Nora
121 lines
5.4 KiB
Python
121 lines
5.4 KiB
Python
"""Pipeline B: NOT_IN_835 visits → fresh 837Ps, batched by (member, ISO-week)."""
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from datetime import date
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from decimal import Decimal
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from cyclone.rebill.pipeline_b import build_pipeline_b_batches
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from cyclone.rebill.reconcile import VisitRow
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def _v(date_, member, proc, amt):
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return VisitRow(date=date_, member_id=member, procedure=proc, billed=Decimal(amt))
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def test_batches_split_by_member_and_iso_week():
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visits = [
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_v(date(2026, 6, 23), "J813715", "T1019", "2.32"),
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_v(date(2026, 6, 25), "J813715", "T1019", "2.32"), # same week
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_v(date(2026, 6, 23), "OTHER", "T1019", "2.32"), # different member
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_v(date(2026, 6, 30), "J813715", "T1019", "2.32"), # different week
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]
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out = build_pipeline_b_batches(visits, as_of=date(2026, 7, 7), override=False)
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assert len(out) == 3
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sizes = sorted(len(b.visits) for b in out)
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assert sizes == [1, 1, 2]
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def test_timely_filing_excludes_old_visits():
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visits = [
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_v(date(2026, 1, 1), "OLD", "T1019", "2.32"), # 187 days old
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_v(date(2026, 6, 27), "NEW", "T1019", "2.32"), # 10 days old
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]
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out = build_pipeline_b_batches(visits, as_of=date(2026, 7, 7), override=False)
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members = {b.member_id for b in out}
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assert "OLD" not in members
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assert "NEW" in members
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def test_override_relaxes_timely_filing():
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visits = [_v(date(2026, 1, 1), "OLD", "T1019", "2.32")]
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out_default = build_pipeline_b_batches(visits, as_of=date(2026, 7, 7), override=False)
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out_overridden = build_pipeline_b_batches(visits, as_of=date(2026, 7, 7), override=True)
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assert out_default == []
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assert len(out_overridden) == 1
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def test_override_flag_set_on_past_window_visit_batch():
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# Same member "OLD" with one past-window visit (187 days old, ISO
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# week 1) and one within-window visit (10 days old, ISO week 26).
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# With override=True the past-window visit survives and the batch
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# for week 1 must be flagged has_overridden_visits=True because the
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# override saved an otherwise-excluded visit.
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visits = [
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_v(date(2026, 1, 1), "OLD", "T1019", "2.32"), # 187 days old (past window, W01)
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_v(date(2026, 6, 27), "OLD", "T1019", "2.32"), # 10 days old (within window, W26)
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]
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out_overridden = build_pipeline_b_batches(
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visits, as_of=date(2026, 7, 7), override=True,
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)
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# Two batches: one per (member, ISO-week) — the past-window visit and
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# the within-window visit land in different weeks.
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assert len(out_overridden) == 2
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by_week = {b.iso_week: b for b in out_overridden}
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assert by_week[1].member_id == "OLD"
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assert by_week[1].has_overridden_visits is True # the override saved this batch
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assert by_week[26].member_id == "OLD"
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assert by_week[26].has_overridden_visits is False # no override needed here
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# With override=False the past-window visit is dropped. The surviving
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# within-window batch (W26) must NOT carry the override flag, and the
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# past-window batch (W01) is absent.
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out_default = build_pipeline_b_batches(
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visits, as_of=date(2026, 7, 7), override=False,
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)
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assert len(out_default) == 1
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assert out_default[0].member_id == "OLD"
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assert out_default[0].iso_week == 26
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assert out_default[0].has_overridden_visits is False
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def test_serialize_member_week_batch_emits_one_envelope():
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"""One 837P envelope per MemberWeekBatch — one CLM + one SV1 + one
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DTP*472 service date per visit.
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The SP41 plan spec wrote ``DTM*472*`` but the canonical 837P service
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date segment is ``DTP*472*`` (per :func:`cyclone.parsers.serialize_837.
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_build_dtp_472` and X12 005010X222A1). This test asserts against the
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canonical segment name so the batch overload stays consistent with
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the existing ``serialize_837`` building blocks.
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"""
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from cyclone.parsers.serialize_837 import serialize_member_week_batch
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visits = [
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_v(date(2026, 6, 23), "J813715", "T1019", "2.32"),
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_v(date(2026, 6, 25), "J813715", "T1019", "2.32"),
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]
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batches = build_pipeline_b_batches(visits, as_of=date(2026, 7, 7), override=False)
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assert len(batches) == 1
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body = serialize_member_week_batch(batches[0])
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text = body.decode("utf-8", errors="ignore") if isinstance(body, bytes) else body
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# CLM* segment appears twice (once per visit)
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assert text.count("CLM*") == 2
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# SV1* appears once per visit (one service line per claim)
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assert text.count("SV1*") == 2
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# DTP*472* service-date segment appears twice (canonical 837P segment name)
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assert text.count("DTP*472*") == 2
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# Single envelope (single ISA / single IEA), not per-visit envelopes
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assert text.count("ISA*") == 1
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assert text.count("IEA*") == 1
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# Deterministic per-visit claim_id pattern (member_id + date + 1-based idx)
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assert "MW-J813715-2026-06-23-01" in text
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assert "MW-J813715-2026-06-25-02" in text
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def test_serialize_member_week_batch_return_type_is_bytes():
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"""Task 14 spec: ``serialize_member_week_batch`` returns ``bytes``
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(the existing ``serialize_837`` returns ``str``; this overload
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diverges intentionally so callers can write the file directly)."""
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from cyclone.parsers.serialize_837 import serialize_member_week_batch
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visits = [_v(date(2026, 6, 23), "J813715", "T1019", "2.32")]
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batches = build_pipeline_b_batches(visits, as_of=date(2026, 7, 7), override=False)
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assert len(batches) == 1
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body = serialize_member_week_batch(batches[0])
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assert isinstance(body, bytes)
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