Commit Graph

101 Commits

Author SHA1 Message Date
Tyler d033ce85db feat(sp7): wire _reconcile_pair into manual_match (T21)
manual_match previously only flipped the claim↔remit FK and the
claim state — it never ran line-level reconciliation, so manually-
paired claims surfaced empty line-reconciliation rows to the UI
and skipped CLP-level CAS aggregate recompute.

Refactor reconcile.run() to call a new per-pair helper
_reconcile_pair(session, claim, remittance) that:
  - clears any existing LineReconciliation rows for the claim
    (idempotent re-run; safe across manual_unmatch + manual_rematch
    cycles that may pair the claim with a different remittance),
  - reads 837 SV1 lines from Claim.raw_json and 835 SVC rows from
    ServiceLinePayment,
  - runs match_service_lines() and persists a LineReconciliation row
    per side,
  - recomputes Remittance.claim_level_adjustment_amount (CLP-level
    CAS) and Remittance.adjustment_amount (total CAS).

manual_match now calls this helper after the FK is set and before
commit, mirroring the auto-match path. Reversals are skipped (they
don't have SV1↔SVC line pairs; per §7.3).

Tests (test_store_reconcile.py):
  - test_manual_match_populates_line_reconciliation_rows: end-to-end
    check that a manual pair writes the expected matched +
    unmatched_837_only rows plus zero CAS aggregates.
  - test_manual_match_idempotent_line_reconciliation: after
    manual_unmatch + manual_rematch + inserting a CLP-level CAS row
    directly, the claim has exactly two fresh LineReconciliation rows
    (no duplicates) and the remittance aggregate reflects the new CAS.

Smoke tested end-to-end via TestClient: parse co_medicaid_837p.txt
+ co_medicaid_835.txt, auto-matcher skips (PCNs differ), manual
match via POST /api/reconciliation/match, then
GET /api/claims/{id}/line-reconciliation returns 2 rows and
GET /api/inbox/lanes shows matched_remittance.total_lines=2.

Note: matched_lines may be 0 on real 835 fixtures due to a
pre-existing parser bug in _consume_service_payment that swaps
SVC04 (units) and SVC05 (unit-of-measure) when reading units from
the segment. The SP7 strict-match criterion requires units parity,
so the misread produces None on the SVC side and strict-match
never succeeds. Surfaced as a follow-up; the SP7 work itself is
correct (line counts are computed and persisted).
2026-06-20 20:13:16 -06:00
Tyler b7bda0662f feat(sp7): inbox lanes matched_remittance includes matched/total line counts 2026-06-20 19:43:43 -06:00
Tyler 6ef59b5d1d feat(sp7): remit detail includes serviceLinePayments + claimLevelAdjustments 2026-06-20 19:39:45 -06:00
Tyler 217f14a52a feat(sp7): claim detail includes lineReconciliation slim projection 2026-06-20 19:37:38 -06:00
Tyler 48d4739864 feat(sp7): GET /api/claims/{id}/line-reconciliation endpoint 2026-06-20 19:35:17 -06:00
Tyler c1323c44d0 feat(sp7): wire match_service_lines into reconcile.run 2026-06-20 19:33:02 -06:00
Tyler 9626eae5f1 feat(sp7): match_service_lines() pure function + tests 2026-06-20 19:29:21 -06:00
Tyler 8442bf91ce feat(sp7): persist ServiceLinePayment + link CAS rows on 835 ingest 2026-06-20 19:27:24 -06:00
Tyler 0dd6d39424 test(sp7): update migration version assertion to 6 (SP7 + TA1 WIP) 2026-06-20 19:25:26 -06:00
Tyler e8b452d255 feat(sp7): migration 0006 — service_line_payments + line_reconciliations + FKs
Migration renumbered from 0005 to 0006 because 0005_create_ta1_acks.sql
(another agent's WIP, unmerged) already claims version 5. Bumping our
migration to version 6 avoids stepping on it; user_version will land
at 6 once both migrations run.
2026-06-20 19:23:14 -06:00
Tyler 1feeff94b9 feat(sp7): LineReconciliation ORM model 2026-06-20 19:19:56 -06:00
Tyler 4c7b82f05b feat(sp7): ServiceLinePayment ORM model 2026-06-20 19:19:48 -06:00
Tyler e4743e41b1 feat(sp7): migration 0005 — service_line_payments + line_reconciliations + FKs 2026-06-20 19:19:34 -06:00
Tyler 76278ec9f6 feat(ta1): TA1 interchange ACK parser, persistence, and API
Adds full TA1 (Interchange Acknowledgment, X12 envelope-level) support
to mirror the existing 999 transaction-set ACK pipeline.

Parser & models
- parsers/models_ta1.py: Pydantic Ta1Ack + ParseResultTa1 models
  (AckCode = Literal['A','E','R'], date serializer mirroring 999)
- parsers/parse_ta1.py: TA1 segment parser
  - Tolerant YYMMDD (6-digit) + CCYYMMDD (8-digit) date handling
    for CO Medicaid interchange_date / ack_generated_date
  - 106-char ISA validation (15-char sender/receiver IDs)
  - source_batch_id = 'TA1-<ISA13>'

Persistence
- migrations/0005_create_ta1_acks.sql: ta1_acks table + indexes
  on source_batch_id and ack_code
- db.py: Ta1Ack ORM model (flat columns + raw_json, mirrors Ack)
- store.py: add_ta1_ack, list_ta1_acks (returns all rows),
  get_ta1_ack
- db version bumped 4 -> 5 (test_acks.py updated)

API (api.py)
- POST /api/parse-ta1: text/file ingest, persists ta1_ack,
  returns detail-ready payload
- GET /api/ta1-acks: list with limit + total (mirrors 999 pattern)
- GET /api/ta1-acks/{ack_id}: detail
- _ta1_to_ui / _serialize_ta1 / _serialize_ta1_from_row helpers

Tests (17 new, 508 total passing)
- tests/test_parse_ta1.py (8): CCYYMMDD + YYMMDD acceptance,
  E/R codes, source_batch_id, missing ISA/TA1, short defaults
- tests/test_api_ta1.py (9): happy path, rejected persists,
  empty/malformed 400, missing file 422, detail regenerates
  segment, 404, empty list, newest-first
- tests/test_prodfiles_smoke.py: extended to smoke-test 352
  production TA1 files (A=0, R=352, E=0)
- tests/test_api_parse_persists.py: cross-pipeline reconciliation
  test asserting invariants across 837P + 835 prod files

Real-data finding: all 352 production TA1s are R (rejected);
operator follow-up warranted.
2026-06-20 18:58:56 -06:00
Tyler f4baceb574 feat(sp6): inbox endpoints — lanes, match, dismiss, resubmit, csv export
T7-T10 combined (single edit: all endpoints share a section).

- GET /api/inbox/lanes — four lanes in one call
- POST /api/inbox/candidates/{remit_id}/match — 409 on conflict
- POST /api/inbox/candidates/dismiss — session-scoped dismissed set
- POST /api/inbox/rejected/resubmit — 200 with conflicts list
- GET /api/inbox/export.csv?lane=<lane> — streams CSV

Also adds module-level imports (db, Claim, ClaimState, Remittance,
csv, io, datetime) that the new endpoints need; cleans up the
duplicated local imports in the parse-999 SP6 T4 block.
2026-06-20 18:34:09 -06:00
Tyler cdffb3faf3 feat(sp6): compute_lanes — 4 lanes on read with scoring 2026-06-20 18:31:01 -06:00
Tyler 3432c76561 feat(sp6): 4-field weighted scoring module 2026-06-20 18:30:05 -06:00
Tyler f4910fd94d feat(sp6): wire 999 ingest → claim rejected state
T4 — calls apply_999_rejections inside /api/parse-999, then
publishes a claim.rejected event for each transitioned claim so
the Inbox live-tail refetches.
2026-06-20 18:29:28 -06:00
Tyler 78ed75a31d feat(sp6): apply_999_rejections state helper
T3 — moves claims to ClaimState.REJECTED on 999 AK5 R/E/X.

- New module: src/cyclone/inbox_state.py
- New tests: tests/test_inbox_state.py (4 cases)
- Adds ORM mappings for rejection_reason / rejected_at / resubmit_count
  / state_changed_at on Claim (db.py) — these were added to the
  schema by migration 0004 but not yet exposed to the ORM.
2026-06-20 18:25:25 -06:00
Tyler 1b1534d8d2 feat(sp6): migration 0004 — rejection columns + state-history index
Adds:
- claims.rejection_reason, claims.rejected_at, claims.resubmit_count
- claims.state_changed_at (was missing, needed for Done-today lane)
- ix_claims_state_changed_at composite index

Also fixes the ClaimState count assertion in test_db_models.py
(7 → 8) to match the REJECTED enum value added in the previous
commit, and bumps the user_version expectation in test_acks.py
(3 → 4) for the same reason.
2026-06-20 18:21:29 -06:00
Tyler 756196e2a8 feat(sp6): add REJECTED to ClaimState enum
T1 of the SP6 workflow automation plan. Paired with the existing test
in test_db_models.py that asserts 8 ClaimState values.
2026-06-20 18:15:38 -06:00
Tyler de09959377 test(835): update prodfile test for PCN dedup behavior
The store dedupes remittances by PCN. Refine the assertions:
- total_clps counts the raw CLP segments across all files (3374)
- unique_pcns counts distinct PCNs (persisted row count)
- Read claimId via the API response shape, not the SQLAlchemy attribute
2026-06-20 18:12:59 -06:00
Tyler b5e27927e0 fix(835): drop over-constraining UNIQUE constraints, add multi-BPR warning
Three related changes for real CO Medicaid data:

1. Drop UNIQUE(batch_id, patient_control_number) on claims and
   UNIQUE(batch_id, payer_claim_control_number) on remittances. The X12
   spec allows multiple CLM segments per 2000B subscriber loop and 835
   ERAs can repeat a payer_claim_control_number for reversals. Claim/
   remittance identity is provided by the primary key (claims.id = CLM01,
   remittances.id = CLP01).

2. Add validator rule R835_MULTI_BPR warning for files with multiple BPR
   segments (CO Medicaid split-payment pattern). The parser already sums
   BPR02 paid_amounts; this surfaces the non-standard data to operators.

3. Skip R835_BAL_BPR_vs_CLP04 when BPR01='I' (Information Only 835).
   In that mode BPR02 is informational and the per-claim CLP04 totals
   are authoritative — a diff is expected, not an error.

Migration 0003 handles the drop with IF EXISTS so fresh DBs skip cleanly.
Updates affected tests to reflect new schema (no UNIQUE constraint on
batch_id + patient_control_number / payer_claim_control_number).

Fixes test_api_835::test_prodfile_round_trip_persists_separately which
was failing on real production data.
2026-06-20 18:10:07 -06:00
Tyler 66da69baa0 build(deps): regenerate uv.lock for SP5 pytest-asyncio
SP5 (commit e8dc8c1) added pytest-asyncio to pyproject.toml but didn't
regenerate uv.lock. This brings the lockfile in sync.
2026-06-20 17:51:13 -06:00
Tyler f4a7cd99b3 merge: ui/batch-diff 2026-06-20 17:30:30 -06:00
Tyler 7b394fff1a feat(batch-diff): side-by-side claim diff between two batches 2026-06-20 17:17:09 -06:00
Tyler da29188dd0 feat(api): GET /api/{claims,remittances,activity}/stream + unsubscribe
Adds three live-tail streaming endpoints that emit an NDJSON snapshot
then forward new event-bus events as they arrive, with a 15s idle
heartbeat (overridable via CYCLONE_TAIL_HEARTBEAT_S for tests).

Each endpoint:
  1. yields a snapshot of existing rows as {"type":"item","data":<row>}
  2. terminates the snapshot with {"type":"snapshot_end","data":{"count":N}}
  3. subscribes to its event kind and forwards each new event as an
     {"type":"item","data":<event>} line
  4. emits a {"type":"heartbeat","data":{"ts":<iso>}} line every
     CYCLONE_TAIL_HEARTBEAT_S seconds when idle
  5. checks request.is_disconnected() before each yield and unsubscribes
     from the bus on cleanup so a closed stream releases its queue

The shared tail loop lives in api._tail_events, which polls
bus.subscribe_raw()'s queue directly instead of using the bus's
async-iterator wrapper — wait_for on an async generator cancels the
inner future on timeout, which poisons subsequent __anext__ calls with
StopAsyncIteration. Queue.get() is idempotent under cancellation, so
heartbeats don't break the subscription.

EventBus gains an unsubscribe(queue, kinds) method (idempotent) so
the tail loop can release its queue in a try/finally. The disconnect
test asserts the subscriber list is empty after the body iterator is
closed, validating no queue leak per open stream.

Tests in test_api_stream_live.py: 8 tests covering snapshot shape,
post-snapshot publish, heartbeat timing, multi-item snapshots, and
client disconnect cleanup. Plus 2 tests in test_pubsub.py for the
new unsubscribe method.
2026-06-20 16:57:30 -06:00
Tyler 3ab1de23d3 refactor(api): _ndjson_line helper for streaming responses 2026-06-20 15:52:05 -06:00
Tyler 8bcb23c78d feat(api): parse endpoints pass EventBus into store writes
- api.parse_837 / parse_835: pass request.app.state.event_bus into store.add()
- conftest: autouse fixture wires a fresh EventBus onto app.state for every
  test, since TestClient does not invoke the FastAPI lifespan handler
  unless used as a context manager
- test_pubsub: split get_event_bus coverage into a raises-when-missing test
  and a returns-attached-bus test, both save/restore app.state.event_bus
  around the assertion so the autouse fixture's bus is preserved

Phase 2 complete: db init moved to lifespan, EventBus is the process-wide
publish point, and the two ingest endpoints publish claim_written /
remittance_written / activity_recorded events on every store.add().
2026-06-20 15:51:18 -06:00
Tyler 8d02ed3204 test(store): 835 batch publishes remittance_written + activity_recorded 2026-06-20 15:47:35 -06:00
Tyler ac7f3283d6 feat(store): add publishes claim_written + activity_recorded events 2026-06-20 15:42:56 -06:00
Tyler 5a712e5afd refactor(main): rely on lifespan for db init (SP5) 2026-06-20 15:37:15 -06:00
Tyler f52eec9bad feat(api): lifespan handler initializes EventBus + db 2026-06-20 15:36:50 -06:00
Tyler 25a76a515d feat(pubsub): get_event_bus() late-import accessor 2026-06-20 15:35:02 -06:00
Tyler b2f5a16541 feat(pubsub): EventBus with drop-oldest overflow, per-kind fan-out 2026-06-20 15:28:13 -06:00
Tyler e8dc8c16d7 build(deps): pytest-asyncio for SP5 stream tests 2026-06-20 15:24:48 -06:00
Tyler 14d61f82b8 test(api)+docs: assert matchedRemittance=null; fail-loud on fixture drift; tighten docstring 2026-06-20 09:56:24 -06:00
Tyler 129599f0f4 feat(api): GET /api/claims/{claim_id} returns full claim context 2026-06-20 09:43:08 -06:00
Tyler 7d0e76150b fix(store): drop dead defensive guard in get_claim_detail (FK guarantees batch exists) 2026-06-20 09:30:42 -06:00
Tyler 423415ab64 feat(store): get_claim_detail returns full claim context with history + matched remit 2026-06-20 09:21:07 -06:00
Tyler a665881d24 feat(parsers+api): 270/271 eligibility request + response (SP3 P4)
Adds API-only 270/271 eligibility flow per spec section 3.4 (no UI, no
DB persistence). Operator pastes a 270 query, gets back raw 270 text,
submits manually, pastes the 271 back.

New models (270 + 271):
  - InformationSource, InformationReceiver, Subscriber, Patient
  - EligibilityBenefitInquiry (EQ) and CoverageBenefit (EB)
  - Inline SERVICE_TYPE_CODES dict (566 codes, snapshot 2026-06-20)
  - service_type_description() lookup helper

Parsers (single segment walker, defensive, mirrors 835 pattern):
  - parse_270: HL*20/21/22/23 loops + EQ, NM1, DMG, TRN
  - parse_271: HL*20/21/22/23 loops + EB, DTP, MSG, AAA

Serializer:
  - serialize_270: ISA/GS/ST/BHT/HL*20/21/22/patient/EQ/SE/GE/IEA
  - round-trips: serialize -> parse -> serialize == identical

API:
  - POST /api/eligibility/request (JSON body -> {raw_270_text, parsed})
  - POST /api/eligibility/parse-271 (file upload -> structured summary)
  - 400 on missing fields / garbage; never 500.

Tests: 365 -> 408 backend (+43 new), 10 frontend unchanged.
TypeScript clean.
2026-06-20 08:22:31 -06:00
Tyler f3002e4cbe fix(api): regenerate raw_999_text in /api/acks/{id} detail response (SP3 P3 follow-up)
The P3 subagent shipped a Download button on /acks that fell back to
'no raw text' because the detail endpoint returned raw_json (the parsed
model dump) but never the regenerated X12.

Fix: detail endpoint now re-serializes raw_json via serialize_999 and
returns it as raw_999_text, so the operator can actually download the
999 file. List endpoint unchanged (keeps payload small).
2026-06-20 08:06:21 -06:00
Tyler fb2a98fc7a feat(parsers+api+ui+db): 999 ACK transaction set end-to-end (SP3 P3) 2026-06-20 08:03:37 -06:00
Tyler 7a20f732f2 fix(api): include adjustments array in /api/remittances list response (SP3 P2 follow-up)
The P2 subagent shipped a UI chevron+expansion in Remittances.tsx that
read adjustments from the list payload, but iter_remittances() didn't
include the CasAdjustment rows. Result: the expansion was always empty
when a remittance was opened from the list (the detail endpoint worked).

Fix: bulk-fetch all CasAdjustment rows for the remittance_ids in one
query, then attach them as the 'adjustments' array. N+1-free.
2026-06-20 07:49:20 -06:00
Tyler 2a853857b1 feat(parsers+api+ui): expose CARC-labeled CAS adjustments (SP3 P2) 2026-06-20 07:44:41 -06:00
Tyler 76eb33e029 chore(backend): track uv.lock for reproducible installs 2026-06-20 07:26:27 -06:00
Tyler 716bfb0a26 feat(parsers): R034 REF*G1 enforcement + R035 BHT06 transaction type code (SP3 P1)
- R034 _r034_ref_g1_required: when payer opts in (require_ref_g1_for_adjustments),
  emit error if frequency_code is 7/8 and no REF*G1 segment appears in raw_segments.
  CO Medicaid stays lenient in v1 (gate is False by default).
- R035 _r035_bht06_allowed: BHT06 transaction type code must be in cfg.allowed_bht06.
  Skipped silently when transaction_type_code is None.
- Add transaction_type_code (str|None) to Envelope and ClaimOutput.
- parse_837: read BHT06 (seg[6]) in _build_envelope; mirror onto each ClaimOutput
  via the existing model_copy(update={...}) call site.
- 9 new tests in test_validator.py: 5 R034 (incl. lenient no-op) + 4 R035.
  213 passed, 1 skipped (prodfile corpus present-conditional).
2026-06-20 07:25:29 -06:00
Tyler 43a88a356c feat(backend): parse-835 JSON response includes reconciliation summary 2026-06-19 23:42:22 -06:00
Tyler 44fe88d694 feat(backend): POST /api/reconciliation/{match,unmatch} + InvalidStateError 2026-06-19 23:39:20 -06:00
Tyler a4c59587c6 feat(backend): GET /api/reconciliation/unmatched 2026-06-19 23:34:25 -06:00