Files
cyclone/backend/tests/test_payer_rejected_acknowledge.py
T
Tyler 534130ee2b feat(db): migration 0014 relaxes claims/remittances PK to (batch_id, id)
Migration 0014 changes the PRIMARY KEYs of claims and remittances from
single-column id to composite (batch_id, id). Enables the spec'd
cross-batch CLM01 / CLP01 collision workflow: same CLM01 in multiple
batches is now representable (resubmits), pre-flight dedup 409 path is
genuinely exercisable, force-insert can skip pre-existing duplicates.

Strategy: PRAGMA defer_foreign_keys = ON + table recreation for every
table whose FKs pointed at the old single-column PK. Tables recreated:
remittances, claims, matches, cas_adjustments, service_line_payments,
line_reconciliations. Each child table gains a batch_id (or
remittance_batch_id) column for the composite FK side; INSERT INTO new
SELECT FROM old JOINs populate it from the already-recreated parent.

Cross-table FKs (remittances.claim_id, claims.matched_remittance_id)
cannot be SQL-enforced with composite PKs (SQLite has no ALTER
CONSTRAINT). Dropped at SQL level; enforced via application-layer
invariants in store.manual_match / manual_unmatch / reconcile.run and
the dedup.preflight_* helpers.

ORM updates (db.py):
- Claim / Remittance: composite PK via explicit PrimaryKeyConstraint in
  __table_args__ (column order matches SQL: batch_id, id).
- New Claim.matched_remittance_batch_id column.
- Match / CasAdjustment / ServiceLinePayment / LineReconciliation:
  added the batch side of their composite FK to the parent table.
- SQLAlchemy before_insert events auto-populate the batch side of the
  composite FK from session.new, then identity_map, then SQL fallback.

Production code updates:
- store.manual_match / manual_unmatch: also write
  matched_remittance_batch_id on the claim (was missing).
- api.py manual-match endpoint: same fix.
- reconcile.run: same fix for auto-matched pairs.

Test updates: replaced s.get(Claim, X) with the composite key
(batch_id, id) where batch_id is known, or s.query().filter().first()
where the test only knows the id. Tests that previously inserted a Match
row pointing at a non-existent Remittance now seed the parent Remittance
so the new NOT NULL composite FK is satisfied.
2026-06-21 18:56:18 -06:00

171 lines
5.7 KiB
Python

"""SP14 — Payer-Rejected acknowledge endpoint tests.
The endpoint marks payer-rejected claims as acknowledged so the
working-surface lane query filters them out. The original
payer_rejected_* fields stay intact (SP11 audit).
"""
from __future__ import annotations
import pytest
from cyclone import db
from cyclone.db import Claim, ClaimState
from cyclone.audit_log import verify_chain
@pytest.fixture(autouse=True)
def _setup(tmp_path, monkeypatch):
monkeypatch.setenv("CYCLONE_DB_URL", f"sqlite:///{tmp_path}/test.db")
db._reset_for_tests()
db.init_db()
def _make_claim(claim_id: str, *, payer_rejected: bool = True) -> None:
"""Insert a minimal claim with optional payer_rejected markers."""
from datetime import datetime, timezone
from cyclone.db import Batch
with db.SessionLocal()() as session:
batch = Batch(
id=f"b-{claim_id}",
kind="837p",
input_filename="t.x12",
parsed_at=datetime.now(timezone.utc),
)
session.add(batch)
session.flush()
claim = Claim(
id=claim_id,
batch_id=batch.id,
patient_control_number=claim_id,
state=ClaimState.SUBMITTED,
charge_amount=100,
)
if payer_rejected:
now = datetime.now(timezone.utc)
claim.payer_rejected_at = now
claim.payer_rejected_reason = "invalid diagnosis code"
claim.payer_rejected_status_code = "A7"
session.add(claim)
session.commit()
def test_acknowledge_marks_unacknowledged_claim():
_make_claim("C1", payer_rejected=True)
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"], "actor": "operator"},
)
assert r.status_code == 200, r.text
body = r.json()
assert body["ok"] is True
assert body["transitioned"] == 1
assert body["already_acked"] == 0
assert body["not_found"] == 0
assert body["not_rejected"] == 0
with db.SessionLocal()() as session:
# Migration 0014: composite PK — filter-by-id returns the single
# claim with this id (no cross-batch duplicates in this fixture).
c = session.query(Claim).filter(Claim.id == "C1").first()
assert c.payer_rejected_acknowledged_at is not None
assert c.payer_rejected_acknowledged_actor == "operator"
# Original fields stay intact for audit.
assert c.payer_rejected_at is not None
assert c.payer_rejected_status_code == "A7"
assert c.payer_rejected_reason == "invalid diagnosis code"
def test_acknowledge_is_idempotent():
_make_claim("C1", payer_rejected=True)
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r1 = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"]},
)
assert r1.json()["transitioned"] == 1
r2 = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"]},
)
assert r2.json()["transitioned"] == 0
assert r2.json()["already_acked"] == 1
def test_acknowledge_skips_non_payer_rejected_claims():
_make_claim("C1", payer_rejected=False)
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"]},
)
assert r.status_code == 200
body = r.json()
assert body["transitioned"] == 0
assert body["not_rejected"] == 1
def test_acknowledge_counts_missing_ids():
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["nope"]},
)
assert r.status_code == 200
body = r.json()
assert body["transitioned"] == 0
assert body["not_found"] == 1
def test_acknowledge_empty_claim_ids_400():
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": []},
)
assert r.status_code == 400
def test_acknowledge_writes_audit_event():
_make_claim("C1", payer_rejected=True)
from fastapi.testclient import TestClient
from cyclone.api import app
with TestClient(app) as client:
r = client.post(
"/api/inbox/payer-rejected/acknowledge",
json={"claim_ids": ["C1"], "actor": "alice"},
)
assert r.status_code == 200
# SP11: the chain is intact and includes the new event.
with db.SessionLocal()() as session:
result = verify_chain(session)
assert result.ok, f"chain broken: {result.reason} at {result.first_bad_id}"
# And the event itself is queryable.
import json as _json
from cyclone.db import AuditLog
with db.SessionLocal()() as session:
events = (
session.query(AuditLog)
.filter(AuditLog.event_type == "claim.payer_rejected_acknowledged")
.all()
)
assert len(events) == 1
e = events[0]
assert e.entity_type == "claim"
assert e.entity_id == "C1"
assert e.actor == "alice"
payload = _json.loads(e.payload_json) if e.payload_json else {}
assert payload["payer_rejected_status_code"] == "A7"