**The bug.** The 837P X12 005010X222A1 IG requires the Payer Name
loop (2010BB / NM1*PR) to live INSIDE 2000B, AFTER the subscriber's
DMG and BEFORE 2000C (HL*3, the patient loop). The previous
serializer emitted NM1*PR AFTER the patient loop, which pyX12 caught
as 'Mandatory loop 2010BB missing' on round-trip. The 10/10 spot-check
files were therefore structurally invalid per the IG even though they
round-tripped through our own parser (which silently swallowed the
misplaced NM1*PR).
**The fix.**
1. Move 2010BB into 2000B in `_build_subscriber_block` so the order
is now: HL*2 → SBR → NM1*IL → N3 → N4 → DMG → NM1*PR → HL*3
→ PAT → NM1*QC → N3 → N4 → DMG → CLM.
2. Add `_consume_patient_loop` to `parse_837.py` so the 2000B
subscriber iteration skips past the 2000C patient loop and
finds loop 2300 (CLM) — the parser was previously relying on
the (invalid) old ordering.
3. Strip NM108/NM109 from NM1*QC (the IG marks these as 'Not Used')
via the QC branch of `_build_nm1`.
4. Add PAT*01 segment (PAT is required whenever 2000C is emitted).
5. Add `include_patient_loop` flag so callers can opt out (e.g.
Patient==Subscriber cases that don't need a 2000C loop at all).
6. Bump HL*2 child count to 1 when 2000C is emitted (was 0 or 1
inconsistently).
**Visits table (gap #3).** Migration 0023 adds a `visits` table
holding the AxisCare visits export rows. The previous spot-check
driver read the CSV in-memory; persisting the roster makes the
source-of-truth reviewable via SQL. `cyclone.rebill.visits_store`
provides `load_visits_csv` (with UNIQUE-key dedup) and
`query_visits` (filterable read-back). 8 new unit tests pin the
contract.
**Misc.**
- guard `s.svc_date is not None` in `reconcile.run` against 835
rows that lack DTP*472.
- `.gitignore`: dev/rebills/ (the 355k generated 837P files from
pipeline-A runs) so they no longer pollute 'git status'.
- Bump migration-head assertions in test_db_migrate / test_acks /
test_migration_0020 from 22 → 23.
**Verification (post-fix).**
- 1568/1568 unit tests pass (10s)
- 20/20 spot-check files pass pyX12 v4.0.0 (BSD-licensed local X12
validator; the Edifabric live API is still quota-blocked)
- 10/10 batch-1 + 10/10 batch-2 files have all required segment
classes (NM1*41, NM1*40, NM1*QC, NM1*IL, CLM*, SV1*HC:, DTP*472)
- spot-check.json + spot-check-summary.txt refreshed from
pyX12 (was 10/10 stale 403 errors; now 20/20 PASS)
Refs: SP41 inwindow-rebill-pipeline, plan step 3 (10 well-formed 837P
files with NM1*QC patient/subscriber loop) + plan step 4 (Edifabric /
v2/x12/validate).
Migration 0020 adds the column additively (nullable, no default) and
backfills from raw_result_json.envelope.transaction_set_control_number
for any existing batch rows that already carry it. Required for the
SP37 join-key update so 999 acks can resolve by ST02 (the source 837's
transaction set control number) instead of just ISA13.
The persistence layer for the SP28 join table lands in
cyclone/store/claim_acks.py:
- add_claim_ack — insert + publish 'claim_ack_written' on the bus
(mirrors the publish-from-store pattern used by the ACKs paths)
- list_acks_for_claim / list_claims_for_ack — read helpers for the
two list endpoints
- find_ack_orphans — Inbox ack-orphans lane source: every ack row
whose ack_id has no ClaimAck row tied to it
- remove_claim_ack — unlink + publish 'claim_ack_dropped'
- batch_envelope_index — D10 in-memory map of
{envelope.control_number: batch.id}, called once per ingest (cost
is ~16 lookups today; trivially cheap)
Plus the to_ui_claim_ack serializer in store/ui.py mirroring
to_ui_ack shape — single source of truth for the wire format so the
live-tail event payload matches the list endpoint byte-for-byte.
Includes a single SELECT against claims for the claim_state field
(TA1 batch-level rows return 'n/a').
The CycloneStore facade in store/__init__.py re-exports all six
methods (add_claim_ack, list_acks_for_claim, list_claims_for_ack,
find_ack_orphans, remove_claim_ack, batch_envelope_index) plus
to_ui_claim_ack from the ui module.
Migration-version assertions in test_acks.py and test_db_migrate.py
bumped 17 → 18 to match the new migration head.
Steps 3.1/3.2/3.3/3.4 of the SP28 implementation plan.
The 837 ingest path (_claim_837_row in store.py:194) populated
Claim.patient_control_number from claim.subscriber.member_id — the
subscriber's 2010BA NM109 Medicaid ID — instead of from
claim.claim_id (CLM01, the claim submitter's identifier the 837
actually sent).
That silently broke every downstream join that uses this column as a
cross-reference key:
* reconcile.match() (reconcile.py:74) — joins
Claim.patient_control_number against
Remittance.payer_claim_control_number (which is parsed from CLP01,
the 835's echo of CLM01 per X12 spec). Member_id never matches
CLP01, so auto-match always fails.
* apply_999_rejections — same lookup, same broken key.
* apply_277ca_rejections — same lookup, same broken key.
* scoring.score_pair — same broken key.
Live DB probe (1,739 remits, 337 claims):
* Claim.id == Remit.payer_claim_control_number → 0 matches
* Claim.patient_control_number == Remit.payer_claim_control_number
→ 9 matches (substring coincidences; synthetic PCN strings share
alphanumeric characters with the human-readable member_ids)
* Claim.matched_remittance_id NOT NULL → 0 claims
This commit changes _claim_837_row to write
Claim.patient_control_number = claim.claim_id (= CLM01). The
reconcile matcher's existing join now hits the row the 835 echoes
back. Companion migration 0017 backfills the 337 pre-fix rows so
they're on equal footing with new ingests (UPDATE claims SET
patient_control_number = id WHERE patient_control_number IS DISTINCT
FROM id — idempotent).
Tests:
* 2 new RED→GREEN tests in test_store_reconcile.py:
- test_837_ingest_populates_patient_control_number_from_claim_id
pins the field semantics directly
- test_837_then_835_with_echoed_pcn_auto_pairs proves the full
end-to-end auto-match now fires
* 3 existing manual_match tests that relied on the bug (had setup
using member_id != claim_id to deliberately prevent auto-match)
updated to use distinct PCNs explicitly so the tests still
exercise the manual-match path with a real orphan pair.
* 3 store_claim_detail / api_gets tests adjusted for the same
reason.
Verified: 1,176 / 1,177 backend tests pass; the one failure is the
pre-existing flake in test_provider_extended_response.py noted before
this work started.
Caveat for the existing dev DB: the 1,739 remits already in the DB
were ingested from 835 fixtures whose CLP01 is a different synthetic
identifier than the 837's CLM01 (the test fixtures never echoed
CLM01 — a fixture-data limitation, not a code bug). After this fix,
new 837+835 ingest pairs whose payer echoes CLM01 in CLP01 will
auto-match as expected. The pre-existing 1,739 remits will continue
to land in the unmatched bucket; that can only be fixed by
regenerating the test fixtures (out of scope for this SP).
Add check_matched_pair_drift() at module level in store.py — read-only
audit of the Claim.matched_remittance_id ↔ Remittance.claim_id FK pair.
Logs WARNING on drift with up to 5 examples of each of two cases
(claim-side and remit-side), returns the count of drifted rows. Wired
into api.py::lifespan right after db.init_db() and ensure_clearhouse_seeded(),
wrapped in try/except so a query failure logs but doesn't crash boot.
The symmetric-write + symmetric-clear invariants on
manual_match / manual_unmatch were already correct; this commit pins
them with focused regression tests in test_store_match_invariant.py
(8 tests covering both directions, both happy-path, rollback pin, and
drift-check unit behavior). PCN asymmetry in the fixture prevents the
auto-match inside CycloneStore.add (Task 10) from pre-pairing, so
manual_match is the only writer.
Migration 0016 adds the missing ix_claims_matched_remittance_id index —
the drift check scans WHERE matched_remittance_id IS NOT NULL on every
boot and would become a full-table scan past ~10k claims. Symmetric
with ix_remittances_claim_id (added in 0007). Migration tests bumped
from head=15 to head=16.
- test_migration_latest_idempotent_on_fresh_db now uses the pytest
tmp_path fixture instead of a literal /tmp path that did not exist,
so sqlite can create the test DB.
- test_drop_claims_unique_constraint_migration now inserts the NOT
NULL batches.kind / input_filename / parsed_at columns when seeding
the parent row for the two same-PCN claims.
Adds migration 0015_drop_claims_unique_constraint.sql that recreates the
claims table without the inline UNIQUE(batch_id, patient_control_number)
constraint, plus tests proving the migration runs cleanly and the
constraint is not re-introduced.