Files
cyclone/backend/src/cyclone/store.py
T
Tyler f003c1f73a feat(sp17): encrypted DB backup automation
Adds automated encrypted backups of the live SQLite file. Closes the
'no backup automation' gap called out in the completeness review
(docs/reviews/2026-06-20-cyclone-completeness-review.md §3.1 #3) and
gives the SP16 MFT scheduler a recovery path when the MFT pipeline
loses days of inbound 999/277CA work in a single crash.

Architecture
------------
- AES-256-GCM with PBKDF2-HMAC-SHA256 (200,000 iters, 16-byte salt)
- Online backups via SQLite's .backup() API — no app downtime
- Salt + passphrase persisted to macOS Keychain (separate accounts
  backup.passphrase + backup.salt) so the key is reproducible across
  processes
- Two-step restore (initiate → confirm) with a one-shot 64-char hex
  token; the second call disposes + rebuilds the engine only if the
  token matches within a 5-minute TTL
- Tamper-evident audit chain (SP11) — db.backup_created,
  db.backup_failed, db.backup_pruned, db.backup_restored,
  db.backup_passphrase_set
- BackupService + BackupScheduler + module-level singletons
- 8 admin endpoints + 6 CLI subcommands
- Auto-start opt-in via CYCLONE_BACKUP_AUTOSTART=true; default
  interval 24h, default retention 30 days
- Fallback posture: if no separate passphrase is set and SQLCipher
  is enabled, the key is derived from the SQLCipher DB key with a
  fixed salt + WARNING log (degraded but never plaintext)

New modules
-----------
- cyclone.backup          — PBKDF2, AES-GCM, sidecar format
- cyclone.backup_service  — create_now / list / verify / restore / prune / status
- cyclone.backup_scheduler — async tick loop with audit hooks

New surface
-----------
- 8 admin endpoints under /api/admin/backup/*
- 6 CLI subcommands under cyclone backup (init-passphrase, create,
  list, verify, restore, prune, status)
- Migration 0012_backups.sql + DbBackup ORM
- store.add_backup_pending()

Tests
-----
- 14 unit tests in test_backup_crypto.py (key derivation, encrypt/
  decrypt round-trip, tampered ciphertext, wrong passphrase, sidecar
  round-trip, filename format)
- 19 tests in test_backup_service.py (create/list/verify/restore/
  prune/status, error handling, fallback key, module singleton)
- 14 API tests in test_api_backup.py (all 8 endpoints + scheduler
  endpoints, two-step restore, error responses)
- 10 tests in test_backup_scheduler.py (tick / start / stop /
  audit / coalescing / module singleton)
- 5 CLI tests in test_cli_backup.py (create / list / verify /
  restore confirm prompt / prune confirm prompt /
  init-passphrase minimum-length check)

Total new tests: 62. All pass. Full backend suite: 833 passed,
9 skipped (gitignored prodfiles), 1 warning.

Design doc: docs/superpowers/specs/2026-06-21-cyclone-encrypted-backup-design.md
README: new 'Encrypted Backups (SP17)' section, SP17 entry in
Roadmap, retention default documented in §Project layout.
2026-06-21 09:43:51 -06:00

2413 lines
93 KiB
Python

"""SQLAlchemy-backed batch store for parsed X12 files.
The module exposes a single ``CycloneStore`` class and a module-level
singleton (``store``). All persistence flows through SQLAlchemy
sessions via ``db.SessionLocal()()`` (the double-paren "function-style
accessor" established in T2/T4).
Public API (preserved from the in-memory version):
- add(record)
- get(batch_id) / get_batch(batch_id)
- list(limit) / all()
- iter_claims(...) / iter_remittances(...)
- distinct_providers() / recent_activity(limit)
New API (T12):
- list_unmatched(kind="both")
- manual_match(claim_id, remit_id)
- manual_unmatch(claim_id)
- AlreadyMatchedError, NotMatchedError, InvalidStateError exception classes
Backward-compat shims for tests that relied on the in-memory internals:
- ``_lock`` — a no-op ``threading.RLock``. SQLAlchemy handles
concurrency via the engine's connection pool, but some existing
tests use it as a context manager around cleanup.
- ``_batches.clear()`` — wipes all rows from the DB tables so tests
that depended on a fresh in-memory list per-test get a fresh DB
state per-test.
"""
from __future__ import annotations
import json
import threading
from datetime import datetime, timezone
from decimal import Decimal
from typing import Any, Literal
from pydantic import BaseModel, ConfigDict, model_validator
from cyclone import db
from cyclone.db import (
Ack,
ActivityEvent,
Batch,
CasAdjustment,
Claim,
ClaimState,
JSONText,
Match,
Remittance,
)
from cyclone.parsers.models import ClaimOutput, ParseResult
from cyclone.parsers.models_835 import ClaimPayment, ParseResult835
from cyclone.parsers.payer import PayerConfig835
from cyclone.providers import Clearhouse, Payer, Provider # SP9: ORM-row DTOs
class AlreadyMatchedError(Exception):
"""Raised by ``CycloneStore.manual_match`` when the claim is already paired.
The claim's ``matched_remittance_id`` is set, so any new pairing would
clobber an existing match. Callers (the T15 API endpoint) should surface
this as a 409 Conflict.
"""
class NotMatchedError(Exception):
"""Raised by ``CycloneStore.manual_unmatch`` when the claim has no match.
Mirrors ``AlreadyMatchedError`` for the unpair operation. Same HTTP
treatment: 409 Conflict at the API layer.
"""
class InvalidStateError(Exception):
"""Raised when an apply_* pure fn returns a skipped ApplyIntent.
``reconcile.apply_payment`` / ``apply_reversal`` may return
``skipped=True`` (e.g. claim already in a terminal state, or reversal
on a non-paid claim). The store surfaces that as ``InvalidStateError``
rather than silently pairing. The T15 API endpoint maps this to a
409 Conflict and echoes ``current_state`` and ``activity_kind`` so
the UI can render a precise message.
"""
def __init__(self, current_state: str, activity_kind: str = "invalid_state"):
self.current_state = current_state
self.activity_kind = activity_kind
super().__init__(
f"invalid state {current_state} for apply (kind={activity_kind})"
)
BatchKind = Literal["837p", "835"]
# ---------------------------------------------------------------------------
# BatchRecord: value object preserved from sub-project 1.
# ---------------------------------------------------------------------------
class BatchRecord(BaseModel):
"""One parsed file, with a stable uuid4 id and the full ParseResult.
``result`` is a union: ``ParseResult`` for ``kind="837p"`` and
``ParseResult835`` for ``kind="835"``. The concrete subclasses
``BatchRecord837`` and ``BatchRecord835`` narrow those fields, so
callers that want type-checked access should use them and check
``isinstance`` rather than pattern-matching on ``kind``.
Constructing ``BatchRecord(kind="837p", ...)`` dispatches to
``BatchRecord837``; ``kind="835"`` dispatches to ``BatchRecord835``.
This lets the union-member narrowing work transparently.
"""
model_config = ConfigDict(extra="ignore")
id: str
kind: BatchKind
input_filename: str
parsed_at: datetime # tz-aware UTC
result: ParseResult | ParseResult835
def __new__(
cls, *args: Any, **kwargs: Any,
) -> BatchRecord837 | BatchRecord835 | BatchRecord:
# Dispatch base-class construction to the right concrete subclass
# so isinstance checks downstream narrow `result` correctly.
if cls is BatchRecord:
kind = kwargs.get("kind")
if kind is None and args and isinstance(args[0], dict):
kind = args[0].get("kind")
if kind == "837p":
return BatchRecord837(*args, **kwargs)
if kind == "835":
return BatchRecord835(*args, **kwargs)
return super().__new__(cls)
@model_validator(mode="after")
def _check_parsed_at_tz(self) -> BatchRecord:
if self.parsed_at.tzinfo is None:
raise ValueError(
"parsed_at must be tz-aware (use datetime.now(timezone.utc))"
)
return self
class BatchRecord837(BatchRecord):
"""A parsed 837P (professional claim) batch."""
kind: Literal["837p"] = "837p"
result: ParseResult
class BatchRecord835(BatchRecord):
"""A parsed 835 (remittance advice) batch."""
kind: Literal["835"] = "835"
result: ParseResult835
def utcnow() -> datetime:
"""tz-aware UTC `datetime` (replaces the old `utcnow_iso` string helper)."""
return datetime.now(timezone.utc)
# ---------------------------------------------------------------------------
# ORM row builders.
# ---------------------------------------------------------------------------
def _service_dates_from_claim(claim: ClaimOutput) -> tuple[date | None, date | None]:
"""Extract (service_date_from, service_date_to) from a ClaimOutput.
The 837P model has ``service_lines[*].service_date`` (one per SV1).
We use the earliest as ``from`` and the latest as ``to``; if there
are no service lines, both are ``None``.
"""
dates: list[date] = []
for sl in claim.service_lines:
if sl.service_date is not None:
dates.append(sl.service_date)
if not dates:
return None, None
return min(dates), max(dates)
def _claim_837_row(claim: ClaimOutput, batch_id: str) -> Claim:
"""Build a Claim ORM row from a ClaimOutput. NOT yet persisted."""
d_from, d_to = _service_dates_from_claim(claim)
return Claim(
id=claim.claim_id,
batch_id=batch_id,
patient_control_number=claim.subscriber.member_id or "",
service_date_from=d_from,
service_date_to=d_to,
charge_amount=Decimal(claim.claim.total_charge or 0),
provider_npi=claim.billing_provider.npi,
payer_id=claim.payer.id,
state=ClaimState.SUBMITTED,
raw_json=json.loads(claim.model_dump_json()),
)
def _remittance_835_row(cp: ClaimPayment, batch_id: str) -> Remittance:
"""Build a Remittance ORM row from a ClaimPayment. NOT yet persisted."""
received_at = utcnow()
# Adjustment amount: sum the CAS rows for the first service line.
# NOTE: This is a best-effort placeholder used until the reconciliation
# pass (T10) overwrites it from the persisted CasAdjustment rows. The
# authoritative value comes from `reconcile.run()`, which sums
# ``CasAdjustment.amount`` per ``remittance_id`` and writes the result
# back to ``Remittance.adjustment_amount``. We keep this stub so the
# row has a sane value if reconciliation is disabled or fails.
adjustment = Decimal("0")
if cp.service_payments:
sp = cp.service_payments[0]
for adj in sp.adjustments:
adjustment += adj.amount
# Use the first service line's service_date as the remit service_date.
service_date: date | None = None
if cp.service_payments and cp.service_payments[0].service_date is not None:
service_date = cp.service_payments[0].service_date
return Remittance(
id=cp.payer_claim_control_number,
batch_id=batch_id,
payer_claim_control_number=cp.payer_claim_control_number,
claim_id=None,
status_code=cp.status_code,
status_label=cp.status_label,
total_charge=Decimal(cp.total_charge or 0),
total_paid=Decimal(cp.total_paid or 0),
patient_responsibility=cp.patient_responsibility,
adjustment_amount=adjustment,
received_at=received_at,
service_date=service_date,
is_reversal=cp.status_code in ("21", "22"),
raw_json=json.loads(cp.model_dump_json()),
)
def _cas_adjustment_row(adj, remittance_id: str) -> "db.CasAdjustment":
"""Build a CasAdjustment ORM row from a ClaimAdjustment. NOT yet persisted.
One row per SVC-level CAS adjustment is persisted so the T10
reconcile aggregator can compute ``Remittance.adjustment_amount``
as ``SUM(CasAdjustment.amount) WHERE remittance_id = ...``.
``quantity`` is optional in the X12 CAS spec; we coerce to Decimal
only when present to keep the column NULL for the common no-QTY case.
"""
from cyclone.db import CasAdjustment
quantity = getattr(adj, "quantity", None)
return CasAdjustment(
remittance_id=remittance_id,
group_code=adj.group_code,
reason_code=adj.reason_code,
amount=Decimal(str(adj.amount)),
quantity=Decimal(str(quantity)) if quantity is not None else None,
)
def _persist_835_remit(session, cp: "ClaimPayment", remittance_id: str) -> None:
"""SP7: persist ServiceLinePayment + CAS rows for one CLP composite.
For each 835 SVC composite in ``cp.service_payments``:
- insert a ServiceLinePayment row (line_number, procedure, modifiers,
charge, payment, units, service_date).
- flush to populate slp.id.
- insert each per-SVC CAS adjustment with ``service_line_payment_id``
set to slp.id.
For CLP-level CAS adjustments (``cp.claim_adjustments``, a future
extension; not produced by today's 835 parser but allowed by the spec):
- insert CAS rows with ``service_line_payment_id IS NULL``.
The caller controls the transaction; this function does not commit.
The 835 ingest site calls this after ``_remittance_835_row`` is
flushed so the FK target is populated.
"""
import json as _json
from cyclone.db import ServiceLinePayment, CasAdjustment
for svc in cp.service_payments:
slp = ServiceLinePayment(
remittance_id=remittance_id,
line_number=svc.line_number,
procedure_qualifier=svc.procedure_qualifier,
procedure_code=svc.procedure_code,
modifiers_json=_json.dumps(svc.modifiers or []),
charge=Decimal(str(svc.charge)),
payment=Decimal(str(svc.payment)),
units=Decimal(str(svc.units)) if svc.units is not None else None,
unit_type=svc.unit_type,
service_date=svc.service_date,
ref_benefit_plan=svc.ref_benefit_plan,
)
session.add(slp)
session.flush() # populate slp.id for the FK below
for adj in svc.adjustments:
quantity = getattr(adj, "quantity", None)
session.add(CasAdjustment(
remittance_id=remittance_id,
group_code=adj.group_code,
reason_code=adj.reason_code,
amount=Decimal(str(adj.amount)),
quantity=Decimal(str(quantity)) if quantity is not None else None,
service_line_payment_id=slp.id,
))
# CLP-level CAS (no SVC composite to attach to). Today's parser does
# not produce these; the branch is forward-compatible.
for adj in getattr(cp, "claim_adjustments", []) or []:
quantity = getattr(adj, "quantity", None)
session.add(CasAdjustment(
remittance_id=remittance_id,
group_code=adj.group_code,
reason_code=adj.reason_code,
amount=Decimal(str(adj.amount)),
quantity=Decimal(str(quantity)) if quantity is not None else None,
service_line_payment_id=None,
))
# ---------------------------------------------------------------------------
# UI mappers: ORM rows → simpler UI types.
# ---------------------------------------------------------------------------
def _claim_status_from_validation(claim: ClaimOutput) -> str:
"""Re-implement the in-memory status rules (sub-project 1 §6.2)."""
v = claim.validation
if not v.passed:
has_r050 = any(e.rule == "R050_diagnosis_present" for e in v.errors)
return "draft" if has_r050 else "denied"
if claim.claim.frequency_code == "1":
return "submitted"
if v.warnings:
return "pending"
return "draft"
def to_ui_claim(
claim: ClaimOutput,
*,
batch_id: str,
parsed_at: datetime,
) -> dict:
"""Map a 837P ClaimOutput to the UI's `Claim` shape (preserved)."""
parsed_iso = parsed_at.isoformat().replace("+00:00", "Z")
return {
"id": claim.claim_id,
"patientName": f"{claim.subscriber.first_name} {claim.subscriber.last_name}".strip(),
"providerNpi": claim.billing_provider.npi,
"payerName": claim.payer.name,
"cptCode": (
claim.service_lines[0].procedure.code
if claim.service_lines
else ""
),
"billedAmount": float(claim.claim.total_charge or 0.0),
"receivedAmount": 0.0,
"status": _claim_status_from_validation(claim),
"denialReason": None,
"submissionDate": parsed_iso,
"batchId": batch_id,
"parsedAt": parsed_iso,
}
def to_ui_remittance(
cp: ClaimPayment,
*,
batch_id: str,
parsed_at: datetime,
payer_config: PayerConfig835 | None = None,
payer_name: str = "",
) -> dict:
"""Map an 835 ClaimPayment to the UI's `Remittance` shape (preserved)."""
code = cp.status_code
if code in {"21", "22"}:
status = "reconciled"
else:
status = "received"
denial_reason: str | None = None
if code == "4" and cp.service_payments:
sp = cp.service_payments[0]
if sp.adjustments:
adj = sp.adjustments[0]
denial_reason = (
f"{adj.group_code}-{adj.reason_code}: ${float(adj.amount):.2f}"
)
cfg = payer_config if payer_config is not None else PayerConfig835.generic_835()
validation_warnings: list[str] = []
if code not in cfg.allowed_status_codes:
validation_warnings.append(
f"CLP02 code {code} not in payer allowlist"
)
# Aggregate adjustmentAmount across ALL service-line CAS rows, not just
# the first line. Mirrors the SUM the reconcile aggregator (T10)
# computes against persisted CasAdjustment rows; this inline version
# is the write-path equivalent (used when streaming 835 NDJSON
# responses before persistence finishes).
adjustment_total = Decimal("0")
for sp in cp.service_payments:
for adj in sp.adjustments:
adjustment_total += adj.amount
parsed_iso = parsed_at.isoformat().replace("+00:00", "Z")
return {
"id": cp.payer_claim_control_number,
"claimId": cp.original_claim_id or "",
"payerName": payer_name,
"paidAmount": float(cp.total_paid or 0.0),
"adjustmentAmount": float(adjustment_total),
"status": status,
"denialReason": denial_reason,
"validationWarnings": validation_warnings,
"receivedDate": parsed_iso,
"batchId": batch_id,
"parsedAt": parsed_iso,
}
def to_ui_claim_from_orm(
row: Claim,
*,
batch_id: str,
parsed_at: datetime,
) -> dict:
"""Map an ORM ``Claim`` row to the UI's claim shape.
``to_ui_claim`` takes a Pydantic ``ClaimOutput`` (used on the write path
during 837 ingest). For read paths — list_unmatched, manual_match return
values — we already have the ORM row and the serialized fields it
carries in ``raw_json``. Reading from ``raw_json`` keeps the UI shape
in sync with the original 837 parse without re-deserializing to a
Pydantic model.
Adds two fields ``to_ui_claim`` doesn't emit: ``state`` (the
reconciliation state machine value) and ``matchedRemittanceId`` (the
FK to the paired remittance, or None). Both are required by the UI.
"""
raw = row.raw_json or {}
bp = raw.get("billing_provider", {})
payer_obj = raw.get("payer", {})
sub = raw.get("subscriber", {})
service_lines = raw.get("service_lines", [])
parsed_iso = parsed_at.isoformat().replace("+00:00", "Z")
cpt = (
service_lines[0].get("procedure", {}).get("code", "")
if service_lines
else ""
)
state_value = (
row.state.value if hasattr(row.state, "value") else str(row.state)
)
return {
"id": row.id,
"state": state_value,
"billedAmount": float(row.charge_amount or 0),
"patientName": (
f"{sub.get('first_name', '')} {sub.get('last_name', '')}".strip()
),
"providerNpi": bp.get("npi") or row.provider_npi or "",
"payerName": payer_obj.get("name") or "",
"cptCode": cpt,
"submissionDate": parsed_iso,
"parsedAt": parsed_iso,
"status": state_value,
"matchedRemittanceId": row.matched_remittance_id,
"batchId": batch_id,
# Parity with ``to_ui_claim``'s shape — the UI tolerates extra keys
# but expects these on freshly-loaded rows from /api/claims too.
"receivedAmount": 0.0,
"denialReason": None,
}
# Max number of ActivityEvent rows surfaced in the detail drawer's
# state history. The spec caps it at 50; a higher claim volume (manual
# match/unmatch thrash) just shows the 50 most recent. Exposed as a
# module constant so the endpoint layer can pass it through as a
# default if it ever supports a `?limit=N` query param.
CLAIM_DETAIL_HISTORY_LIMIT = 50
def _iso_z(value: datetime | None) -> str:
"""Format a tz-aware-or-naive UTC datetime as ISO-8601 with trailing Z.
The DB columns are declared ``DateTime(timezone=True)`` and rows are
stored UTC at write time, but SQLite drops the tzinfo on read
(returning a naive ``datetime``). Re-attach UTC for naive values
so the spec contract holds: every ISO datetime field ends in Z.
"""
if value is None:
return ""
if value.tzinfo is None:
value = value.replace(tzinfo=timezone.utc)
return value.isoformat().replace("+00:00", "Z")
def _address_to_ui(addr: dict | None) -> dict:
"""Render a raw ``Address`` dict in the spec's parties address shape.
Returns an empty dict when the source is missing so the UI can
branch on the field's presence rather than the value. The spec
shape is ``{line1, line2|null, city, state, zip}``.
"""
if not addr:
return {}
return {
"line1": addr.get("line1") or "",
"line2": addr.get("line2"),
"city": addr.get("city") or "",
"state": addr.get("state") or "",
"zip": addr.get("zip") or "",
}
def _validation_issues_to_ui(issues: list[dict] | None) -> list[dict]:
"""Project ValidationIssue dicts onto the spec's per-issue shape.
Source includes ``segment_index`` (a parser debug aid) which the
spec doesn't surface; we drop it. The endpoint contract is
``{rule, severity, message}`` per issue.
"""
if not issues:
return []
return [
{
"rule": issue.get("rule", ""),
"severity": issue.get("severity", "error"),
"message": issue.get("message", ""),
}
for issue in issues
]
def to_ui_claim_detail(
row: Claim,
*,
batch_id: str,
parsed_at: datetime,
) -> dict:
"""Map an ORM ``Claim`` row to the SP4 detail-drawer UI shape.
A superset of :func:`to_ui_claim_from_orm`: same top-level identity
fields, plus the full parties / validation / service-lines /
diagnoses / raw-segments / service-date / state-label payload that
the drawer needs. ``matchedRemittance`` and ``stateHistory`` are
*not* filled in here — they require extra queries and are stitched
in by :meth:`CycloneStore.get_claim_detail`.
The mapper is deliberately a pure function (no DB I/O) so the
endpoint layer can call it from a worker thread or swap the
history/remittance sources for tests without re-implementing the
body.
"""
raw = row.raw_json or {}
bp = raw.get("billing_provider", {}) or {}
payer_obj = raw.get("payer", {}) or {}
sub = raw.get("subscriber", {}) or {}
service_lines = raw.get("service_lines", []) or []
diagnoses = raw.get("diagnoses", []) or []
validation = raw.get("validation", {}) or {}
raw_segments = raw.get("raw_segments", []) or []
parsed_iso = parsed_at.isoformat().replace("+00:00", "Z")
state_value = (
row.state.value if hasattr(row.state, "value") else str(row.state)
)
# Service dates come from the dedicated ORM columns (denormalized at
# ingest in _claim_837_row so the list views can sort/filter on
# them without a JSON parse). ``isoformat()`` on a ``date`` gives
# ``YYYY-MM-DD`` — the spec shape.
service_date_from_iso = (
row.service_date_from.isoformat() if row.service_date_from else None
)
service_date_to_iso = (
row.service_date_to.isoformat() if row.service_date_to else None
)
return {
# -- identity + state -----------------------------------------
"id": row.id,
"batchId": batch_id,
"state": state_value,
"stateLabel": state_value.capitalize(),
# -- money + dates --------------------------------------------
"billedAmount": float(row.charge_amount or 0),
"serviceDateFrom": service_date_from_iso,
"serviceDateTo": service_date_to_iso,
"submissionDate": parsed_iso,
"parsedAt": parsed_iso,
# -- patient / provider / payer -------------------------------
"patientName": (
f"{sub.get('first_name', '')} {sub.get('last_name', '')}".strip()
),
"providerNpi": bp.get("npi") or row.provider_npi or "",
"providerName": bp.get("name") or "",
"payerName": payer_obj.get("name") or "",
"payerId": payer_obj.get("id") or row.payer_id or "",
# -- diagnoses ------------------------------------------------
"diagnoses": [
{
"code": d.get("code", ""),
"qualifier": d.get("qualifier"),
}
for d in diagnoses
],
# -- service lines --------------------------------------------
# ``service_lines[i].procedure`` is a nested dict in the
# serialized raw_json; the spec flattens it into the line.
# ``charge`` and ``units`` are stored as Decimal via Pydantic
# and serialized to string — coerce defensively. ``modifiers``
# defaults to [] so the UI doesn't have to handle null.
"serviceLines": [
{
"lineNumber": sl.get("line_number"),
"procedureQualifier": (
sl.get("procedure", {}).get("qualifier", "") or ""
),
"procedureCode": (
sl.get("procedure", {}).get("code", "") or ""
),
"modifiers": list(
sl.get("procedure", {}).get("modifiers") or []
),
"charge": float(sl.get("charge") or 0),
"units": (
float(sl["units"])
if sl.get("units") is not None
else None
),
"unitType": sl.get("unit_type"),
"serviceDate": sl.get("service_date"),
}
for sl in service_lines
],
# -- parties --------------------------------------------------
"parties": {
"billingProvider": {
"name": bp.get("name") or "",
"npi": bp.get("npi") or "",
"taxId": bp.get("tax_id") or "",
"address": _address_to_ui(bp.get("address")),
},
"subscriber": {
"firstName": sub.get("first_name") or "",
"lastName": sub.get("last_name") or "",
"memberId": sub.get("member_id") or "",
"dob": sub.get("dob"),
"gender": sub.get("gender"),
},
"payer": {
"name": payer_obj.get("name") or "",
"id": payer_obj.get("id") or "",
},
},
# -- validation ----------------------------------------------
"validation": {
"passed": bool(validation.get("passed", True)),
"errors": _validation_issues_to_ui(validation.get("errors")),
"warnings": _validation_issues_to_ui(validation.get("warnings")),
},
# -- raw segments (debug aid) --------------------------------
"rawSegments": raw_segments,
# -- matched remittance (filled by get_claim_detail) ---------
"matchedRemittance": None,
# -- state history (filled by get_claim_detail) --------------
"stateHistory": [],
}
def to_ui_remittance_from_orm(
row: Remittance,
*,
batch_id: str,
parsed_at: datetime,
) -> dict:
"""Map an ORM ``Remittance`` row to the UI's remittance shape.
Same idea as ``to_ui_claim_from_orm``: read the PayerName from the
parent batch's ``raw_result_json`` (the ParseResult835 stashed at
insert time) since ``Remittance`` itself doesn't carry it.
"""
parsed_iso = parsed_at.isoformat().replace("+00:00", "Z")
payer_name = ""
if row.batch is not None and row.batch.raw_result_json:
payer_obj = row.batch.raw_result_json.get("payer", {}) or {}
payer_name = payer_obj.get("name") or ""
status = (
"reconciled" if row.status_code in ("21", "22") else "received"
)
return {
"id": row.id,
"payerClaimControlNumber": row.payer_claim_control_number,
"claimId": row.claim_id or "",
"payerName": payer_name,
"paidAmount": float(row.total_paid or 0),
"adjustmentAmount": float(row.adjustment_amount or 0),
"status": status,
"denialReason": None,
"validationWarnings": [],
"receivedDate": row.received_at.isoformat().replace("+00:00", "Z"),
"batchId": batch_id,
"parsedAt": parsed_iso,
}
def to_ui_remittance_with_adjustments(
row: Remittance,
*,
batch_id: str,
parsed_at: datetime,
cas_rows: list["db.CasAdjustment"] | None = None,
) -> dict:
"""Same shape as :func:`to_ui_remittance_from_orm` plus an ``adjustments`` array.
Each persisted ``CasAdjustment`` row is rendered as
``{"group", "reason", "label", "amount", "quantity"}``. The ``label``
is resolved through :func:`cyclone.parsers.cas_codes.reason_label`
so the UI does not have to ship its own CARC dictionary.
``cas_rows`` is optional so callers that don't have the rows handy
can still get the base dict; in that case ``adjustments`` is ``[]``.
Pass ``cas_rows`` to avoid an extra round-trip; the endpoint at
``GET /api/remittances/{id}`` passes them in to keep this mapper a
pure function.
"""
base = to_ui_remittance_from_orm(
row, batch_id=batch_id, parsed_at=parsed_at,
)
if not cas_rows:
base["adjustments"] = []
return base
# Lazy import to avoid the circular store ↔ parsers import that
# happens on cold start; mirrors the same pattern used elsewhere
# in this module.
from cyclone.parsers.cas_codes import reason_label
base["adjustments"] = [
{
"group": c.group_code,
"reason": c.reason_code,
"label": reason_label(c.group_code, c.reason_code),
"amount": float(c.amount or 0),
"quantity": (
float(c.quantity) if c.quantity is not None else None
),
}
for c in cas_rows
]
return base
def _svc_to_wire_dict(svc) -> dict:
"""Project an ORM ``ServiceLinePayment`` to the wire format used by
the remit drawer's ``serviceLinePayments`` array.
Mirrors the shape produced by the line-reconciliation endpoint so
the UI can render the same components from either source.
"""
import json as _json
return {
"id": svc.id,
"line_number": svc.line_number,
"procedure_qualifier": svc.procedure_qualifier,
"procedure_code": svc.procedure_code,
"modifiers": _json.loads(svc.modifiers_json or "[]"),
"charge": str(Decimal(str(svc.charge))),
"payment": str(Decimal(str(svc.payment))),
"units": str(Decimal(str(svc.units))) if svc.units is not None else None,
"unit_type": svc.unit_type,
"service_date": svc.service_date.isoformat() if svc.service_date else None,
}
def to_ui_provider(
*,
npi: str,
name: str,
tax_id: str | None = None,
address: str | None = None,
city: str | None = None,
state: str | None = None,
zip: str | None = None,
phone: str | None = None,
claim_count: int = 0,
outstanding_ar: float = 0.0,
) -> dict:
return {
"npi": npi,
"name": name,
"taxId": tax_id or "",
"address": address or "",
"city": city or "",
"state": state or "",
"zip": zip or "",
"phone": phone or "",
"claimCount": claim_count,
"outstandingAr": float(outstanding_ar),
}
def to_activity_event(
*,
id: str,
kind: str,
message: str,
timestamp: datetime,
npi: str | None = None,
amount: float | None = None,
) -> dict:
return {
"id": id,
"kind": kind,
"message": message,
"timestamp": timestamp.isoformat().replace("+00:00", "Z"),
"npi": npi,
"amount": amount,
}
def _date_in_bounds(
item: dict,
field: str,
date_from: str | None,
date_to: str | None,
) -> bool:
"""True if ``item[field]`` falls within ``[date_from, date_to]``."""
val = item.get(field)
if val is None:
return date_from is None and date_to is None
date_part = val[:10]
if date_from is not None and date_part < date_from:
return False
if date_to is not None and date_part > date_to:
return False
return True
# ---------------------------------------------------------------------------
# Backward-compat shim: tests called ``_batches.clear()`` on the in-memory
# store. The DB-backed store doesn't have an in-memory list, so we expose
# a tiny shim object whose ``.clear()`` wipes the DB.
# ---------------------------------------------------------------------------
class _BatchesShim:
"""Drop-in replacement for the old in-memory ``_batches`` list.
``clear()`` removes every row from the DB tables in FK-safe order.
Other list operations are not implemented because the only call site
is the ``clear()`` inside the test fixtures (``test_api_gets.py`` and
``test_api_parse_persists.py``).
"""
def clear(self) -> None: # type: ignore[no-untyped-def]
with db.SessionLocal()() as s:
s.query(ActivityEvent).delete()
s.query(Match).delete()
s.query(CasAdjustment).delete()
s.query(Remittance).delete()
s.query(Claim).delete()
s.query(Batch).delete()
s.commit()
# ---------------------------------------------------------------------------
# CycloneStore: the SQLAlchemy-backed facade.
# ---------------------------------------------------------------------------
class CycloneStore:
"""SQLAlchemy-backed facade over the parsed X12 store.
Each public method opens a short-lived session via
``db.SessionLocal()()`` so callers don't have to manage session
lifecycles. Concurrency is handled by the SQLAlchemy engine; the
``_lock`` attribute is a no-op ``RLock`` retained for backward
compatibility with code that wrapped cleanup in a lock context.
"""
def __init__(self) -> None:
self._lock = threading.RLock()
self._batches = _BatchesShim()
# -- write path -----------------------------------------------------
def add(
self,
record: BatchRecord,
*,
event_bus: "EventBus | None" = None,
) -> None:
"""Persist a parsed batch (837P or 835) to the DB.
For 837P batches: inserts the Batch row, one Claim row per
claim, and a ``claim_submitted`` ActivityEvent per claim.
For 835 batches: inserts the Batch row, one Remittance row per
ClaimPayment, and a ``remit_received`` ActivityEvent per
ClaimPayment. After commit, calls ``_run_reconcile`` (T10 stub)
in a fail-soft manner — reconciliation errors are logged but
do not roll back the persisted batch.
Idempotency: ``Claim.id`` and ``Remittance.id`` are PRIMARY KEYS,
so a re-ingest of the same fixture (e.g. ``/api/parse-837`` called
twice with the same file) would otherwise raise
``IntegrityError``. We do a per-row ``session.get(...)`` check
before each insert; if the row already exists, we log a warning
and skip. The batch row itself is still inserted (each parse
has a fresh ``uuid4`` id from the API). O(n) per row, but
acceptable for the small fixture sizes — production load is
one batch at a time via the API, not bulk inserts.
When ``event_bus`` is provided, publishes one ``claim_written``
or ``remittance_written`` event per newly-inserted row plus an
``activity_recorded`` event per activity row, after commit. The
publish calls are best-effort — failures are logged but do not
roll back the persisted batch.
"""
from cyclone.pubsub import EventBus
import logging
log = logging.getLogger(__name__)
# Track rows we actually inserted so we can publish events for them.
inserted_claim_ids: list[str] = []
inserted_remit_ids: list[str] = []
with db.SessionLocal()() as s:
batch_row = Batch(
id=record.id,
kind=record.kind,
input_filename=record.input_filename,
parsed_at=record.parsed_at,
totals_json=None,
validation_json=None,
raw_result_json=json.loads(record.result.model_dump_json()),
)
s.add(batch_row)
if isinstance(record, BatchRecord837):
result: ParseResult = record.result
for claim in result.claims:
if s.get(Claim, claim.claim_id) is not None:
log.warning(
"add: claim %s already exists; skipping (batch=%s)",
claim.claim_id, record.id,
)
continue
s.add(_claim_837_row(claim, record.id))
s.add(ActivityEvent(
ts=record.parsed_at,
kind="claim_submitted",
batch_id=record.id,
claim_id=claim.claim_id,
payload_json={
"message": (
f"Claim {claim.claim_id} submitted · "
f"{claim.payer.name}"
),
"npi": claim.billing_provider.npi,
"amount": float(claim.claim.total_charge or 0.0),
},
))
inserted_claim_ids.append(claim.claim_id)
elif isinstance(record, BatchRecord835):
result835: ParseResult835 = record.result
payer_name = result835.payer.name
for cp in result835.claims:
if s.get(Remittance, cp.payer_claim_control_number) is not None:
log.warning(
"add: remittance %s already exists; skipping (batch=%s)",
cp.payer_claim_control_number, record.id,
)
continue
remit_row = _remittance_835_row(cp, record.id)
s.add(remit_row)
# Flush so remit_row.id (FK target of cas_adjustments) is
# populated. SQLAlchemy assigns the PK on flush; without
# this the CasAdjustment inserts below would reference an
# unset id and violate the FK.
s.flush()
# SP7: persist per-line ServiceLinePayment + linked
# SVC-level CAS rows + claim-level CAS bucket. Replaces
# the previous per-SVC CAS insert loop so the
# service_line_payment_id FK is set correctly.
_persist_835_remit(s, cp, remit_row.id)
s.add(ActivityEvent(
ts=record.parsed_at,
kind="remit_received",
batch_id=record.id,
remittance_id=cp.payer_claim_control_number,
payload_json={
"message": (
f"Remit {cp.payer_claim_control_number} received"
),
"payerName": payer_name,
"amount": float(cp.total_paid or 0.0),
},
))
inserted_remit_ids.append(cp.payer_claim_control_number)
else:
raise TypeError(
f"Unsupported BatchRecord subclass: {type(record).__name__}"
)
s.commit()
# Reconcile 835 batches after the batch is durably persisted.
# Fail-soft: errors are logged, not raised, so an 835 parse that
# crashes in reconciliation still shows up in /api/batches.
if record.kind == "835":
try:
self._run_reconcile(record.id)
except Exception: # pragma: no cover - logged via default handler
import logging
logging.getLogger(__name__).exception(
"reconcile.run failed for batch %s", record.id,
)
# Publish live-tail events synchronously. EventBus.publish is async
# but its body is purely synchronous ``put_nowait`` enqueues; we
# bypass the async wrapper and call the internal enqueue directly
# so callers (sync FastAPI endpoints, sync test harnesses) don't
# need to await.
if event_bus is not None and (inserted_claim_ids or inserted_remit_ids):
self._publish_events_sync(
event_bus, record, inserted_claim_ids, inserted_remit_ids,
)
def _publish_events_sync(
self,
event_bus: "EventBus",
record: BatchRecord,
claim_ids: list[str],
remit_ids: list[str],
) -> None:
"""Build UI-shaped payloads for newly-inserted rows and publish.
Runs after commit so subscribers can immediately re-fetch from
the API and see consistent data. Each ``claim_written`` /
``remittance_written`` payload is identical to what the matching
list endpoint would return for that row.
This is sync because EventBus's enqueue path is sync; we don't
need a coroutine for ``put_nowait``.
"""
import logging
log = logging.getLogger(__name__)
try:
with db.SessionLocal()() as s:
for cid in claim_ids:
row = s.get(Claim, cid)
if row is None:
continue
ui = to_ui_claim_from_orm(
row, batch_id=row.batch_id or record.id,
parsed_at=record.parsed_at,
)
self._sync_publish(event_bus, "claim_written", ui)
for rid in remit_ids:
row = s.get(Remittance, rid)
if row is None:
continue
ui = to_ui_remittance_from_orm(
row, batch_id=row.batch_id or record.id,
parsed_at=record.parsed_at,
)
self._sync_publish(event_bus, "remittance_written", ui)
# Activity events for this batch.
from sqlalchemy import select
activity_rows = s.execute(
select(ActivityEvent).where(ActivityEvent.batch_id == record.id)
).scalars().all()
for arow in activity_rows:
ui = {
"kind": arow.kind,
"ts": arow.ts.isoformat().replace("+00:00", "Z"),
"batchId": arow.batch_id,
"claimId": arow.claim_id,
"remittanceId": arow.remittance_id,
"payload": arow.payload_json,
}
self._sync_publish(event_bus, "activity_recorded", ui)
except Exception:
log.exception("add: event publish failed for batch %s", record.id)
@staticmethod
def _sync_publish(event_bus: "EventBus", kind: str, payload: dict) -> None:
"""Synchronous fan-out helper. Mirrors ``EventBus.publish`` but
bypasses the async wrapper so callers don't need an event loop.
"""
event = {**payload, "_kind": kind}
for queue in list(event_bus._subscribers.get(kind, ())):
event_bus._enqueue_or_drop_oldest(queue, event)
def _run_reconcile(self, batch_id: str) -> None:
"""T10 stub: invoke the reconcile orchestrator for a batch.
The actual reconciliation is implemented in T10 (this method
will import ``cyclone.reconcile`` and call ``reconcile.run``
with the current session). For T9 we keep the import lazy and
fail-soft so a missing or NotImplementedError reconcile module
never breaks the 835 ingest path.
"""
# T10 will replace this with the real implementation. Until then
# we accept the failure modes the spec lists: ImportError
# (module not yet wired), NotImplementedError (stub in place),
# or any other transient reconcile error — all swallowed.
try:
from cyclone import reconcile as _reconcile
with db.SessionLocal()() as s:
_reconcile.run(s, batch_id)
except (ImportError, NotImplementedError):
pass
# -- read path ------------------------------------------------------
def _row_to_record(self, row: Batch) -> BatchRecord:
"""Rehydrate a ``BatchRecord`` (837 or 835) from a Batch ORM row.
The full ``ParseResult`` / ``ParseResult835`` lives in
``raw_result_json`` (stashed at insert time). Re-parsing JSON
here means callers get the same typed Pydantic object the old
in-memory store handed out, so api.py and tests that do
``rec.result.claims`` keep working unchanged.
SQLite drops tz info on round-trip even though the column type
is ``DateTime(timezone=True)``. We re-attach UTC so the
``BatchRecord`` validator (``parsed_at must be tz-aware``)
passes.
"""
if row.kind == "835":
result_cls = ParseResult835
else:
result_cls = ParseResult
payload = row.raw_result_json or {}
result = result_cls.model_validate(payload)
parsed_at = row.parsed_at
if parsed_at is not None and parsed_at.tzinfo is None:
parsed_at = parsed_at.replace(tzinfo=timezone.utc)
record_cls = BatchRecord835 if row.kind == "835" else BatchRecord837
return record_cls(
id=row.id,
kind=row.kind,
input_filename=row.input_filename,
parsed_at=parsed_at,
result=result,
)
def get_batch(self, batch_id: str) -> dict | None:
"""Return a summary dict for ``batch_id`` or ``None`` if missing.
The dict shape matches what ``/api/batches/{id}`` callers need:
``id``, ``kind``, ``input_filename``, ``parsed_at``, and the
full ``result`` (raw_result_json) as a dict.
"""
with db.SessionLocal()() as s:
row = s.get(Batch, batch_id)
if row is None:
return None
return {
"id": row.id,
"kind": row.kind,
"input_filename": row.input_filename,
"parsed_at": row.parsed_at,
"result": row.raw_result_json,
}
def get(self, batch_id: str) -> BatchRecord | None:
"""Return the ``BatchRecord`` for ``batch_id`` or ``None``.
Preserves the in-memory store contract: callers get a Pydantic
``BatchRecord`` (subclass ``BatchRecord837`` / ``BatchRecord835``)
with ``.id``, ``.kind``, ``.input_filename``, ``.parsed_at``,
and ``.result`` (typed ``ParseResult`` / ``ParseResult835``).
"""
with db.SessionLocal()() as s:
row = s.get(Batch, batch_id)
if row is None:
return None
return self._row_to_record(row)
def list(self, *, limit: int = 100) -> list[BatchRecord]:
"""Return up to ``limit`` ``BatchRecord``s, newest first."""
with db.SessionLocal()() as s:
rows = (
s.query(Batch)
.order_by(Batch.parsed_at.desc())
.limit(limit)
.all()
)
return [self._row_to_record(r) for r in rows]
def get_remittance(self, remittance_id: str) -> dict | None:
"""Return a UI-shaped remittance dict with ``adjustments`` array.
Joins the persisted ``CasAdjustment`` rows for ``remittance_id``
and labels each via :mod:`cyclone.parsers.cas_codes`. Returns
``None`` when the remittance is not found so the API layer can
map that to a 404.
SP7: also returns the per-line SVC composites
(``serviceLinePayments``) and the CLP-level (claim-level) CAS
bucket (``claimLevelAdjustments``) so the remit drawer can show
per-line payments + adjustments without a second fetch.
"""
with db.SessionLocal()() as s:
row = s.get(Remittance, remittance_id)
if row is None:
return None
cas_rows = (
s.query(CasAdjustment)
.filter(CasAdjustment.remittance_id == remittance_id)
.all()
)
parsed_at = (
row.batch.parsed_at if row.batch is not None else row.received_at
)
if parsed_at is not None and parsed_at.tzinfo is None:
parsed_at = parsed_at.replace(tzinfo=timezone.utc)
body = to_ui_remittance_with_adjustments(
row,
batch_id=row.batch_id,
parsed_at=parsed_at,
cas_rows=cas_rows,
)
# SP7: per-line SVC composites + claim-level CAS bucket.
from cyclone.db import ServiceLinePayment as SLP
slps = (
s.query(SLP)
.filter(SLP.remittance_id == remittance_id)
.order_by(SLP.line_number)
.all()
)
body["serviceLinePayments"] = [
_svc_to_wire_dict(svc) for svc in slps
]
body["claimLevelAdjustments"] = [
{
"id": c.id,
"group_code": c.group_code,
"reason_code": c.reason_code,
"amount": str(Decimal(str(c.amount))),
"quantity": (
str(Decimal(str(c.quantity)))
if c.quantity is not None
else None
),
}
for c in cas_rows
if c.service_line_payment_id is None
]
return body
def get_claim_detail(self, claim_id: str) -> dict | None:
"""Return the SP4 detail-drawer shape for one claim, or ``None``.
Drives ``GET /api/claims/{claim_id}``. Returns the spec-shaped
dict from :func:`to_ui_claim_detail` (header + state + parties +
validation + service lines + diagnoses + raw segments) stitched
with the claim's recent activity history and, if paired, a
matched-remittance summary.
Returns ``None`` when ``claim_id`` is not in the DB so the API
layer can map that to a 404 — the URL-driven drawer
distinguishes "claim doesn't exist" from "fetch failed" (the
spec §3.4 calls for a distinct 404 state in the drawer).
The history is capped at :data:`CLAIM_DETAIL_HISTORY_LIMIT`
(50, per the spec) and ordered ``ts DESC`` so the most recent
event is first. The status string in ``matchedRemittance``
follows the same ``reconciled``/``received`` mapping used by
:func:`to_ui_remittance_from_orm`.
"""
# Lazy import — same pattern used throughout this module to
# avoid a circular store ↔ db import on cold start.
from cyclone import db as _db
with _db.SessionLocal()() as s:
row = s.get(Claim, claim_id)
if row is None:
return None
history_rows = (
s.query(ActivityEvent)
.filter(ActivityEvent.claim_id == claim_id)
.order_by(ActivityEvent.ts.desc())
.limit(CLAIM_DETAIL_HISTORY_LIMIT)
.all()
)
# Claim.batch_id is FK NOT NULL with ON DELETE CASCADE, so
# ``row.batch`` is always populated in normal flow. Re-attach
# UTC only when SQLite drops the tzinfo on read.
parsed_at = row.batch.parsed_at
if parsed_at.tzinfo is None:
parsed_at = parsed_at.replace(tzinfo=timezone.utc)
detail = to_ui_claim_detail(
row,
batch_id=row.batch_id,
parsed_at=parsed_at,
)
detail["stateHistory"] = [
{
"kind": ev.kind,
# SQLite drops tzinfo on read; rows are stored UTC
# at write time (see ``add`` / ``manual_match``),
# so re-attach UTC if needed to keep the spec
# contract that ``ts`` ends in Z.
"ts": _iso_z(ev.ts),
"batchId": ev.batch_id,
"remittanceId": ev.remittance_id,
}
for ev in history_rows
]
if row.matched_remittance_id is not None:
remit = s.get(Remittance, row.matched_remittance_id)
if remit is not None:
status = (
"reconciled"
if remit.status_code in ("21", "22")
else "received"
)
detail["matchedRemittance"] = {
"id": remit.id,
"totalPaid": float(remit.total_paid or 0),
"status": status,
"receivedAt": _iso_z(remit.received_at),
}
# If the remittance was deleted out from under the FK
# (the FK is ``ON DELETE SET NULL`` so the column is
# already cleared in normal flow), the matched_remittance_id
# would be None here and we wouldn't enter this branch.
# If the FK is non-null but the row is gone (e.g. tests
# that bypass the cascade), fall through with the
# default ``None`` — the UI shows "no match" rather
# than crashing.
# SP7 §5.2: slim per-line projection so the ServiceLinesTable
# can show Paid + Adjustments columns without a second fetch.
# The 837 side is keyed by ``claim_service_line_number`` (the
# 1-based line number from raw_json) since 837 service lines
# are not a separate ORM table.
from cyclone.db import (
LineReconciliation, ServiceLinePayment, CasAdjustment,
)
slim_lrs = list(
s.query(LineReconciliation)
.filter(LineReconciliation.claim_id == claim_id)
.all()
)
svc_ids_for_cas = [
lr.service_line_payment_id
for lr in slim_lrs
if lr.service_line_payment_id is not None
]
cas_sums_by_svc: dict = {}
svc_by_id_slim: dict = {}
if svc_ids_for_cas:
cas_rows = (
s.query(CasAdjustment.service_line_payment_id, CasAdjustment.amount)
.filter(CasAdjustment.service_line_payment_id.in_(svc_ids_for_cas))
.all()
)
from collections import defaultdict
agg = defaultdict(lambda: Decimal("0"))
for svc_id, amount in cas_rows:
agg[svc_id] += Decimal(str(amount))
cas_sums_by_svc = {k: str(v) for k, v in agg.items()}
for svc in (
s.query(ServiceLinePayment)
.filter(ServiceLinePayment.id.in_(svc_ids_for_cas))
.all()
):
svc_by_id_slim[svc.id] = svc
slim_by_num: dict = {
lr.claim_service_line_number: lr
for lr in slim_lrs
if lr.claim_service_line_number is not None
}
line_reconciliation_slim: list = []
for sl in detail["serviceLines"]:
ln = sl.get("lineNumber")
lr = slim_by_num.get(ln)
if lr is None:
line_reconciliation_slim.append({
"lineNumber": ln,
"status": "unmatched_837_only",
"paid": None,
"adjustmentsSum": None,
})
continue
svc = (
svc_by_id_slim.get(lr.service_line_payment_id)
if lr.service_line_payment_id
else None
)
line_reconciliation_slim.append({
"lineNumber": ln,
"status": lr.status,
"paid": str(Decimal(str(svc.payment))) if svc else None,
"adjustmentsSum": (
cas_sums_by_svc.get(lr.service_line_payment_id)
if lr.service_line_payment_id
else None
),
})
detail["lineReconciliation"] = line_reconciliation_slim
return detail
def all(self) -> list[BatchRecord]:
"""Return every ``BatchRecord``, oldest first (no pagination)."""
with db.SessionLocal()() as s:
rows = s.query(Batch).order_by(Batch.parsed_at.asc()).all()
return [self._row_to_record(r) for r in rows]
def load_two_for_diff(
self,
a_id: str,
b_id: str,
) -> tuple[BatchRecord, BatchRecord]:
"""Load two batches by id for the side-by-side diff view.
Returns ``(a, b)`` as ``BatchRecord`` objects. Raises
:class:`LookupError` when either id is missing — the API layer
catches it and maps it to ``404 Not Found`` (matching the
``GET /api/batches/{id}`` contract). The two loads happen in
independent sessions so a transient failure on one side can't
poison the other.
Used exclusively by :mod:`cyclone.batch_diff` via the
``/api/batch-diff`` endpoint.
"""
a = self.get(a_id)
if a is None:
raise LookupError(f"batch {a_id} not found")
b = self.get(b_id)
if b is None:
raise LookupError(f"batch {b_id} not found")
return a, b
def iter_claims(
self,
*,
batch_id: str | None = None,
status: str | None = None,
provider_npi: str | None = None,
payer: str | None = None,
date_from: str | None = None,
date_to: str | None = None,
sort: str | None = None,
order: str = "desc",
limit: int = 100,
offset: int = 0,
) -> list[dict]:
"""Return UI-shaped claim dicts from the DB.
Filters mirror the in-memory version. The ``payer`` filter is
a case-insensitive substring on the payer's ``name``, recovered
from each claim's ``raw_json`` payload (the DB stores it there
because ``Claim`` itself only carries ``payer_id``).
"""
with db.SessionLocal()() as s:
q = s.query(Claim)
if batch_id is not None:
q = q.filter(Claim.batch_id == batch_id)
if status is not None:
q = q.filter(Claim.state == ClaimState(status))
if provider_npi is not None:
q = q.filter(Claim.provider_npi == provider_npi)
rows = q.all()
out: list[dict] = []
for r in rows:
raw = r.raw_json or {}
bp = raw.get("billing_provider", {})
payer_obj = raw.get("payer", {})
sub = raw.get("subscriber", {})
claim_hdr = raw.get("claim", {})
service_lines = raw.get("service_lines", [])
parsed_at_iso = (
r.batch.parsed_at.isoformat().replace("+00:00", "Z")
if r.batch is not None
else ""
)
cpt = (
service_lines[0].get("procedure", {}).get("code", "")
if service_lines
else ""
)
out.append({
"id": r.id,
"patientName": (
f"{sub.get('first_name', '')} "
f"{sub.get('last_name', '')}".strip()
),
"providerNpi": bp.get("npi") or r.provider_npi or "",
"payerName": payer_obj.get("name") or "",
"cptCode": cpt,
"billedAmount": float(r.charge_amount or 0),
"receivedAmount": 0.0,
"status": r.state.value if hasattr(r.state, "value") else str(r.state),
"state": r.state.value if hasattr(r.state, "value") else str(r.state),
"denialReason": None,
"submissionDate": parsed_at_iso,
"batchId": r.batch_id,
"parsedAt": parsed_at_iso,
# Keep these so we can sort on them in-memory below.
"_sort_billedAmount": float(r.charge_amount or 0),
"_sort_submissionDate": parsed_at_iso,
})
if payer is not None:
needle = payer.casefold()
out = [
c for c in out
if needle in (c.get("payerName") or "").casefold()
]
out = [
c for c in out
if _date_in_bounds(c, "submissionDate", date_from, date_to)
]
if sort is not None:
out.sort(
key=lambda c: c.get(f"_sort_{sort}", 0) or 0,
reverse=(order == "desc"),
)
# Drop the private sort keys before returning.
for c in out:
c.pop("_sort_billedAmount", None)
c.pop("_sort_submissionDate", None)
return out[offset:offset + limit]
def iter_remittances(
self,
*,
batch_id: str | None = None,
payer: str | None = None,
claim_id: str | None = None,
date_from: str | None = None,
date_to: str | None = None,
sort: str | None = None,
order: str = "desc",
limit: int = 100,
offset: int = 0,
) -> list[dict]:
"""Return UI-shaped remittance dicts from the DB."""
with db.SessionLocal()() as s:
q = s.query(Remittance)
if batch_id is not None:
q = q.filter(Remittance.batch_id == batch_id)
if claim_id is not None:
q = q.filter(Remittance.claim_id == claim_id)
rows = q.all()
# Bulk-fetch all CAS rows for these remittances in one query
# (SP3 P2 follow-up — fixes the list-view's empty adjustments
# expansion). N+1-free.
cas_by_remit: dict[str, list] = {}
if rows:
from cyclone.parsers.cas_codes import reason_label
cas_rows = (
s.query(CasAdjustment)
.filter(CasAdjustment.remittance_id.in_([r.id for r in rows]))
.all()
)
for c in cas_rows:
cas_by_remit.setdefault(c.remittance_id, []).append(c)
out: list[dict] = []
for r in rows:
raw = r.raw_json or {}
parsed_at_iso = (
r.batch.parsed_at.isoformat().replace("+00:00", "Z")
if r.batch is not None
else r.received_at.isoformat().replace("+00:00", "Z")
)
payer_name = ""
if r.batch is not None and r.batch.raw_result_json:
payer_name = (
r.batch.raw_result_json.get("payer", {}).get("name", "")
)
adjustments = [
{
"group": c.group_code,
"reason": c.reason_code,
"label": reason_label(c.group_code, c.reason_code),
"amount": float(c.amount),
"quantity": float(c.quantity) if c.quantity is not None else None,
}
for c in cas_by_remit.get(r.id, [])
]
out.append({
"id": r.id,
"claimId": r.claim_id or "",
"payerName": payer_name,
"paidAmount": float(r.total_paid or 0),
"adjustmentAmount": float(r.adjustment_amount or 0),
"status": (
"reconciled" if r.status_code in ("21", "22")
else "received"
),
"denialReason": None,
"validationWarnings": [],
"receivedDate": r.received_at.isoformat().replace("+00:00", "Z"),
"batchId": r.batch_id,
"parsedAt": parsed_at_iso,
"adjustments": adjustments,
"_sort_receivedDate": r.received_at.isoformat().replace("+00:00", "Z"),
})
if payer is not None:
out = [r for r in out if r.get("payerName") == payer]
out = [
r for r in out
if _date_in_bounds(r, "receivedDate", date_from, date_to)
]
if sort is not None:
out.sort(
key=lambda r: r.get(f"_sort_{sort}", 0) or 0,
reverse=(order == "desc"),
)
for r in out:
r.pop("_sort_receivedDate", None)
return out[offset:offset + limit]
def distinct_providers(self) -> list[dict]:
"""Group claims by NPI and return one row per provider."""
with db.SessionLocal()() as s:
rows = s.query(Claim).all()
by_npi: dict[str, dict] = {}
for r in rows:
npi = r.provider_npi or ""
if npi not in by_npi:
raw = r.raw_json or {}
bp = raw.get("billing_provider", {})
by_npi[npi] = to_ui_provider(
npi=npi,
name=bp.get("name") or "",
tax_id=bp.get("tax_id"),
address=None,
city=None,
state=None,
zip=None,
phone=None,
claim_count=0,
outstanding_ar=0.0,
)
by_npi[npi]["claimCount"] += 1
return list(by_npi.values())
def recent_activity(self, *, limit: int = 200) -> list[dict]:
"""Return recent activity events from the DB, newest first."""
with db.SessionLocal()() as s:
rows = (
s.query(ActivityEvent)
.order_by(ActivityEvent.ts.desc())
.limit(limit)
.all()
)
return [
{
"id": f"ae-{r.id}",
"kind": r.kind,
"message": (r.payload_json or {}).get("message", ""),
"timestamp": r.ts.isoformat().replace("+00:00", "Z"),
"npi": (r.payload_json or {}).get("npi"),
"amount": (r.payload_json or {}).get("amount"),
}
for r in rows
]
# -- 999 ACKs (SP3 P3 T13) -------------------------------------------
def add_ack(
self,
*,
source_batch_id: str,
accepted_count: int,
rejected_count: int,
received_count: int,
ack_code: str,
raw_json: dict,
) -> db.Ack:
"""Persist a 999 ACK row and return it.
``source_batch_id`` must reference an existing ``batches.id``.
For received 999s with no source batch the caller should pass a
synthetic id (e.g. ``"999-<interchange_control_number>"``) —
see ``/api/parse-999`` for that policy.
``raw_json`` is the full ``ParseResult999`` model dump; the
detail endpoint surfaces it without re-parsing the original
X12 text.
"""
with db.SessionLocal()() as s:
row = Ack(
source_batch_id=source_batch_id,
accepted_count=accepted_count,
rejected_count=rejected_count,
received_count=received_count,
ack_code=ack_code,
parsed_at=utcnow(),
raw_json=raw_json,
)
s.add(row)
s.commit()
s.refresh(row)
return row
def list_acks(self) -> list[db.Ack]:
"""Return every 999 ACK row, newest first (auto-increment id desc)."""
with db.SessionLocal()() as s:
return (
s.query(Ack)
.order_by(Ack.id.desc())
.all()
)
def get_ack(self, ack_id: int) -> db.Ack | None:
"""Return a single ACK row by id, or ``None`` if not found."""
with db.SessionLocal()() as s:
return s.get(Ack, ack_id)
# -- TA1 (Interchange Acknowledgment) -------------------------------
def add_ta1_ack(
self,
*,
source_batch_id: str,
control_number: str,
interchange_date: date | None,
interchange_time: str | None,
ack_code: str,
note_code: str | None,
ack_generated_date: date | None,
sender_id: str,
receiver_id: str,
raw_json: dict,
) -> db.Ta1Ack:
"""Persist a TA1 (Interchange Acknowledgment) row and return it.
Mirrors :meth:`add_ack` for the lower-level envelope ack. The
flat columns are promoted out of ``raw_json`` so the list
endpoint can sort/filter without a JSON parse; the full
``ParseResultTa1`` stays in ``raw_json`` for the detail endpoint.
"""
with db.SessionLocal()() as s:
row = db.Ta1Ack(
source_batch_id=source_batch_id,
control_number=control_number,
interchange_date=interchange_date,
interchange_time=interchange_time,
ack_code=ack_code,
note_code=note_code,
ack_generated_date=ack_generated_date,
sender_id=sender_id,
receiver_id=receiver_id,
parsed_at=utcnow(),
raw_json=raw_json,
)
s.add(row)
s.commit()
s.refresh(row)
return row
def list_ta1_acks(self) -> list[db.Ta1Ack]:
"""Return every TA1 ACK row, newest first (auto-increment id desc).
Mirrors :meth:`list_acks` — the API endpoint slices to its own
``limit`` so the ``total`` field reflects the full row count.
"""
with db.SessionLocal()() as s:
return (
s.query(db.Ta1Ack)
.order_by(db.Ta1Ack.id.desc())
.all()
)
def get_ta1_ack(self, ack_id: int) -> db.Ta1Ack | None:
"""Return a single TA1 ACK row by id, or ``None`` if not found."""
with db.SessionLocal()() as s:
return s.get(db.Ta1Ack, ack_id)
# -- 277CA (SP10) --------------------------------------------------
def add_277ca_ack(
self,
*,
source_batch_id: str,
control_number: str,
accepted_count: int,
rejected_count: int,
paid_count: int,
pended_count: int,
raw_json: dict,
) -> db.Two77caAck:
"""Persist a 277CA (Claim Acknowledgment) row and return it.
Mirrors :meth:`add_ack` but for the claim-level ack. The
per-claim status detail stays in ``raw_json``; only the four
counts are promoted so the list endpoint stays fast.
"""
with db.SessionLocal()() as s:
row = db.Two77caAck(
source_batch_id=source_batch_id,
control_number=control_number,
accepted_count=accepted_count,
rejected_count=rejected_count,
paid_count=paid_count,
pended_count=pended_count,
parsed_at=utcnow(),
raw_json=raw_json,
)
s.add(row)
s.commit()
s.refresh(row)
return row
def list_277ca_acks(self) -> list[db.Two77caAck]:
"""Return every 277CA ACK row, newest first (auto-increment id desc)."""
with db.SessionLocal()() as s:
return (
s.query(db.Two77caAck)
.order_by(db.Two77caAck.id.desc())
.all()
)
def get_277ca_ack(self, ack_id: int) -> db.Two77caAck | None:
"""Return a single 277CA ACK row by id, or ``None`` if not found."""
with db.SessionLocal()() as s:
return s.get(db.Two77caAck, ack_id)
# -- SP17: encrypted DB backups -------------------------------------
def add_backup_pending(self, *, filename: str, backup_dir: str) -> db.DbBackup:
"""Insert a ``pending`` row for a backup that is about to start.
The BackupService fills in ``status`` / ``size_bytes`` /
``db_fingerprint`` / ``table_count`` / ``completed_at`` after
the encrypted blob lands on disk.
"""
with db.SessionLocal()() as s:
row = db.DbBackup(
filename=filename,
backup_dir=backup_dir,
size_bytes=0,
db_fingerprint=None,
table_count=0,
created_at=utcnow(),
completed_at=None,
status="pending",
error_message=None,
)
s.add(row)
s.commit()
s.refresh(row)
return row
# -- manual reconciliation (T12) -----------------------------------
def list_unmatched(self, *, kind: str = "both") -> dict:
"""Return unmatched claims and/or remittances.
An unmatched claim is one with ``matched_remittance_id IS NULL`` —
either auto-match never paired it, or it was unpaired by
``manual_unmatch``. An unmatched remittance is one with
``claim_id IS NULL`` — symmetric FK on the remittance side; we
update this in ``manual_match`` so the filter reflects the pair.
Note: T10's ``reconcile.run`` only writes the claim-side FK
(``Claim.matched_remittance_id``) when auto-pairing. Auto-matched
remittances therefore still show as "unmatched" here until the
pair is touched (re-ingest, manual unmatch + rematch). That gap
is intentional for T12 — fixing it requires modifying T10.
``kind`` selects which side(s) to return:
- "claims": only claims
- "remittances": only remittances
- "both": both (default)
Returns ``{"claims": [...], "remittances": [...]}`` with the
unused side always an empty list (never absent) so callers can
unconditionally index.
"""
if kind not in ("claims", "remittances", "both"):
raise ValueError(
f"list_unmatched: unknown kind={kind!r} "
"(expected 'claims', 'remittances', or 'both')"
)
result: dict = {"claims": [], "remittances": []}
with db.SessionLocal()() as s:
if kind in ("claims", "both"):
rows = (
s.query(Claim)
.filter(Claim.matched_remittance_id.is_(None))
.order_by(Claim.id.asc())
.all()
)
for r in rows:
parsed_at = (
r.batch.parsed_at
if r.batch is not None
else r.service_date_from or utcnow()
)
result["claims"].append(
to_ui_claim_from_orm(
r, batch_id=r.batch_id, parsed_at=parsed_at,
)
)
if kind in ("remittances", "both"):
rows = (
s.query(Remittance)
.filter(Remittance.claim_id.is_(None))
.order_by(Remittance.id.asc())
.all()
)
for r in rows:
parsed_at = (
r.batch.parsed_at
if r.batch is not None
else r.received_at
)
result["remittances"].append(
to_ui_remittance_from_orm(
r, batch_id=r.batch_id, parsed_at=parsed_at,
)
)
return result
def manual_match(self, claim_id: str, remit_id: str) -> dict:
"""Pair a claim with a remittance manually (operator override).
Steps:
1. Load the claim; raise ``AlreadyMatchedError`` if it already
has a match (we never silently overwrite an existing pair).
2. Load the remittance; raise ``LookupError`` if missing.
3. Compute the new claim state via ``reconcile.apply_payment``
(or ``apply_reversal`` for status codes 21/22).
4. Insert a ``Match`` row with ``strategy="manual"``.
5. Update the claim (``state``, ``matched_remittance_id``) AND
the remittance (``claim_id``) so the symmetric FK reflects
the pair — required for ``list_unmatched`` to drop them.
6. Record an ``ActivityEvent(kind="manual_match", ...)``.
7. Commit; return ``{"claim": <ui>, "match": <ui>}``.
``reconcile.apply_payment`` may return a noop (claim in terminal
state); we surface that as ``InvalidStateError`` rather than
silently pairing, because the operator clearly intended a state
change. The T15 API endpoint maps this to a 409 Conflict.
"""
from cyclone import reconcile as _reconcile
with db.SessionLocal()() as s:
claim = s.get(Claim, claim_id)
if claim is None:
raise LookupError(f"claim {claim_id} not found")
if claim.matched_remittance_id is not None:
raise AlreadyMatchedError(
f"claim {claim_id} already matched to "
f"{claim.matched_remittance_id}"
)
remit = s.get(Remittance, remit_id)
if remit is None:
raise LookupError(f"remittance {remit_id} not found")
prior_state = claim.state
if remit.is_reversal:
intent = _reconcile.apply_reversal(claim, remit)
else:
intent = _reconcile.apply_payment(
claim, remit,
charge=claim.charge_amount,
paid=remit.total_paid,
status_code=remit.status_code,
)
if intent.skipped or intent.new_state is None:
current = (
claim.state.value
if hasattr(claim.state, "value")
else str(claim.state)
)
raise InvalidStateError(
current_state=current,
activity_kind=intent.activity_kind,
)
new_state = intent.new_state
now = utcnow()
s.add(Match(
claim_id=claim_id,
remittance_id=remit_id,
strategy="manual",
matched_at=now,
prior_claim_state=prior_state,
is_reversal=remit.is_reversal,
))
claim.state = new_state
claim.matched_remittance_id = remit_id
# Symmetric FK update — see list_unmatched docstring for why
# we don't rely on T10 to do this.
remit.claim_id = claim_id
# SP7: line-level reconciliation + claim-level CAS aggregate.
# Skipped for reversals — they don't have SV1↔SVC line pairs.
if not remit.is_reversal:
_reconcile._reconcile_pair(s, claim, remit)
s.add(ActivityEvent(
ts=now,
kind="manual_match",
batch_id=remit.batch_id,
claim_id=claim_id,
remittance_id=remit_id,
payload_json={
"strategy": "manual",
"new_state": new_state.value,
"prior_state": prior_state.value,
"is_reversal": remit.is_reversal,
},
))
s.commit()
parsed_at = (
claim.batch.parsed_at
if claim.batch is not None
else now
)
claim_dict = to_ui_claim_from_orm(
claim, batch_id=claim.batch_id, parsed_at=parsed_at,
)
matched_at_iso = now.isoformat().replace("+00:00", "Z")
return {
"claim": claim_dict,
"match": {
"strategy": "manual",
"claimId": claim_id,
"remittanceId": remit_id,
"matchedAt": matched_at_iso,
"isReversal": remit.is_reversal,
"priorState": prior_state.value,
"newState": new_state.value,
},
}
def manual_unmatch(self, claim_id: str) -> dict:
"""Unpair a previously matched claim and restore its prior state.
Reverses ``manual_match`` (and auto-match as a side-effect of
clearing the FK). Strategy:
1. Load the claim; raise ``NotMatchedError`` if it isn't
currently matched.
2. Delete every ``Match`` row for the claim (there may be more
than one — reversals create a 2nd row, see T10 spec).
3. Restore ``claim.state`` from the latest Match's
``prior_claim_state``; fall back to ``SUBMITTED`` when
``prior_claim_state`` is NULL (auto-match doesn't set it for
non-reversal payments — see reconcile.run line ~278).
4. Clear ``claim.matched_remittance_id`` and the symmetric
``remit.claim_id`` so ``list_unmatched`` surfaces the pair
again.
5. Record ``ActivityEvent(kind="manual_unmatch", ...)`` and
commit.
6. Return ``{"claim": <ui>, "deletedMatches": <count>}``.
"""
with db.SessionLocal()() as s:
claim = s.get(Claim, claim_id)
if claim is None:
raise LookupError(f"claim {claim_id} not found")
if claim.matched_remittance_id is None:
raise NotMatchedError(
f"claim {claim_id} has no active match"
)
matches = (
s.query(Match)
.filter(Match.claim_id == claim_id)
.order_by(Match.matched_at.desc())
.all()
)
if not matches:
# Defensive: matched_remittance_id was set but no Match
# rows exist. Shouldn't happen, but if it does, fall back
# to clearing the FK and starting fresh.
latest = None
restored_state = ClaimState.SUBMITTED
else:
latest = matches[0]
restored_state = (
latest.prior_claim_state
if latest.prior_claim_state is not None
else ClaimState.SUBMITTED
)
deleted_count = len(matches)
for m in matches:
s.delete(m)
claim.state = restored_state
claim.matched_remittance_id = None
# Clear the symmetric FK on the remittance so list_unmatched
# surfaces the pair again. The remittance may have been
# deleted between the match and this call — guard with a
# get() so we don't blow up on a stale FK.
if latest is not None:
paired_remit = s.get(Remittance, latest.remittance_id)
if paired_remit is not None:
paired_remit.claim_id = None
now = utcnow()
s.add(ActivityEvent(
ts=now,
kind="manual_unmatch",
claim_id=claim_id,
payload_json={
"restored_state": restored_state.value,
"deleted_matches": deleted_count,
},
))
s.commit()
parsed_at = (
claim.batch.parsed_at
if claim.batch is not None
else now
)
claim_dict = to_ui_claim_from_orm(
claim, batch_id=claim.batch_id, parsed_at=parsed_at,
)
return {
"claim": claim_dict,
"deletedMatches": deleted_count,
}
# ------------------------------------------------------------------
# SP9: providers / payers / payer_configs / clearhouse
# ------------------------------------------------------------------
def list_providers(self, *, is_active: bool | None = True) -> list[Provider]:
"""List providers. ``is_active=None`` returns all."""
from cyclone.db import Provider as ProviderORM
from cyclone.providers import Provider
with db.SessionLocal()() as s:
q = s.query(ProviderORM)
if is_active is not None:
q = q.filter(ProviderORM.is_active == (1 if is_active else 0))
rows = q.order_by(ProviderORM.label).all()
return [Provider.model_validate(_provider_orm_to_dict(r)) for r in rows]
def get_provider(self, npi: str) -> Provider | None:
from cyclone.db import Provider as ProviderORM
from cyclone.providers import Provider
with db.SessionLocal()() as s:
row = s.get(ProviderORM, npi)
return Provider.model_validate(_provider_orm_to_dict(row)) if row else None
def upsert_provider(self, provider: Provider) -> Provider:
from cyclone.db import Provider as ProviderORM
with db.SessionLocal()() as s:
row = s.get(ProviderORM, provider.npi)
now = utcnow().isoformat()
if row is None:
row = ProviderORM(
npi=provider.npi, label=provider.label,
legal_name=provider.legal_name, tax_id=provider.tax_id,
taxonomy_code=provider.taxonomy_code,
address_line1=provider.address_line1,
address_line2=provider.address_line2,
city=provider.city, state=provider.state, zip=provider.zip,
is_active=1 if provider.is_active else 0,
created_at=provider.created_at.isoformat(),
updated_at=now,
)
s.add(row)
else:
row.label = provider.label
row.legal_name = provider.legal_name
row.tax_id = provider.tax_id
row.taxonomy_code = provider.taxonomy_code
row.address_line1 = provider.address_line1
row.address_line2 = provider.address_line2
row.city = provider.city
row.state = provider.state
row.zip = provider.zip
row.is_active = 1 if provider.is_active else 0
row.updated_at = now
s.commit()
return self.get_provider(provider.npi) # type: ignore[return-value]
def list_payers(self, *, is_active: bool | None = True) -> list[Payer]:
from cyclone.db import Payer as PayerORM
from cyclone.providers import Payer
with db.SessionLocal()() as s:
q = s.query(PayerORM)
if is_active is not None:
q = q.filter(PayerORM.is_active == (1 if is_active else 0))
rows = q.order_by(PayerORM.payer_id).all()
return [Payer.model_validate(_payer_orm_to_dict(r)) for r in rows]
def get_payer_config(self, payer_id: str, transaction_type: str) -> dict | None:
from cyclone.db import PayerConfigORM
with db.SessionLocal()() as s:
row = s.get(PayerConfigORM, (payer_id, transaction_type))
return dict(row.config_json) if row else None
def get_clearhouse(self) -> Clearhouse | None:
from cyclone.db import ClearhouseORM
from cyclone.providers import Clearhouse
with db.SessionLocal()() as s:
row = s.get(ClearhouseORM, 1)
if row is None:
return None
return Clearhouse.model_validate({
"id": 1,
"name": row.name,
"tpid": row.tpid,
"submitter_name": row.submitter_name,
"submitter_id_qual": row.submitter_id_qual,
"submitter_contact_name": row.submitter_contact_name,
"submitter_contact_email": row.submitter_contact_email,
"filename_block": dict(row.filename_block_json),
"sftp_block": dict(row.sftp_block_json),
"updated_at": row.updated_at,
})
def ensure_clearhouse_seeded(self) -> None:
"""Insert the default clearhouse singleton + 3 providers + CO_TXIX payer
if they don't exist. Idempotent. Called from the API lifespan."""
from cyclone.db import ClearhouseORM, Payer as PayerORM, PayerConfigORM, Provider as ProviderORM
from cyclone.providers import Clearhouse
with db.SessionLocal()() as s:
if s.get(ClearhouseORM, 1) is None:
ch = Clearhouse(
id=1,
name="dzinesco",
tpid="11525703",
submitter_name="Dzinesco",
submitter_id_qual="46",
submitter_contact_name="Tyler Martinez",
submitter_contact_email="tyler@dzinesco.com",
filename_block={
"tz": "America/Denver",
"outbound_template": "{tpid}-{tx}-{ts_mt}-1of1.{ext}",
"inbound_template": "TP{tpid}-{orig_tx}_M{tracking}-{ts}-1of1_{file_type}.x12",
},
sftp_block={
"host": "mft.gainwelltechnologies.com",
"port": 22,
"username": "colorado-fts\\coxix_prod_11525703",
"paths": {
"outbound": "/CO XIX/PROD/coxix_prod_11525703/FromHPE",
"inbound": "/CO XIX/PROD/coxix_prod_11525703/ToHPE",
},
"stub": True,
"staging_dir": "./var/sftp/staging",
"poll_seconds": 300,
"auth": {"method": "keychain", "secret_ref": "sftp.gainwell.password"},
},
updated_at=utcnow(),
)
s.add(ClearhouseORM(
id=1,
name=ch.name,
tpid=ch.tpid,
submitter_name=ch.submitter_name,
submitter_id_qual=ch.submitter_id_qual,
submitter_contact_name=ch.submitter_contact_name,
submitter_contact_email=ch.submitter_contact_email,
filename_block_json=ch.filename_block.model_dump(),
sftp_block_json=ch.sftp_block.model_dump(),
updated_at=ch.updated_at.isoformat(),
))
# Seed 3 providers (idempotent)
from cyclone.providers import Provider
now = utcnow().isoformat()
for npi, label in [
("1881068062", "Montrose"),
("1851446637", "Delta"),
("1467507269", "Salida"),
]:
if s.get(ProviderORM, npi) is None:
s.add(ProviderORM(
npi=npi,
label=label,
legal_name="TOC, Inc.",
tax_id="721587149",
taxonomy_code="251E00000X",
address_line1="1100 East Main St",
address_line2="Suite A",
city="Montrose",
state="CO",
zip="814014063",
is_active=1,
created_at=now,
updated_at=now,
))
# Seed CO_TXIX payer (idempotent)
if s.get(PayerORM, "CO_TXIX") is None:
s.add(PayerORM(
payer_id="CO_TXIX",
name="Colorado Medical Assistance Program",
receiver_name="COLORADO MEDICAL ASSISTANCE PROGRAM",
receiver_id="COMEDASSISTPROG",
is_active=1,
created_at=now,
updated_at=now,
))
# 837P config block
s.add(PayerConfigORM(
payer_id="CO_TXIX",
transaction_type="837P",
config_json={
"submitter_name": "Dzinesco",
"submitter_contact_name": "Tyler Martinez",
"submitter_contact_email": "tyler@dzinesco.com",
"receiver_name": "COLORADO MEDICAL ASSISTANCE PROGRAM",
"receiver_id_qualifier": "46",
"receiver_id": "COMEDASSISTPROG",
"bht06_allowed": ["CH", "RP"],
"bht06_default": "CH",
"sbr09_default": "MC",
"sbr09_allowed": ["MC", "16", "MA", "MB", "ZZ"],
"payer_id_qualifier": "PI",
"payer_id": "CO_TXIX",
"pwk_supported": False,
"cas_2320_group_allowed": False,
"claim_type_codes": {"11": "Office", "12": "Home", "99": "Other"},
},
updated_at=now,
))
# 835 config block
s.add(PayerConfigORM(
payer_id="CO_TXIX",
transaction_type="835",
config_json={
"expected_payer_tax_ids": [
"81-1725341", "811725341", "84-0644739",
"840644739", "1811725341",
],
"expected_payer_health_plan_id": "7912900843",
"payer_name_pattern": "^CO_(TXIX|BHA)$",
},
updated_at=now,
))
s.commit()
# ---------------------------------------------------------------------------
# SP9: ORM-to-Pydantic conversion helpers
# ---------------------------------------------------------------------------
def _provider_orm_to_dict(row) -> dict:
return {
"npi": row.npi,
"label": row.label,
"legal_name": row.legal_name,
"tax_id": row.tax_id,
"taxonomy_code": row.taxonomy_code,
"address_line1": row.address_line1,
"address_line2": row.address_line2,
"city": row.city,
"state": row.state,
"zip": row.zip,
"is_active": bool(row.is_active),
"created_at": row.created_at,
"updated_at": row.updated_at,
}
def _payer_orm_to_dict(row) -> dict:
return {
"payer_id": row.payer_id,
"name": row.name,
"receiver_name": row.receiver_name,
"receiver_id": row.receiver_id,
"is_active": bool(row.is_active),
"created_at": row.created_at,
"updated_at": row.updated_at,
}
# Module-level singleton — same import path the old InMemoryStore used.
store = CycloneStore()