docs(spec): SP24 design + plan for reissue-claims CLI + IG-correctness regression test
Locks in:
- cyclone.reissue subpackage (parse_inputs / emit_outputs /
zip_outputs / ig_correctness_check — pure functions, no Click).
- @main.command('reissue-claims') thin wrapper in cli.py.
- PATIENT_LOOP_DEFAULT_INCLUDED public constant in serialize_837.py
(replaces inspect.signature on the private _build_subscriber_block).
- IG-correctness regression test in test_serialize_837.py pinning the
constant to False.
- deprecation shim at scripts/reissue_claims.py.
- RUNBOOK entry under 'Operator workflows → Reissue claims'.
Workflow coverage: the dzinesco July-8 batches (4 files, 358 claims)
that triggered the 999 '2000C HL must be absent when 2000B SBR02=18'
rejection on 2026-07-08.
This commit is contained in:
Nora
@@ -0,0 +1,489 @@
|
||||
# Reissue Claims CLI + IG-Correctness Regression Test Implementation Plan
|
||||
|
||||
> **For agentic workers:** REQUIRED SUB-SKILL: Use
|
||||
> superpowers:subagent-driven-development (recommended) or
|
||||
> superpowers:executing-plans to implement this plan task-by-task. Steps
|
||||
> use checkbox (`- [ ]`) syntax for tracking.
|
||||
|
||||
**Goal:** Move `scripts/reissue_claims.py` into a `cyclone.reissue` subpackage, expose it as `cyclone reissue-claims`, and lock in the IG-correct serializer default via a regression test.
|
||||
**Architecture:** `cyclone/reissue/core.py` (pure functions, no Click) + a thin `@main.command("reissue-claims")` wrapper in `cli.py`. The IG-correctness default is promoted from `inspect.signature` introspection of `_build_subscriber_block` to a public `PATIENT_LOOP_DEFAULT_INCLUDED` constant in `serialize_837.py`, exposed via `__all__` and read by the guard.
|
||||
**Tech Stack:** Python 3.11, Click 8, pytest, `cyclone.parsers.parse_837` + `cyclone.parsers.serialize_837` + `cyclone.edi.filenames.build_outbound_filename`.
|
||||
**Spec:** [`docs/superpowers/specs/2026-07-08-cyclone-reissue-claims-design.md`](../specs/2026-07-08-cyclone-reissue-claims-design.md)
|
||||
|
||||
---
|
||||
|
||||
## File structure
|
||||
|
||||
```
|
||||
backend/src/cyclone/
|
||||
reissue/ ← new subpackage
|
||||
__init__.py re-exports the public surface
|
||||
core.py parse_inputs / emit_outputs /
|
||||
zip_outputs / ig_correctness_check
|
||||
cli.py ← registers @main.command("reissue-claims")
|
||||
(~50 LOC, calls into cyclone.reissue.core)
|
||||
parsers/serialize_837.py ← adds PATIENT_LOOP_DEFAULT_INCLUDED constant
|
||||
in __all__; _build_subscriber_block reads
|
||||
from it instead of hardcoding `False`
|
||||
|
||||
backend/tests/
|
||||
test_reissue_core.py ← new (pure-unit)
|
||||
test_cli_reissue_claims.py ← new (CliRunner smoke)
|
||||
test_serialize_837.py ← adds test_serialize_837_patient_loop_default_is_false
|
||||
|
||||
scripts/
|
||||
reissue_claims.py ← 1-line deprecation shim; prints WARNING
|
||||
at import time, delegates to cyclone.reissue.core
|
||||
|
||||
docs/
|
||||
RUNBOOK.md ← adds "Operator workflows → Reissue claims"
|
||||
section pointing at `cyclone reissue-claims`
|
||||
|
||||
/tmp/refactor-cyclone.md ← progress tracker (already created)
|
||||
```
|
||||
|
||||
## Task 0: branch + worktree
|
||||
|
||||
- [ ] Branch `sp24-reissue-claims` from `main` (no worktree — the user is
|
||||
already in the main checkout; the branch is local).
|
||||
- [ ] Verify `git log --oneline main -1` shows
|
||||
`ea68ae8 feat(sp41): add CYCLONE_EDIFABRIC_DISABLED=1 bypass hook`.
|
||||
- [ ] First commit on the branch: `docs(spec): design for reissue-claims CLI
|
||||
+ IG-correctness regression test (Step 0)` (commits the spec file).
|
||||
|
||||
## Task 1: promote `PATIENT_LOOP_DEFAULT_INCLUDED` to a public constant
|
||||
|
||||
- [ ] In `backend/src/cyclone/parsers/serialize_837.py`, add the constant
|
||||
after the imports (around line 65):
|
||||
|
||||
```python
|
||||
#: Default value for ``_build_subscriber_block(include_patient_loop=...)``.
|
||||
#: Per X12 005010X222A1, the 2000C Patient Hierarchical Level
|
||||
#: (HL*3 → PAT → NM1*QC) is REQUIRED only when Patient != Subscriber
|
||||
#: (i.e. SBR02 != "18"). When SBR02 == "18" (Self), the 2000C loop
|
||||
#: MUST be absent. The serializer's default of False matches the
|
||||
#: CO-Medicaid IHSS workflow and is the IG-correct shape.
|
||||
#:
|
||||
#: The IG-correctness regression test
|
||||
#: ``test_serialize_837_patient_loop_default_is_false`` pins this
|
||||
#: value; flipping it requires an explicit PR-level discussion.
|
||||
PATIENT_LOOP_DEFAULT_INCLUDED: bool = False
|
||||
```
|
||||
|
||||
- [ ] Replace the existing hardcoded `include_patient_loop: bool = False`
|
||||
default on `_build_subscriber_block(...)` with
|
||||
`include_patient_loop: bool = PATIENT_LOOP_DEFAULT_INCLUDED`.
|
||||
- [ ] Add `PATIENT_LOOP_DEFAULT_INCLUDED` to the module's `__all__`
|
||||
tuple (find the existing `__all__` near the top of the file;
|
||||
if missing, create one with the public functions plus the
|
||||
constant).
|
||||
- [ ] **Live-test:** `cd backend && .venv/bin/pytest tests/test_serialize_837.py -v`
|
||||
(56 cases should still pass; the default behavior is unchanged).
|
||||
- [ ] **Autoreview:** no flake, no lint regressions. Run
|
||||
`cd backend && .venv/bin/python -c "from cyclone.parsers.serialize_837 import PATIENT_LOOP_DEFAULT_INCLUDED; print(PATIENT_LOOP_DEFAULT_INCLUDED)"`
|
||||
and confirm it prints `False`.
|
||||
- [ ] Commit: `feat(sp24): expose PATIENT_LOOP_DEFAULT_INCLUDED constant in serialize_837`.
|
||||
|
||||
## Task 2: create `cyclone.reissue` subpackage
|
||||
|
||||
- [ ] Create `backend/src/cyclone/reissue/__init__.py` with re-exports:
|
||||
|
||||
```python
|
||||
"""cyclone.reissue — offline 837P re-emission workflow.
|
||||
|
||||
See :mod:`cyclone.reissue.core` for the public functions.
|
||||
"""
|
||||
from cyclone.reissue.core import (
|
||||
parse_inputs,
|
||||
emit_outputs,
|
||||
zip_outputs,
|
||||
ig_correctness_check,
|
||||
)
|
||||
|
||||
__all__ = [
|
||||
"parse_inputs",
|
||||
"emit_outputs",
|
||||
"zip_outputs",
|
||||
"ig_correctness_check",
|
||||
]
|
||||
```
|
||||
|
||||
- [ ] Create `backend/src/cyclone/reissue/core.py` mirroring the script's
|
||||
logic but as pure functions. The signatures match the script:
|
||||
|
||||
```python
|
||||
def ig_correctness_check(*, logger: logging.Logger | None = None) -> bool:
|
||||
"""Return True if the serializer's IG-correct patient-loop default is in place."""
|
||||
...
|
||||
|
||||
def parse_inputs(input_dir: Path, payer_config) -> tuple[list[ClaimOutput], list[tuple[Path, str]]]:
|
||||
"""Parse every *.x12 / *.txt / *.edi under input_dir. Tolerates per-file failures."""
|
||||
...
|
||||
|
||||
def emit_outputs(
|
||||
claims: list[ClaimOutput],
|
||||
*,
|
||||
payer_config,
|
||||
output_dir: Path,
|
||||
sender_id: str,
|
||||
receiver_id: str,
|
||||
submitter_name: str,
|
||||
submitter_contact_name: str,
|
||||
submitter_contact_email: str,
|
||||
receiver_name: str,
|
||||
) -> list[Path]:
|
||||
"""Emit one X12 file per claim under output_dir using HCPF-spec filenames."""
|
||||
...
|
||||
|
||||
def zip_outputs(files: list[Path], zip_path: Path) -> None:
|
||||
"""Zip the per-claim X12 files into a single flat archive with integrity check."""
|
||||
...
|
||||
```
|
||||
|
||||
Implementation details:
|
||||
- `ig_correctness_check` reads
|
||||
`cyclone.parsers.serialize_837.PATIENT_LOOP_DEFAULT_INCLUDED`;
|
||||
returns True iff it is False. Logs a WARNING (via the optional
|
||||
`logger` argument, or `logging.getLogger(__name__)`) if False
|
||||
is not what the caller expected.
|
||||
- `parse_inputs` skips AppleDouble (`._*`) files, tolerates
|
||||
per-file parse errors (returns them as the second tuple
|
||||
element), and skips claims with hard validation errors.
|
||||
- `emit_outputs` uses `datetime.now(tz=ZoneInfo("America/Denver"))`
|
||||
for the base timestamp + `timedelta(milliseconds=i)` for
|
||||
per-claim uniqueness. Sorts claims by `claim_id`. Writes
|
||||
`_serialize_summary.json` next to the files (caller does this).
|
||||
- `zip_outputs` uses `zipfile.ZIP_DEFLATED` and runs
|
||||
`ZipFile.testzip()` after writing; raises `RuntimeError` if
|
||||
any entry is corrupt.
|
||||
|
||||
- [ ] **Live-test:**
|
||||
`cd backend && .venv/bin/python -c "from cyclone.reissue import parse_inputs, emit_outputs, zip_outputs, ig_correctness_check; print('ok')"`
|
||||
should print `ok`.
|
||||
- [ ] Commit: `feat(sp24): add cyclone.reissue subpackage with pure core functions`.
|
||||
|
||||
## Task 3: write `test_reissue_core.py` (pure-unit)
|
||||
|
||||
- [ ] Create `backend/tests/test_reissue_core.py` with:
|
||||
- `test_ig_correctness_check_returns_true_when_default_is_false`
|
||||
(default state — guard silent).
|
||||
- `test_ig_correctness_check_returns_false_when_default_flipped`
|
||||
(monkeypatches `PATIENT_LOOP_DEFAULT_INCLUDED = True` via
|
||||
`monkeypatch.setattr`; assert False).
|
||||
- `test_parse_inputs_skips_apple_double_metadata`
|
||||
(creates `tmp_path/in/foo.x12` and `tmp_path/in/._foo.x12`;
|
||||
asserts only foo.x12 is parsed).
|
||||
- `test_parse_inputs_tolerates_per_file_failures`
|
||||
(creates one valid + one malformed file; asserts the malformed
|
||||
one is in the errors list and the valid one is in claims).
|
||||
- `test_emit_outputs_writes_hcpf_spec_filenames`
|
||||
(parses a minimal 837P, emits to `tmp_path/out`, asserts the
|
||||
filenames match `tp*-837P-*-1of1.x12`).
|
||||
- `test_emit_outputs_sorts_claims_by_claim_id`
|
||||
(two-claim fixture, asserts the filename suffixes are sorted
|
||||
by claim_id).
|
||||
- `test_zip_outputs_round_trip_integrity`
|
||||
(writes a tiny zip, asserts `ZipFile.testzip()` returns None).
|
||||
|
||||
- [ ] **Live-test:** `cd backend && .venv/bin/pytest tests/test_reissue_core.py -v`
|
||||
(all new cases should pass).
|
||||
- [ ] **Autoreview:** confirm no test relies on network, no test
|
||||
reaches into `docs/prodfiles/`, no test uses wall-clock sleep.
|
||||
- [ ] Commit: `test(sp24): pure-unit tests for cyclone.reissue.core`.
|
||||
|
||||
## Task 4: register `@main.command("reissue-claims")` in cli.py
|
||||
|
||||
- [ ] Append the CLI subcommand to `backend/src/cyclone/cli.py` after
|
||||
the existing `rebill-from-835` block. The Click signature follows
|
||||
§2 Decision 3 of the spec:
|
||||
|
||||
```python
|
||||
@main.command("reissue-claims")
|
||||
@click.option("--input-dir", type=click.Path(exists=True, file_okay=False, path_type=Path), required=True)
|
||||
@click.option("--output-root", type=click.Path(file_okay=False, path_type=Path),
|
||||
default=Path("dev/rebills"), show_default=True)
|
||||
@click.option("--date", default=None, help="YYYY-MM-DD subfolder under output-root (default: today MT).")
|
||||
@click.option("--pipeline", default="initial", show_default=True)
|
||||
@click.option("--payer", default="co_medicaid", show_default=True)
|
||||
@click.option("--sender-id", default="11525703", show_default=True)
|
||||
@click.option("--receiver-id", default="COMEDASSISTPROG", show_default=True)
|
||||
@click.option("--submitter-name", default="Dzinesco", show_default=True)
|
||||
@click.option("--submitter-contact-name", default="Tyler Martinez", show_default=True)
|
||||
@click.option("--submitter-contact-email", default="tyler@dzinesco.com", show_default=True)
|
||||
@click.option("--receiver-name", default="COLORADO MEDICAL ASSISTANCE PROGRAM", show_default=True)
|
||||
@click.option("--zip-output", type=click.Path(file_okay=False, path_type=Path), default=None)
|
||||
@click.option("--no-clean", is_flag=True, default=False,
|
||||
help="Don't wipe prior .x12 outputs in the pipeline subdir before writing.")
|
||||
@click.option("--log-level", default="INFO", show_default=True,
|
||||
type=click.Choice(["DEBUG", "INFO", "WARNING", "ERROR"]))
|
||||
def reissue_claims(
|
||||
input_dir: Path,
|
||||
output_root: Path,
|
||||
date: str | None,
|
||||
pipeline: str,
|
||||
payer: str,
|
||||
sender_id: str,
|
||||
receiver_id: str,
|
||||
submitter_name: str,
|
||||
submitter_contact_name: str,
|
||||
submitter_contact_email: str,
|
||||
receiver_name: str,
|
||||
zip_output: Path | None,
|
||||
no_clean: bool,
|
||||
log_level: str,
|
||||
) -> None:
|
||||
"""Re-parse raw 837P files and emit one IG-correct single-claim X12 per claim (SP24).
|
||||
|
||||
Workflow:
|
||||
1. Parse every *.x12 / *.txt / *.edi under --input-dir.
|
||||
2. Validate each parsed claim; skip hard-error claims.
|
||||
3. Serialize each surviving claim via the IG-correct serializer.
|
||||
4. Write one X12 file per claim under
|
||||
``--output-root/--date/--pipeline/`` using HCPF-spec filenames.
|
||||
5. Optionally zip the output to --zip-output.
|
||||
|
||||
Exit codes: 0 success; 1 IG-correctness guard tripped or unexpected
|
||||
error; 2 parse / validation failure on a file (zero claims survived).
|
||||
"""
|
||||
setup_logging(level=log_level)
|
||||
import logging as _logging
|
||||
from cyclone.reissue import (
|
||||
parse_inputs, emit_outputs, zip_outputs, ig_correctness_check,
|
||||
)
|
||||
from cyclone.parsers.payer import PayerConfig
|
||||
|
||||
log = _logging.getLogger("reissue-claims")
|
||||
if not ig_correctness_check(logger=log):
|
||||
click.echo("REFUSING to run: PATIENT_LOOP_DEFAULT_INCLUDED is True; "
|
||||
"the 2000C patient loop is forbidden when SBR02='18'. "
|
||||
"Restore the IG-correct default (False) in serialize_837.py.",
|
||||
err=True)
|
||||
sys.exit(1)
|
||||
|
||||
payer_factories = {"co_medicaid": PayerConfig.co_medicaid}
|
||||
if payer not in payer_factories:
|
||||
raise click.BadParameter(f"Unknown payer {payer!r}. Choose from: {', '.join(payer_factories)}")
|
||||
payer_config = payer_factories[payer]()
|
||||
|
||||
date_label = date or datetime.now().strftime("%Y-%m-%d")
|
||||
out_dir = output_root / date_label / pipeline
|
||||
if out_dir.exists() and not no_clean:
|
||||
for p in out_dir.glob("tp*.x12"):
|
||||
p.unlink()
|
||||
log.info("cleaned prior .x12 outputs under %s", out_dir)
|
||||
|
||||
log.info("parse: input_dir=%s payer=%s", input_dir, payer)
|
||||
claims, parse_errors = parse_inputs(input_dir, payer_config)
|
||||
log.info("parse: %d claims read, %d file-level errors",
|
||||
len(claims), len(parse_errors))
|
||||
for src, err in parse_errors[:10]:
|
||||
log.warning(" %s: %s", src, err)
|
||||
if parse_errors and not claims:
|
||||
click.echo(f"PARSE FAILED: zero claims survived; first error: {parse_errors[0][1]}", err=True)
|
||||
sys.exit(2)
|
||||
|
||||
log.info("serialize: output_dir=%s", out_dir)
|
||||
written = emit_outputs(
|
||||
claims,
|
||||
payer_config=payer_config,
|
||||
output_dir=out_dir,
|
||||
sender_id=sender_id,
|
||||
receiver_id=receiver_id,
|
||||
submitter_name=submitter_name,
|
||||
submitter_contact_name=submitter_contact_name,
|
||||
submitter_contact_email=submitter_contact_email,
|
||||
receiver_name=receiver_name,
|
||||
)
|
||||
|
||||
import json as _json
|
||||
summary_path = out_dir / "_serialize_summary.json"
|
||||
summary = [
|
||||
{"claim_id": c.claim_id, "output_file": str(p), "byte_size": p.stat().st_size}
|
||||
for c, p in zip(sorted(claims, key=lambda c: c.claim_id), written)
|
||||
]
|
||||
summary_path.write_text(_json.dumps(summary, indent=2), encoding="utf-8")
|
||||
log.info("serialize: %d files, %d bytes, summary=%s",
|
||||
len(written), sum(p.stat().st_size for p in written), summary_path)
|
||||
|
||||
if zip_output:
|
||||
zip_outputs(written, zip_output)
|
||||
log.info("zip: %s (%d bytes)", zip_output, zip_output.stat().st_size)
|
||||
|
||||
click.echo(f"DONE files={len(written)} errors={len(parse_errors)} out={out_dir}")
|
||||
if parse_errors:
|
||||
sys.exit(2)
|
||||
```
|
||||
|
||||
- [ ] **Live-test:**
|
||||
`cd backend && .venv/bin/python -m cyclone.cli reissue-claims --help`
|
||||
should print the help with the long-form flags listed in §2 Decision 3.
|
||||
- [ ] **Live-test end-to-end:**
|
||||
`cd backend && .venv/bin/python -m cyclone.cli reissue-claims \
|
||||
--input-dir /home/tyler/dev/cyclone/july8billing \
|
||||
--date 2026-07-08 \
|
||||
--output-root /tmp/sp24-smoke \
|
||||
--zip-output /tmp/sp24-smoke.zip`
|
||||
should produce `/tmp/sp24-smoke/2026-07-08/initial/` with 358 files
|
||||
and `/tmp/sp24-smoke.zip` with 358 entries.
|
||||
- [ ] **Autoreview:** confirm the help text is readable, exit codes
|
||||
behave per the spec, and no click.UsageError leaks a
|
||||
CycloneParseError stack trace.
|
||||
- [ ] Commit: `feat(sp24): register cyclone reissue-claims CLI subcommand`.
|
||||
|
||||
## Task 5: write `test_cli_reissue_claims.py` (CliRunner smoke)
|
||||
|
||||
- [ ] Create `backend/tests/test_cli_reissue_claims.py` with:
|
||||
- `test_reissue_claims_help_renders` — `CliRunner().invoke(main,
|
||||
["reissue-claims", "--help"])` exits 0 and contains
|
||||
`--input-dir`, `--output-root`, `--zip-output`,
|
||||
`--no-clean`.
|
||||
- `test_reissue_claims_happy_path` — writes a minimal 837P fixture
|
||||
to `tmp_path/in`, runs the CLI with `--input-dir tmp_path/in
|
||||
--output-root tmp_path/out --date 2026-07-08`, asserts exit 0
|
||||
and 1+ .x12 file in `tmp_path/out/2026-07-08/initial/`.
|
||||
- `test_reissue_claims_empty_input_exits_2` — empty input dir,
|
||||
asserts exit 2 with "no claims" / "PARSE FAILED" in stderr.
|
||||
- `test_reissue_claims_ig_correctness_guard_fires` —
|
||||
`monkeypatch.setattr("cyclone.parsers.serialize_837.PATIENT_LOOP_DEFAULT_INCLUDED",
|
||||
True, raising=False)`, asserts exit 1 with `REFUSING to run`
|
||||
in captured output. Use `monkeypatch.undo()` via a
|
||||
`with`-block or `addfinalizer` so other tests are unaffected.
|
||||
- `test_reissue_claims_zip_output_round_trip` — happy path + zip,
|
||||
asserts the zip file exists and `ZipFile(path).testzip() is None`.
|
||||
|
||||
- [ ] **Live-test:**
|
||||
`cd backend && .venv/bin/pytest tests/test_cli_reissue_claims.py -v`
|
||||
(all new cases should pass).
|
||||
- [ ] Commit: `test(sp24): CliRunner smoke tests for reissue-claims`.
|
||||
|
||||
## Task 6: write the IG-correctness regression test in `test_serialize_837.py`
|
||||
|
||||
- [ ] Add a new test to `backend/tests/test_serialize_837.py`:
|
||||
|
||||
```python
|
||||
def test_serialize_837_patient_loop_default_is_false():
|
||||
"""SP24: the IG-correct default for include_patient_loop is False.
|
||||
|
||||
Per X12 005010X222A1, the 2000C Patient Hierarchical Level
|
||||
(HL*3 → PAT → NM1*QC) is REQUIRED only when Patient != Subscriber.
|
||||
For SBR02 == "18" (Self-pay, the CO Medicaid IHSS workflow),
|
||||
the 2000C loop MUST be absent. Flipping this default back to
|
||||
True reintroduces the Edifabric 999 "2000C HL must be absent
|
||||
when 2000B SBR02 = '18'" rejection — see the 2026-07-08 audit.
|
||||
"""
|
||||
from cyclone.parsers.serialize_837 import (
|
||||
PATIENT_LOOP_DEFAULT_INCLUDED,
|
||||
_build_subscriber_block,
|
||||
)
|
||||
from cyclone.parsers.models import Subscriber
|
||||
|
||||
assert PATIENT_LOOP_DEFAULT_INCLUDED is False, (
|
||||
f"PATIENT_LOOP_DEFAULT_INCLUDED must be False (got {PATIENT_LOOP_DEFAULT_INCLUDED!r}); "
|
||||
"the IG-correct serializer shape for SBR02='18' claims is 2000C-absent."
|
||||
)
|
||||
|
||||
# Construct a minimal subscriber + payer fixture and call
|
||||
# _build_subscriber_block without the kwarg; verify no HL*3
|
||||
# segment appears in the output.
|
||||
from datetime import date
|
||||
sub = Subscriber(
|
||||
member_id="TEST123",
|
||||
first_name="Test", last_name="Patient",
|
||||
dob=date(1990, 1, 1), gender="F",
|
||||
)
|
||||
out = _build_subscriber_block(sub, "MC")
|
||||
assert not any(seg.startswith("HL*3") for seg in out), (
|
||||
f"HL*3 emitted with the IG-correct default; segments={out}"
|
||||
)
|
||||
```
|
||||
|
||||
- [ ] **Live-test:** `cd backend && .venv/bin/pytest
|
||||
tests/test_serialize_837.py::test_serialize_837_patient_loop_default_is_false -v`
|
||||
passes.
|
||||
- [ ] **Autoreview:** try flipping the constant to `True` locally,
|
||||
re-run the test, confirm it fails with the assertion message;
|
||||
restore the constant.
|
||||
- [ ] Commit: `test(sp24): regression test pinning PATIENT_LOOP_DEFAULT_INCLUDED to False`.
|
||||
|
||||
## Task 7: deprecation shim for `scripts/reissue_claims.py`
|
||||
|
||||
- [ ] Replace `scripts/reissue_claims.py` with a 1-line shim:
|
||||
|
||||
```python
|
||||
"""DEPRECATED shim — use `cyclone reissue-claims` instead.
|
||||
|
||||
See `docs/superpowers/specs/2026-07-08-cyclone-reissue-claims-design.md`
|
||||
for the canonical entry point.
|
||||
"""
|
||||
import warnings
|
||||
warnings.warn(
|
||||
"`scripts/reissue_claims.py` is deprecated; use "
|
||||
"`cyclone reissue-claims` (the Click subcommand in cli.py) "
|
||||
"for the canonical offline reissue workflow. This shim will be "
|
||||
"removed in a follow-up increment.",
|
||||
DeprecationWarning,
|
||||
stacklevel=2,
|
||||
)
|
||||
|
||||
from cyclone.cli import main
|
||||
import sys
|
||||
if __name__ == "__main__":
|
||||
# Strip the script argv prefix so `python scripts/reissue_claims.py --help`
|
||||
# behaves like `cyclone reissue-claims --help`. The Click group
|
||||
# expects the subcommand as argv[1].
|
||||
sys.exit(main())
|
||||
```
|
||||
|
||||
- [ ] **Live-test:**
|
||||
`python scripts/reissue_claims.py --help` prints the canonical
|
||||
Click help for the `cyclone` group (and emits a DeprecationWarning).
|
||||
- [ [ ] Commit: `refactor(sp24): deprecation shim for scripts/reissue_claims.py`.
|
||||
|
||||
## Task 8: `docs/RUNBOOK.md` operator-workflow entry
|
||||
|
||||
- [ ] Add a section under "Operator workflows" pointing at the new
|
||||
CLI subcommand with a worked example:
|
||||
|
||||
```markdown
|
||||
### Reissue claims (SP24)
|
||||
|
||||
The canonical workflow to rebuild a batch of 837P files into
|
||||
single-claim, IG-correct X12 files:
|
||||
|
||||
```bash
|
||||
cd backend && .venv/bin/python -m cyclone.cli reissue-claims \
|
||||
--input-dir <path-to-raw-837ps> \
|
||||
--date 2026-07-08 \
|
||||
--output-root dev/rebills \
|
||||
--zip-output xxxclaims.zip
|
||||
```
|
||||
|
||||
Exit codes: 0 = success; 1 = IG-correctness guard tripped or
|
||||
unexpected error; 2 = parse / validation failure on a file.
|
||||
```
|
||||
|
||||
- [ ] Commit: `docs(sp24): RUNBOOK entry for cyclone reissue-claims`.
|
||||
|
||||
## Task 9: autoreview (the merge gate)
|
||||
|
||||
- [ ] `cd backend && .venv/bin/pytest -q` — full backend suite passes.
|
||||
- [ ] `cd backend && .venv/bin/pytest tests/test_serialize_837.py tests/test_reissue_core.py tests/test_cli_reissue_claims.py -v`
|
||||
— all new + adjacent tests pass.
|
||||
- [ ] `cd backend && .venv/bin/python -m cyclone.cli reissue-claims --help`
|
||||
— CLI help renders cleanly.
|
||||
- [ ] End-to-end live-test against `/home/tyler/dev/cyclone/july8billing/`
|
||||
produces 358 files + a valid zip (per acceptance criterion #2 + #3).
|
||||
- [ ] No `git status --short` shows any unexpected untracked files.
|
||||
- [ ] No regressions in the existing `rebill-from-835` or
|
||||
`submit-batch` CLIs (they don't import from `cyclone.reissue`).
|
||||
|
||||
## Task 10: merge to `main`
|
||||
|
||||
- [ ] `git checkout main && git merge --no-ff --no-squash --no-rebase
|
||||
sp24-reissue-claims -m "merge: SP24 reissue-claims CLI + IG-correctness
|
||||
regression test into main"`
|
||||
- [ ] `git log --oneline main -1` shows the merge commit with the
|
||||
expected subject.
|
||||
- [ ] `git push origin main` only after the operator has reviewed
|
||||
and approved the merge (per cyclone-spec — the merge commit is
|
||||
the audit trail; the operator must approve).
|
||||
@@ -0,0 +1,250 @@
|
||||
# Sub-project 24 — Reissue Claims CLI + IG-Correctness Regression Test: Design Spec
|
||||
|
||||
**Date:** 2026-07-08
|
||||
**Status:** Draft, awaiting user sign-off
|
||||
**Branch:** `sp24-reissue-claims`
|
||||
**Aesthetic direction:** No new UI (operator-only CLI; the workflow is the on-call page already documented in `docs/RUNBOOK.md`).
|
||||
|
||||
## 1. Scope
|
||||
|
||||
On 2026-07-08 the operator rebuilt the four dzinesco July-8 837P batches
|
||||
into 358 single-claim, IG-correct X12 files (zipped at `/home/tyler/dev/cyclone/xxxclaims.zip`)
|
||||
using a one-shot script at `scripts/reissue_claims.py`. The script solved
|
||||
an immediate crisis: an Edifabric 999 had rejected the original four
|
||||
multi-claim files because the serializer was unconditionally emitting the
|
||||
Loop 2000C patient hierarchy (`HL*3 → PAT*01 → NM1*QC`) when
|
||||
`SBR02 == "18"` (Self-pay), which is forbidden by X12 005010X222A1.
|
||||
|
||||
The serializer default was fixed in `serialize_837.py` (see commit
|
||||
`ee1a397` on `sp41-inwindow-rebill-pipeline`), but the workflow that
|
||||
proved the fix — parse + per-claim re-serialize + HCPF-spec filename +
|
||||
zip — still lives in a script the rest of the cyclone pipeline doesn't
|
||||
know about. SP24 brings that workflow into the canonical CLI surface as
|
||||
`cyclone reissue-claims`, behind a regression test that locks in the
|
||||
IG-correct serializer default forever so a future code change cannot
|
||||
silently reintroduce the same 999 rejection.
|
||||
|
||||
**In scope:**
|
||||
|
||||
- A new subpackage `backend/src/cyclone/reissue/` containing the pure
|
||||
functions `parse_inputs`, `emit_outputs`, `zip_outputs`, and
|
||||
`ig_correctness_check`. No Click imports inside the core module —
|
||||
it accepts plain Python types so the CLI is a thin wrapper and the
|
||||
functions are unit-testable without `click.testing.CliRunner`.
|
||||
- A new CLI subcommand `cyclone reissue-claims` registered against
|
||||
the existing `@main` Click group in `backend/src/cyclone/cli.py`,
|
||||
following the conventions in `cyclone-cli` (long-form flags,
|
||||
exit codes 0/1/2, `click.echo(..., err=True)` for errors).
|
||||
- A new module-level public constant in `serialize_837.py`:
|
||||
`PATIENT_LOOP_DEFAULT_INCLUDED = False`, exported in the module's
|
||||
`__all__`. The default is read by the IG-correctness guard instead
|
||||
of `inspect.signature`-ing a private helper, so a future rename of
|
||||
`_build_subscriber_block` cannot silently break the guard.
|
||||
- A regression test
|
||||
`test_serialize_837_patient_loop_default_is_false` in
|
||||
`backend/tests/test_serialize_837.py` that asserts the constant is
|
||||
`False` and that calling `_build_subscriber_block` with no
|
||||
`include_patient_loop` kwarg emits `HL*2 child_count=0` (no `HL*3`).
|
||||
- Smoke tests under `backend/tests/test_cli_reissue_claims.py` covering
|
||||
the help screen, an empty-input path, a happy-path re-issue, and
|
||||
the IG-correctness guard firing when the constant is monkeypatched.
|
||||
- Pure-unit tests under `backend/tests/test_reissue_core.py` covering
|
||||
parse_inputs (AppleDouble filter, per-file failure tolerance),
|
||||
emit_outputs (HCPF-spec filenames, unique-per-millisecond, sorted
|
||||
by claim_id), zip_outputs (round-trip integrity check), and
|
||||
ig_correctness_check (fires on mismatch, silent on match).
|
||||
- A deprecation shim at `scripts/reissue_claims.py` that re-exports
|
||||
the new CLI subcommand as a thin wrapper with a WARNING printed at
|
||||
import time telling the operator `cyclone reissue-claims` is the
|
||||
canonical entry. The shim is removed in a follow-up increment.
|
||||
- A `docs/RUNBOOK.md` entry under "Operator workflows" pointing at
|
||||
the new CLI subcommand with a worked example against the dzinesco
|
||||
July-8 billing layout.
|
||||
|
||||
**Out of scope:**
|
||||
|
||||
- New UI exposure for the reissue workflow. The CLI is the operator's
|
||||
on-call surface today; a dashboard widget is a future increment.
|
||||
- A bulk-ingest pipeline for the reissue path. The operator's flow is
|
||||
point-in-time ("rebuild yesterday's 358 files from this batch"),
|
||||
not a streaming one. `cyclone bulk-ingest` already handles the
|
||||
streaming case for inbound files; the outbound reissue path stays
|
||||
explicit.
|
||||
- The SFTP-upload step. `reissue-claims` writes files to a local
|
||||
directory (and optionally zips them). The operator moves the
|
||||
resulting zip to Gainwell via their SFTP client per the
|
||||
"Manual SFTP mode" posture documented in `docs/RUNBOOK.md`.
|
||||
- An automatic regeneration of historical files. The four dzinesco
|
||||
July-8 batches are the immediate operator concern; running
|
||||
`reissue-claims` against older batches is a deliberate operator
|
||||
action with the explicit `--input-dir` path.
|
||||
- Edifabric validation. The original script did not gate through
|
||||
Edifabric (the July-8 files were validated by the operator's manual
|
||||
999 audit). A follow-up SP wires the SP41 SP40 Edifabric gate into
|
||||
the reissue path; this increment keeps the surface minimal.
|
||||
|
||||
## 2. Decisions (locked during brainstorming)
|
||||
|
||||
1. **Subpackage layout, not a single `cli.py` block.** The other
|
||||
cross-cutting workflows (`cyclone.rebill`, `cyclone.submission`,
|
||||
`cyclone.bulk_ingest`) follow the `cyclone/<verb>/` layout. Putting
|
||||
the reissue logic inside `cli.py` directly — like
|
||||
`rebill-from-835` does — would make `cli.py` grow past 2,200 LOC
|
||||
(already at 2,054) and force the unit tests to live in the
|
||||
CLI-flavored `test_cli_*.py` file. The subpackage layout keeps the
|
||||
pure functions unit-testable without Click, matches the rest of the
|
||||
codebase, and lets `cli.py` stay a thin registration surface.
|
||||
|
||||
2. **Public `PATIENT_LOOP_DEFAULT_INCLUDED` constant, not
|
||||
`inspect.signature` introspection.** The original script
|
||||
introspected the private `_build_subscriber_block` helper via
|
||||
`inspect.signature`, which is fragile against rename / refactor.
|
||||
Promoting the default to a named public constant in
|
||||
`serialize_837.py` and exporting it in `__all__` gives the guard a
|
||||
stable handle that survives any future refactor of the helper.
|
||||
|
||||
3. **`cyclone reissue-claims` long-form CLI flags.** `--input-dir`,
|
||||
`--output-root`, `--date`, `--pipeline`, `--payer`,
|
||||
`--sender-id`, `--receiver-id`, `--submitter-name`,
|
||||
`--submitter-contact-name`, `--submitter-contact-email`,
|
||||
`--receiver-name`, `--zip-output`, `--no-clean`, `--log-level`.
|
||||
Long-form, not positional, so the destructive surface is
|
||||
self-documenting. Defaults match the dzinesco canonical sender
|
||||
(`11525703`) / receiver (`COMEDASSISTPROG`) so the typical
|
||||
invocation is just `cyclone reissue-claims --input-dir <batch>`.
|
||||
|
||||
4. **IG-correctness guard fires on every CLI invocation.** Not gated
|
||||
behind a `--strict` flag — the constant is part of the canonical
|
||||
contract the spec requires. The guard's only job is to fail loud if
|
||||
the constant flips to `True` in a future refactor; running it on
|
||||
every call is the cheapest possible regression test.
|
||||
|
||||
5. **Exit codes 0 / 1 / 2 mirror the existing CLI conventions.**
|
||||
`0` = success (all files written, zip optional); `1` = IG-correctness
|
||||
guard tripped OR a configuration / unexpected error; `2` =
|
||||
parse / validation failure on a file (per-file failures reported
|
||||
in stdout, but other files continue; only exits 2 if **zero**
|
||||
claims survived).
|
||||
|
||||
6. **Deprecation shim, not deletion.** The original
|
||||
`scripts/reissue_claims.py` stays as a 1-line shim that prints a
|
||||
WARNING at import time and re-exports the new module's `main()`
|
||||
function. The shim is removed in a follow-up increment once the
|
||||
operator's muscle memory has switched over.
|
||||
|
||||
7. **The CLI subcommand does NOT call `cyclone.submission.submit_file`.**
|
||||
Reissue is an offline-rebuild workflow; it produces local X12
|
||||
files for the operator to inspect / upload manually. Wiring the
|
||||
SFTP path would conflate "regenerate clean files" with
|
||||
"submit them to Gainwell", and the operator wants the inspection
|
||||
step in between.
|
||||
|
||||
8. **HCPF-spec filename unchanged.** The canonical
|
||||
`cyclone.edi.filenames.build_outbound_filename(sender_id, "837P")`
|
||||
produces the file names already in use (`tp11525703-837P-...-1of1.x12`);
|
||||
no change to the filename format. Per-claim 1 ms timestamp offsets
|
||||
(via `datetime.now(tz=ZoneInfo("America/Denver"))` + per-claim
|
||||
`timedelta(milliseconds=i)`) guarantee uniqueness within a batch.
|
||||
|
||||
## 3. Threat model
|
||||
|
||||
This increment does not change the auth boundary or the network posture.
|
||||
The threat model is unchanged from SP24 (this spec): the auth boundary
|
||||
is HTTP (login required, bcrypt + HttpOnly session cookie); the
|
||||
file-system threat is local-only and handled by SQLCipher at rest and
|
||||
the macOS Keychain. The CLI subcommand runs against the operator's
|
||||
local environment only — there is no HTTP surface, no auth gate, no
|
||||
network call. The IG-correctness guard is a static check against the
|
||||
serializer's documented default; it does not change the security
|
||||
posture.
|
||||
|
||||
The regression test in `test_serialize_837.py` is structural: it pins
|
||||
a constant to a specific value. If a future refactor flips the constant
|
||||
back to `True` (the broken pattern), the test fails, the CLI guard
|
||||
fires, and the operator sees a clear `REFUSING to run` log line before
|
||||
any X12 byte is emitted.
|
||||
|
||||
## 4. Test impact
|
||||
|
||||
Following the `cyclone-tests` conventions:
|
||||
|
||||
- **Unit tests (pure-unit):**
|
||||
- `backend/tests/test_reissue_core.py` — covers `parse_inputs`
|
||||
(AppleDouble metadata filter, per-file failure tolerance, claim
|
||||
validation error path), `emit_outputs` (HCPF-spec filename
|
||||
format, sorted by `claim_id`, per-claim unique timestamps,
|
||||
directory creation), `zip_outputs` (round-trip integrity via
|
||||
`testzip()`), and `ig_correctness_check` (fires on mismatch,
|
||||
silent on match). Each test uses `tmp_path` + a fixture
|
||||
`*.x12` file containing a minimal valid 837P — no prodfiles
|
||||
dropped into `fixtures/`.
|
||||
- `backend/tests/test_serialize_837.py` — adds
|
||||
`test_serialize_837_patient_loop_default_is_false` asserting
|
||||
that `serialize_837.PATIENT_LOOP_DEFAULT_INCLUDED is False` and
|
||||
that calling `_build_subscriber_block` with no kwargs emits
|
||||
`HL*2` with `child_count = 0` (no `HL*3`). This test is the
|
||||
long-term regression guard; flipping it should require an
|
||||
explicit PR-level discussion.
|
||||
- **Integration tests (CLI smoke):**
|
||||
- `backend/tests/test_cli_reissue_claims.py` — `CliRunner`-based
|
||||
smoke tests for `cyclone reissue-claims`. Covers:
|
||||
- `--help` exits 0 with the expected long-form flags listed.
|
||||
- happy path: a single-file input dir produces the expected
|
||||
number of output files under `tmp_path/out`.
|
||||
- empty input dir: exits 2 with a clear "no claims found" message.
|
||||
- IG-correctness guard: monkeypatches
|
||||
`serialize_837.PATIENT_LOOP_DEFAULT_INCLUDED` to `True`, asserts
|
||||
the CLI exits 1 with the `REFUSING to run` log line in the
|
||||
captured stderr.
|
||||
- **Fixture additions:** none. The CLI smoke test synthesizes a
|
||||
minimal 837P file inline via `parse_837` round-tripping a stub
|
||||
`ClaimOutput`. No prodfiles are dropped into `fixtures/`.
|
||||
- **Frontend tests:** none (no UI in this increment).
|
||||
- **Live-test smoke:** a canonical end-to-end run against
|
||||
`/home/tyler/dev/cyclone/july8billing/` to confirm the CLI produces
|
||||
the same 358 files + zip as the original script. The smoke command
|
||||
is documented at the top of `/tmp/refactor-cyclone.md`.
|
||||
|
||||
## 5. Spec & plan anchors
|
||||
|
||||
- **Spec anchor (this file):**
|
||||
`docs/superpowers/specs/2026-07-08-cyclone-reissue-claims-design.md`
|
||||
- **Plan anchor:** `docs/superpowers/plans/2026-07-08-cyclone-reissue-claims.md`
|
||||
- **Related serializer fix:** commit `ee1a397` on
|
||||
`sp41-inwindow-rebill-pipeline` (already merged to `main`),
|
||||
which flipped the `_build_subscriber_block.include_patient_loop`
|
||||
default from `True` to `False` and updated the docstring.
|
||||
- **Original operator workflow:** `scripts/reissue_claims.py` (the
|
||||
one-shot script this increment supersedes).
|
||||
- **Edifabric 999 that surfaced the bug:** `/tmp/ig_check.log` (the
|
||||
operator's 999 audit reference for the IG rule).
|
||||
|
||||
## 6. Acceptance criteria
|
||||
|
||||
1. `cyclone reissue-claims --help` exits 0 and lists the long-form
|
||||
flags listed in §2 Decision 3.
|
||||
2. `cyclone reissue-claims --input-dir /home/tyler/dev/cyclone/july8billing --date 2026-07-08 --output-root /tmp/sp24-acceptance-out`
|
||||
produces exactly 358 `.x12` files under
|
||||
`/tmp/sp24-acceptance-out/2026-07-08/initial/`, plus a
|
||||
`_serialize_summary.json` sidecar with one row per file.
|
||||
3. `cyclone reissue-claims --input-dir ... --zip-output /tmp/sp24-acceptance.zip`
|
||||
produces a zip whose `testzip()` returns `None` (integrity OK)
|
||||
and which contains exactly 358 entries.
|
||||
4. The IG-correctness guard exits 1 with the `REFUSING to run` log
|
||||
line when the constant is monkeypatched to `True`. Verified by the
|
||||
`test_cli_reissue_claims.py` smoke test.
|
||||
5. `pytest backend/tests/test_reissue_core.py -v` exits 0 with all
|
||||
cases passing.
|
||||
6. `pytest backend/tests/test_cli_reissue_claims.py -v` exits 0 with
|
||||
all cases passing.
|
||||
7. `pytest backend/tests/test_serialize_837.py -v` exits 0 with the
|
||||
new `test_serialize_837_patient_loop_default_is_false` case
|
||||
passing alongside the existing 56 cases.
|
||||
8. `pytest` (full backend suite) exits 0; no regressions.
|
||||
9. The CLI runs without requiring a Keychain entry or DB connection —
|
||||
`reissue-claims` is a pure parser + serializer + filesystem
|
||||
workflow. This matches the original script's posture.
|
||||
10. After the merge to `main`, `scripts/reissue_claims.py` is a
|
||||
1-line shim that prints a WARNING at import time telling the
|
||||
operator `cyclone reissue-claims` is the canonical entry. The
|
||||
shim does NOT duplicate the argparse surface.
|
||||
Reference in New Issue
Block a user