines": svc_lines_json},
+        ))
+        # 835 batch + remit
+        s.add(db.Batch(
+            id=bid_835, kind="835", input_filename="x.835",
+            parsed_at=datetime.now(timezone.utc),
+            totals_json={}, validation_json={}, raw_result_json={},
+        ))
+        cp = ClaimPayment(
+            payer_claim_control_number="PCN-INBOX",
+            status_code="1",
+            total_charge=Decimal("100.00"),
+            total_paid=Decimal("80.00"),
+            service_payments=[
+                ServicePayment(
+                    line_number=1, procedure_qualifier="HC",
+                    procedure_code="99213",
+                    charge=Decimal("100.00"),
+                    payment=Decimal("80.00"),
+                    units=Decimal("1"),
+                    service_date=date(2026, 6, 1),
+                ),
+            ],
+        )
+        remit = _remittance_835_row(cp, bid_835)
+        s.add(remit)
+        s.flush()
+        _persist_835_remit(s, cp, remit.id)
+        # Force the claim to a terminal state so it lands in done_today.
+        # Run reconcile which auto-matches by PCN + sets state to PAID.
+        reconcile_run(s, bid_835)
+        s.commit()
+
+    return claim_id
+
+
+def test_done_today_lane_includes_matched_remittance_line_counts(client):
+    claim_id = _seed_pair_with_two_lines()
+    # Backfill state_changed_at so the claim lands in the done_today lane
+    # (reconcile.run() doesn't write it; the API surface is exercised by
+    # the existing manual-match flow which sets it).
+    from sqlalchemy.orm import Session
+    with db.SessionLocal()() as s:
+        cl = s.get(db.Claim, claim_id)
+        cl.state_changed_at = datetime.now(timezone.utc)
+        s.commit()
+
+    r = client.get("/api/inbox/lanes")
+    assert r.status_code == 200
+    body = r.json()
+    # The seeded claim should be in done_today (auto-reconciled by run()).
+    ids = [row["id"] for row in body["done_today"]]
+    assert claim_id in ids, f"expected claim in done_today, got ids={ids}"
+    row = next(r for r in body["done_today"] if r["id"] == claim_id)
+    mr = row.get("matched_remittance")
+    assert mr is not None, "expected matched_remittance block on done_today claim row"
+    assert "id" in mr
+    assert mr["total_lines"] == 2  # two 837 service lines
+    assert mr["matched_lines"] == 1  # only line 1 has a matching SVC composite