Tyler
113 lines
3.8 KiB
Python
113 lines
3.8 KiB
Python
"""SP7 — endpoint test for GET /api/claims/{id}/line-reconciliation.
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Spec §5.1.
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Architecture note: 837 service lines live in ``Claim.raw_json``, not a
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separate ORM table, so the test seeds them via the raw_json blob.
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"""
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from datetime import date, datetime, timezone
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from decimal import Decimal
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import json
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import uuid
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import pytest
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from fastapi.testclient import TestClient
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from sqlalchemy import select
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from cyclone import db
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from cyclone.api import app
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from cyclone.parsers.models_835 import ClaimPayment, ServicePayment
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from cyclone.reconcile import run
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from cyclone.store import _persist_835_remit, _remittance_835_row
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@pytest.fixture
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def client():
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return TestClient(app)
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def _seed(client):
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"""Insert one claim + matching remit + 4 service lines (3 matched, 1 unmatched 837).
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Returns the claim id."""
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bid = str(uuid.uuid4())
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claim_id = "CLM-API-1"
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svc_lines_json = []
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# 4 837 service lines: 99213, 99214, 99215, 90837 (last one is 837-only — no SVC)
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for i, code in enumerate(["99213", "99214", "99215", "90837"], start=1):
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svc_lines_json.append({
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"line_number": i,
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"procedure": {"qualifier": "HC", "code": code, "modifiers": []},
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"charge": "100.00",
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"unit_type": "UN",
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"units": "1",
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"place_of_service": "11",
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"service_date": f"2026-06-0{i}",
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"provider_reference": None,
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})
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with db.SessionLocal()() as s:
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s.add(db.Batch(
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id=bid, kind="835", input_filename="x.835",
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parsed_at=datetime.now(timezone.utc),
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totals_json={"total_claims": 1, "total_paid": "240"},
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validation_json={"passed": True, "warnings": [], "errors": []},
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raw_result_json={"_": "stub"},
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))
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s.add(db.Claim(
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id=claim_id,
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patient_control_number="PCN-API",
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charge_amount=Decimal("300.00"),
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provider_npi="1234567890",
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payer_id="SKCO0",
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service_date_from=date(2026, 6, 1),
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service_date_to=date(2026, 6, 4),
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state="submitted",
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batch_id=bid,
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raw_json={"service_lines": svc_lines_json},
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))
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# Remit pays the first 3 lines (line 4 is 837-only)
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cp = ClaimPayment(
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payer_claim_control_number="PCN-API",
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status_code="1",
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total_charge=Decimal("300.00"),
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total_paid=Decimal("240.00"),
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service_payments=[
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ServicePayment(
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line_number=i, procedure_qualifier="HC",
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procedure_code=code, charge=Decimal("100.00"),
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payment=Decimal("80.00"),
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units=Decimal("1"),
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service_date=date(2026, 6, i),
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)
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for i, code in enumerate(["99213", "99214", "99215"], start=1)
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],
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)
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remit = _remittance_835_row(cp, bid)
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s.add(remit)
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s.flush()
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_persist_835_remit(s, cp, remit.id)
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s.commit()
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# Run reconcile so matched_remittance_id gets set + LineReconciliation rows persist
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run(s, bid)
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s.commit()
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return claim_id
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def test_endpoint_returns_documented_shape(client):
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claim_id = _seed(client)
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r = client.get(f"/api/claims/{claim_id}/line-reconciliation")
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assert r.status_code == 200, r.text
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body = r.json()
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assert body["claim_id"] == claim_id
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assert body["summary"]["total_lines"] == 4
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assert body["summary"]["matched_lines"] == 3
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statuses = sorted(row["status"] for row in body["lines"])
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assert statuses == ["matched", "matched", "matched", "unmatched_837_only"]
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def test_endpoint_404_for_unknown_claim(client):
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r = client.get("/api/claims/UNKNOWN/line-reconciliation")
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assert r.status_code == 404
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