feat: Delta Indiv eligibility on coversme portal and ADA paper claim/preauth
Eligibility: rebuilt the Delta Indiv worker for my.deltadentalcoversme.com — Dentist tab -> Universal Delta Sign In -> username/Next -> password -> SIGN IN, confirmation-code (MFA) page detected by URL so the app's OTP popup shows, then Search for Patient -> Last Name + DOB -> Submit. On the "Benefits for" details page it reads the patient name, Subscriber # and Eligible through (active while that date is today or later) and saves the PDF downloaded by the Print link. Session persists: login is skipped while Search for Patient is reachable, and Delta Indiv cookies are no longer wiped on agent startup. The button needs Last Name + DOB (member ID optional; backend falls back to the scraped Subscriber #). Chatbot gains a Delta Indiv option and aliases. Claims: Delta Indiv uses the same 2024 ADA form as BCBS with the payer address Delta Dental, P.O. Box 103, Stevens Point, WI 54481-0103. Adds Delta Indiv Claim/PreAuth (ADA Form) buttons, Claim All and AI queue routing, Print ADA Form in the claim viewer, a Delta Indiv fee schedule (copied from BCBS), and Delta Indiv as its own insurance type so it is no longer treated as Deltains. Also renames eligibility buttons: Delta Indiv (Last name, DOB or ID), Metlife Dental (ID or SSN), Altus (ID, First name, DOB). Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
This commit is contained in:
Claude Opus 5.5
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[
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{ "Procedure Code": "D0120", "Description": "Periodic oral evaluation - established patient", "Price": 105 },
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{ "Procedure Code": "D0140", "Description": "Limited oral evaluation - problem focused", "Price": 90 },
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{ "Procedure Code": "D0145", "Description": "Oral evaluation for a patient under three years of age and counseling with primary caregiver", "Price": "NC" },
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{ "Procedure Code": "D0150", "Description": "Comprehensive oral evaluation - new or established patient", "Price": 120 },
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{ "Procedure Code": "D0180", "Description": "Comprehensive periodontal evaluation - new or established patient", "Price": 37 },
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{ "Procedure Code": "D0190", "Description": "Screening of a patient (PHDH only)", "Price": 20 },
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{ "Procedure Code": "D0191", "Description": "Assessment of a patient (PHDH only)", "Price": 20 },
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{ "Procedure Code": "D0210", "Description": "Intraoral - complete series of radiographic images", "Price": 120 },
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{ "Procedure Code": "D0220", "Description": "Intraoral - periapical, first radiographic image", "Price": 60 },
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{ "Procedure Code": "D0230", "Description": "Intraoral - periapical, each additional radiographic image", "Price": 50 },
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{ "Procedure Code": "D0240", "Description": "Intraoral - occlusal radiographic image", "Price": "NC" },
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{ "Procedure Code": "D0270", "Description": "Bitewing - single radiographic image", "Price": 14 },
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{ "Procedure Code": "D0272", "Description": "Bitewings - two radiographic images", "Price": 80 },
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{ "Procedure Code": "D0273", "Description": "Bitewings - three radiographic images", "Price": 27 },
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{ "Procedure Code": "D0274", "Description": "Bitewings - four radiographic images", "Price": 160 },
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{ "Procedure Code": "D0330", "Description": "Panoramic radiographic image", "Price": 150 },
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{ "Procedure Code": "D0340", "Description": "Cephalometric radiograph image (Oral surgeon only)", "Price": 74 },
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{ "Procedure Code": "D0364", "Description": "CBCT - less than one jaw (interpret)", "Price": 350 },
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{ "Procedure Code": "D0365", "Description": "CBCT - mandible (interpret)", "Price": 350 },
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{ "Procedure Code": "D0366", "Description": "CBCT - maxilla (interpret)", "Price": 350 },
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{ "Procedure Code": "D0367", "Description": "CBCT - both jaws (interpret)", "Price": 400 },
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{ "Procedure Code": "D0368", "Description": "CBCT - include TMJ (interpret)", "Price": 375 },
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{ "Procedure Code": "D0380", "Description": "CBCT - less than one jaw (capture only)", "Price": 300 },
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{ "Procedure Code": "D0381", "Description": "CBCT - mandible (capture only)", "Price": 300 },
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{ "Procedure Code": "D0382", "Description": "CBCT - maxilla (capture only)", "Price": 300 },
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{ "Procedure Code": "D0383", "Description": "CBCT - both jaws / include TMJ (capture only)", "Price": 350 },
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{ "Procedure Code": "D1110", "Description": "Prophylaxis - adult, 14 yo or older", "Price": 150 },
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{ "Procedure Code": "D1120", "Description": "Prophylaxis - child, 0-13 yo", "Price": 120 },
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{ "Procedure Code": "D1206", "Description": "Topical application of fluoride varnish", "Price": 26 },
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{ "Procedure Code": "D1208", "Description": "Topical application of fluoride - excluding varnish", "Price": 90 },
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{ "Procedure Code": "D1351", "Description": "Sealant - per tooth", "Price": 80 },
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{ "Procedure Code": "D1354", "Description": "Application of caries arresting medicament - per tooth", "Price": 15 },
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{ "Procedure Code": "D1510", "Description": "Space maintainer - fixed, unilateral - per quadrant", "Price": "NC" },
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{ "Procedure Code": "D1516", "Description": "Space maintainer - fixed, bilateral, maxillary", "Price": "NC" },
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{ "Procedure Code": "D1517", "Description": "Space maintainer - fixed, bilateral, mandibular", "Price": "NC" },
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{ "Procedure Code": "D1520", "Description": "Space maintainer - removable, unilateral, per quadrant", "Price": "NC" },
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{ "Procedure Code": "D1526", "Description": "Space maintainer - removable, bilateral, maxillary", "Price": "NC" },
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{ "Procedure Code": "D1527", "Description": "Space maintainer - removable, bilateral, mandibular", "Price": "NC" },
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{ "Procedure Code": "D1575", "Description": "Distal shoe space maintainer - fixed, unilateral, per quadrant", "Price": "NC" },
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{ "Procedure Code": "D1701", "Description": "Pfizer-BioNTech Covid-19 vaccine - first dose", "Price": 45.87 },
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{ "Procedure Code": "D1702", "Description": "Pfizer-BioNTech Covid-19 vaccine - second dose", "Price": 45.87 },
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{ "Procedure Code": "D1707", "Description": "Janssen Covid-19 vaccine - single dose", "Price": 45.87 },
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{ "Procedure Code": "D1708", "Description": "Pfizer-BioNTech Covid-19 vaccine - third dose", "Price": 45.87 },
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{ "Procedure Code": "D1709", "Description": "Pfizer-BioNTech Covid-19 vaccine - booster dose", "Price": 45.87 },
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{ "Procedure Code": "D1712", "Description": "Janssen Covid-19 vaccine - booster dose", "Price": 45.87 },
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{ "Procedure Code": "D1713", "Description": "Pfizer-BioNTech Covid-19 vaccine pediatric - first dose", "Price": 45.87 },
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{ "Procedure Code": "D1714", "Description": "Pfizer-BioNTech Covid-19 vaccine pediatric - second dose", "Price": 45.87 },
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{ "Procedure Code": "D1999", "Description": "Unspecified preventive procedure, by report", "Price": 50 },
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{ "Procedure Code": "D2140", "Description": "Amalgam - one surface, primary or permanent", "Price": 150 },
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{ "Procedure Code": "D2150", "Description": "Amalgam - two surfaces, primary or permanent", "Price": 200 },
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{ "Procedure Code": "D2160", "Description": "Amalgam - three surfaces, primary or permanent", "Price": 92 },
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{ "Procedure Code": "D2161", "Description": "Amalgam - four or more surfaces, primary or permanent", "Price": 116 },
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{ "Procedure Code": "D2330", "Description": "Resin-based composite - one surface, anterior", "Price": 180 },
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{ "Procedure Code": "D2331", "Description": "Resin-based composite - two surfaces, anterior", "Price": 220 },
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{ "Procedure Code": "D2332", "Description": "Resin-based composite - three surfaces, anterior", "Price": 280 },
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{ "Procedure Code": "D2335", "Description": "Resin-based composite - four or more surfaces or involving incisal angle (anterior)", "Price": 350 },
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{ "Procedure Code": "D2390", "Description": "Resin-based composite crown, anterior", "Price": "NC" },
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{ "Procedure Code": "D2391", "Description": "Resin-based composite - one surface, posterior", "Price": 200 },
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{ "Procedure Code": "D2392", "Description": "Resin-based composite - two surfaces, posterior", "Price": 250 },
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{ "Procedure Code": "D2393", "Description": "Resin-based composite - three surfaces, posterior", "Price": 280 },
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{ "Procedure Code": "D2394", "Description": "Resin-based composite - four or more surfaces, posterior", "Price": 320 },
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{ "Procedure Code": "D2710", "Description": "Crown - resin-based composite (indirect)", "Price": "NC" },
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{ "Procedure Code": "D2740", "Description": "Crown - porcelain/ceramic", "Price": 1300 },
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{ "Procedure Code": "D2750", "Description": "Crown - porcelain fused to high noble metal", "Price": 1300 },
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{ "Procedure Code": "D2751", "Description": "Crown - porcelain fused to predominantly base metal", "Price": 1200 },
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{ "Procedure Code": "D2752", "Description": "Crown - porcelain fused to noble metal", "Price": 1200 },
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{ "Procedure Code": "D2790", "Description": "Crown - full cast high noble metal", "Price": "NC" },
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{ "Procedure Code": "D2910", "Description": "Re-cement or re-bond inlay, onlay or partial coverage restoration", "Price": 57 },
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{ "Procedure Code": "D2920", "Description": "Re-cement or re-bond crown", "Price": 120 },
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{ "Procedure Code": "D2929", "Description": "Prefabricated porcelain/ceramic crown - primary tooth", "Price": "NC" },
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{ "Procedure Code": "D2930", "Description": "Prefabricated stainless steel crown - primary tooth", "Price": "NC" },
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{ "Procedure Code": "D2931", "Description": "Prefabricated stainless steel crown - permanent tooth", "Price": 171 },
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{ "Procedure Code": "D2932", "Description": "Prefabricated resin crown", "Price": "NC" },
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{ "Procedure Code": "D2934", "Description": "Prefabricated esthetic coated stainless steel crown - primary tooth", "Price": "NC" },
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{ "Procedure Code": "D2950", "Description": "Core buildup, including any pins when required", "Price": 350 },
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{ "Procedure Code": "D2951", "Description": "Pin retention - per tooth, in addition to restoration", "Price": 27 },
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{ "Procedure Code": "D2954", "Description": "Prefabricated post and core in addition to crown", "Price": 450 },
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{ "Procedure Code": "D2955", "Description": "Post removal", "Price": 350 },
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{ "Procedure Code": "D2980", "Description": "Crown repair necessitated by restorative material failure", "Price": 115 },
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{ "Procedure Code": "D2999", "Description": "Unspecified restorative procedure, by report", "Price": "IC" },
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{ "Procedure Code": "D3120", "Description": "Pulp cap - indirect (excluding final restoration)", "Price": 34 },
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{ "Procedure Code": "D3220", "Description": "Therapeutic pulpotomy (excluding final restoration)", "Price": "NC" },
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{ "Procedure Code": "D3230", "Description": "Pulpal therapy (resorbable filling) - anterior, primary tooth", "Price": 280 },
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{ "Procedure Code": "D3240", "Description": "Pulpal therapy (resorbable filling) - posterior, primary tooth", "Price": 490 },
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{ "Procedure Code": "D3310", "Description": "Endodontic therapy, anterior tooth (excluding final restoration)", "Price": 900 },
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{ "Procedure Code": "D3320", "Description": "Endodontic therapy, premolar tooth (excluding final restoration)", "Price": 1050 },
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{ "Procedure Code": "D3330", "Description": "Endodontic therapy, molar tooth (excluding final restoration)", "Price": 1250 },
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{ "Procedure Code": "D3346", "Description": "Retreatment of previous root canal therapy - anterior", "Price": 950 },
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{ "Procedure Code": "D3347", "Description": "Retreatment of previous root canal therapy - premolar", "Price": 1100 },
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{ "Procedure Code": "D3348", "Description": "Retreatment of previous root canal therapy - molar", "Price": 1500 },
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{ "Procedure Code": "D3410", "Description": "Apicoectomy - anterior", "Price": 407 },
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{ "Procedure Code": "D3421", "Description": "Apicoectomy - premolar (first root)", "Price": 460 },
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{ "Procedure Code": "D3425", "Description": "Apicoectomy - molar (first root)", "Price": 598 },
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{ "Procedure Code": "D3426", "Description": "Apicoectomy (each additional root)", "Price": 230 },
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{ "Procedure Code": "D4210", "Description": "Gingivectomy or gingivoplasty - four or more contiguous teeth per quadrant", "Price": 307 },
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{ "Procedure Code": "D4211", "Description": "Gingivectomy or gingivoplasty - one to three contiguous teeth per quadrant", "Price": 111 },
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{ "Procedure Code": "D4341", "Description": "Periodontal scaling and root planing - four or more teeth per quadrant", "Price": 250 },
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{ "Procedure Code": "D4342", "Description": "Periodontal scaling and root planing - one to three teeth, per quadrant", "Price": 90 },
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{ "Procedure Code": "D4346", "Description": "Scaling in presence of generalized moderate or severe gingival inflammation - full mouth", "Price": 60 },
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{ "Procedure Code": "D4910", "Description": "Periodontal maintenance", "Price": 250 },
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{ "Procedure Code": "D5110", "Description": "Complete denture - maxillary", "Price": 1700 },
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{ "Procedure Code": "D5120", "Description": "Complete denture - mandibular", "Price": 1700 },
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{ "Procedure Code": "D5130", "Description": "Immediate denture - maxillary", "Price": "NC" },
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{ "Procedure Code": "D5140", "Description": "Immediate denture - mandibular", "Price": "NC" },
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{ "Procedure Code": "D5211", "Description": "Maxillary partial denture - resin base", "Price": 1300 },
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{ "Procedure Code": "D5212", "Description": "Mandibular partial denture - resin base", "Price": 1300 },
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{ "Procedure Code": "D5213", "Description": "Maxillary partial denture - cast metal framework with resin denture bases", "Price": 1700 },
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{ "Procedure Code": "D5214", "Description": "Mandibular partial denture - cast metal framework with resin denture bases", "Price": 1700 },
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{ "Procedure Code": "D5225", "Description": "Maxillary partial denture - flexible base", "Price": "NC" },
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{ "Procedure Code": "D5226", "Description": "Mandibular partial denture - flexible base", "Price": "NC" },
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{ "Procedure Code": "D5510", "Description": "Repair broken complete denture base (QUAD)", "Price": 400 },
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{ "Procedure Code": "D5511", "Description": "Repair broken complete denture base, mandibular", "Price": 85 },
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{ "Procedure Code": "D5512", "Description": "Repair broken complete denture base, maxillary", "Price": 85 },
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{ "Procedure Code": "D5520", "Description": "Replace missing or broken teeth - complete denture (each tooth)", "Price": 200 },
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{ "Procedure Code": "D5611", "Description": "Repair broken resin partial denture base, mandibular", "Price": 77 },
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{ "Procedure Code": "D5612", "Description": "Repair broken resin partial denture base, maxillary", "Price": 77 },
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{ "Procedure Code": "D5621", "Description": "Repair broken cast partial denture base, mandibular", "Price": 104 },
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{ "Procedure Code": "D5622", "Description": "Repair broken cast partial denture base, maxillary", "Price": 104 },
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{ "Procedure Code": "D5630", "Description": "Repair or replace broken retentive/clasping materials - per tooth", "Price": 99 },
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{ "Procedure Code": "D5640", "Description": "Replace broken teeth - per tooth", "Price": 77 },
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{ "Procedure Code": "D5650", "Description": "Add tooth to existing partial denture", "Price": 92 },
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{ "Procedure Code": "D5660", "Description": "Add clasp to existing partial denture per tooth", "Price": 98 },
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{ "Procedure Code": "D5730", "Description": "Reline complete maxillary denture (chairside)", "Price": 500 },
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{ "Procedure Code": "D5731", "Description": "Reline complete mandibular denture (chairside)", "Price": 500 },
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{ "Procedure Code": "D5740", "Description": "Reline maxillary partial denture (chairside)", "Price": "NC" },
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{ "Procedure Code": "D5741", "Description": "Reline mandibular partial denture (chairside)", "Price": "NC" },
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{ "Procedure Code": "D5750", "Description": "Reline complete maxillary denture (laboratory)", "Price": 600 },
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{ "Procedure Code": "D5751", "Description": "Reline complete mandibular denture (laboratory)", "Price": 600 },
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{ "Procedure Code": "D5760", "Description": "Reline maxillary partial denture (laboratory)", "Price": "NC" },
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{ "Procedure Code": "D5761", "Description": "Reline mandibular partial denture (laboratory)", "Price": "NC" },
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{ "Procedure Code": "D6010", "Description": "Surgical placement of implant body", "Price": 1600 },
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{ "Procedure Code": "D6056", "Description": "Prefabricated abutment", "Price": 750 },
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{ "Procedure Code": "D6057", "Description": "Custom abutment", "Price": 800 },
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{ "Procedure Code": "D6058", "Description": "Implant crown - porcelain/ceramic", "Price": 1400 },
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{ "Procedure Code": "D6059", "Description": "Implant crown - PFM", "Price": 1400 },
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{ "Procedure Code": "D6100", "Description": "Surgical removal of implant body", "Price": 320 },
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{ "Procedure Code": "D6110", "Description": "Implant/abutment supported removable denture - maxillary", "Price": 1600 },
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{ "Procedure Code": "D6111", "Description": "Implant/abutment supported removable denture - mandibular", "Price": 1600 },
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{ "Procedure Code": "D6241", "Description": "Pontic - porcelain fused to metal", "Price": "NC" },
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{ "Procedure Code": "D6242", "Description": "Pontic - noble metal", "Price": 1400 },
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{ "Procedure Code": "D6245", "Description": "Pontic - porcelain/ceramic", "Price": 1400 },
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{ "Procedure Code": "D6751", "Description": "Retainer crown - porcelain fused to metal", "Price": "NC" },
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{ "Procedure Code": "D6930", "Description": "Re-cement or re-bond fixed partial denture", "Price": "NC" },
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{ "Procedure Code": "D6980", "Description": "Fixed partial denture repair", "Price": "NC" },
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{ "Procedure Code": "D6999", "Description": "Fixed prosthodontic procedure, by report", "Price": "IC" },
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{ "Procedure Code": "D7111", "Description": "Extraction, coronal remnants - primary tooth", "Price": 120 },
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{ "Procedure Code": "D7140", "Description": "Extraction, erupted tooth or exposed root (simple)", "Price": 150 },
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{ "Procedure Code": "D7210", "Description": "Extraction, erupted tooth requiring removal of bone and/or sectioning (surgical)", "Price": 280 },
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{ "Procedure Code": "D7220", "Description": "Removal of impacted tooth - soft tissue", "Price": 380 },
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{ "Procedure Code": "D7230", "Description": "Removal of impacted tooth - partially bony", "Price": 450 },
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{ "Procedure Code": "D7240", "Description": "Removal of impacted tooth - completely bony", "Price": 550 },
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{ "Procedure Code": "D7250", "Description": "Surgical removal of residual tooth roots", "Price": 280 },
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{ "Procedure Code": "D7251", "Description": "Coronectomy - intentional partial tooth removal, impacted teeth only", "Price": 134 },
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{ "Procedure Code": "D7270", "Description": "Tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth", "Price": 106 },
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{ "Procedure Code": "D7280", "Description": "Surgical access of an unerupted tooth", "Price": "NC" },
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{ "Procedure Code": "D7283", "Description": "Placement of device to facilitate eruption of impacted tooth", "Price": "NC" },
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{ "Procedure Code": "D7310", "Description": "Alveoloplasty in conjunction with extractions - four or more teeth per quadrant", "Price": 142 },
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{ "Procedure Code": "D7311", "Description": "Alveoloplasty in conjunction with extractions - one to three teeth per quadrant", "Price": 128 },
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{ "Procedure Code": "D7320", "Description": "Alveoloplasty not in conjunction with extractions - four or more teeth per quadrant", "Price": 187 },
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{ "Procedure Code": "D7321", "Description": "Alveoloplasty not in conjunction with extractions - one to three teeth per quadrant", "Price": 149 },
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{ "Procedure Code": "D7340", "Description": "Vestibuloplasty - ridge extension (second epithelialization)", "Price": 747 },
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{ "Procedure Code": "D7350", "Description": "Vestibuloplasty - ridge extension (Oral surgeon only)", "Price": 943 },
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{ "Procedure Code": "D7410", "Description": "Excision of benign lesion - diameter up to 1.25 cm", "Price": 115 },
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{ "Procedure Code": "D7411", "Description": "Excision of benign lesion - diameter greater than 1.25 cm", "Price": 208 },
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{ "Procedure Code": "D7450", "Description": "Removal of benign odontogenic cyst or tumor - up to 1.25 cm", "Price": 248 },
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{ "Procedure Code": "D7451", "Description": "Removal of benign odontogenic cyst or tumor - greater than 1.25 cm", "Price": 288 },
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{ "Procedure Code": "D7460", "Description": "Removal of benign nonodontogenic cyst or tumor - up to 1.25 cm", "Price": 121 },
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{ "Procedure Code": "D7461", "Description": "Removal of benign nonodontogenic cyst or tumor - greater than 1.25 cm", "Price": 143 },
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{ "Procedure Code": "D7471", "Description": "Removal of lateral exostosis (maxilla or mandible)", "Price": 143 },
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{ "Procedure Code": "D7472", "Description": "Removal of torus palatinus", "Price": 143 },
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{ "Procedure Code": "D7473", "Description": "Removal of torus mandibularis", "Price": 143 },
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{ "Procedure Code": "D7910", "Description": "Suture of recent small wounds up to 5 cm", "Price": 400 },
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{ "Procedure Code": "D7950", "Description": "Bone graft - maxilla/mandible", "Price": 800 },
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{ "Procedure Code": "D7953", "Description": "Bone graft for socket preservation after extraction", "Price": 800 },
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{ "Procedure Code": "D7961", "Description": "Buccal/labial frenectomy (frenulectomy)", "Price": 107 },
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{ "Procedure Code": "D7962", "Description": "Lingual frenectomy (frenulectomy)", "Price": 107 },
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{ "Procedure Code": "D7963", "Description": "Frenuloplasty", "Price": 416 },
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{ "Procedure Code": "D7970", "Description": "Excision of hyperplastic tissue - per arch", "Price": 246 },
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{ "Procedure Code": "D7999", "Description": "Unspecified oral surgery procedure, by report", "Price": "IC" },
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{ "Procedure Code": "D8010", "Description": "Limited orthodontic treatment of the primary dentition (Orthodontist only)", "Price": "NC" },
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{ "Procedure Code": "D8020", "Description": "Limited orthodontic treatment of the transitional dentition (Orthodontist only)", "Price": "NC" },
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{ "Procedure Code": "D8030", "Description": "Limited orthodontic treatment of the adolescent dentition (Orthodontist only)", "Price": "NC" },
|
||||
{ "Procedure Code": "D8040", "Description": "Limited orthodontic treatment of the adult dentition (Orthodontist only)", "Price": "NC" },
|
||||
{ "Procedure Code": "D8070", "Description": "Comprehensive orthodontic treatment of the transitional dentition (Orthodontist only)", "Price": "NC" },
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||||
{ "Procedure Code": "D8080", "Description": "Comprehensive orthodontic treatment of the adolescent dentition (Orthodontist only)", "Price": "NC" },
|
||||
{ "Procedure Code": "D8090", "Description": "Comprehensive orthodontic treatment of the adult dentition (Orthodontist only)", "Price": "NC" },
|
||||
{ "Procedure Code": "D8660", "Description": "Pre-orthodontic treatment examination (Orthodontist only)", "Price": "NC" },
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||||
{ "Procedure Code": "D8670", "Description": "Periodic orthodontic treatment visit (Orthodontist only)", "Price": 215 },
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||||
{ "Procedure Code": "D8680", "Description": "Orthodontic retention (Orthodontist only)", "Price": 85 },
|
||||
{ "Procedure Code": "D8703", "Description": "Replacement of lost or broken retainer - maxillary (Orthodontist only)", "Price": "NC" },
|
||||
{ "Procedure Code": "D8704", "Description": "Replacement of lost or broken retainer - mandibular (Orthodontist only)", "Price": "NC" },
|
||||
{ "Procedure Code": "D8999", "Description": "Unspecified orthodontic procedure, by report (Orthodontist only)", "Price": "NC" },
|
||||
{ "Procedure Code": "D9110", "Description": "Palliative treatment of dental pain - per visit", "Price": 36 },
|
||||
{ "Procedure Code": "D9222", "Description": "Deep sedation/general anesthesia - first 15 minutes", "Price": 90 },
|
||||
{ "Procedure Code": "D9223", "Description": "Deep sedation/general anesthesia - each additional 15-minute increment", "Price": 90 },
|
||||
{ "Procedure Code": "D9230", "Description": "Analgesia, anxiolysis, inhalation of nitrous oxide", "Price": 15 },
|
||||
{ "Procedure Code": "D9248", "Description": "Nonintravenous conscious sedation", "Price": 45 },
|
||||
{ "Procedure Code": "D9310", "Description": "Consultation - diagnostic service (Specialist only)", "Price": 63 },
|
||||
{ "Procedure Code": "D9410", "Description": "House/extended care facility call, once per facility per day", "Price": 39 },
|
||||
{ "Procedure Code": "D9450", "Description": "Rural add-on encounter payment", "Price": 31 },
|
||||
{ "Procedure Code": "D9920", "Description": "Behavior management, by report", "Price": 86 },
|
||||
{ "Procedure Code": "D9930", "Description": "Treatment of complications (postsurgical) - unusual circumstances, by report", "Price": 30 },
|
||||
{ "Procedure Code": "D9941", "Description": "Fabrication of athletic mouthguard", "Price": "NC" },
|
||||
{ "Procedure Code": "D9944", "Description": "Occlusal guard - hard appliance, full arch", "Price": "NC" },
|
||||
{ "Procedure Code": "D9945", "Description": "Occlusal guard - soft appliance, full arch", "Price": "NC" },
|
||||
{ "Procedure Code": "D9946", "Description": "Occlusal guard - hard appliance, partial arch", "Price": "NC" },
|
||||
{ "Procedure Code": "D9999", "Description": "Unspecified adjunctive procedure, by report", "Price": "IC" }
|
||||
]
|
||||
@@ -828,6 +828,7 @@ export function ClaimForm({
|
||||
if (!p) return "";
|
||||
if (p.includes("masshealth") || p === "mh" || p === "mass health" || p.includes("cmsp")) return "MH";
|
||||
if (p.includes("commonwealth care alliance") || p === "cca") return "CCA";
|
||||
if (p.includes("indiv")) return "DeltaIndiv";
|
||||
if (p.includes("ddma") || p.includes("delta dental ma")) return "DDMA";
|
||||
if (p.includes("delta ins") || p === "deltains") return "DeltaIns";
|
||||
if (p.includes("tufts") || p.includes("dentaquest") || p === "tuftssco") return "TuftsSCO";
|
||||
@@ -1660,6 +1661,8 @@ export function ClaimForm({
|
||||
runWithPriceCheck(() => handleBCBSClaim());
|
||||
} else if (siteKey === "ALTUS") {
|
||||
runWithPriceCheck(() => handleAltusClaim());
|
||||
} else if (siteKey === "DELTAINDIV" || siteKey === "DELTA_INDIV") {
|
||||
runWithPriceCheck(() => handleDeltaIndivClaim());
|
||||
} else {
|
||||
toast({
|
||||
title: "No automated claim for this insurance",
|
||||
@@ -1997,6 +2000,7 @@ export function ClaimForm({
|
||||
const ADA_PAPER_PAYERS = {
|
||||
BCBS_MA: { label: "BCBS", insuranceProvider: "BCBS MA", mailTo: "BCBS MA" },
|
||||
ALTUS: { label: "Altus", insuranceProvider: "Altus Dental", mailTo: "Altus Dental" },
|
||||
DELTA_INDIV: { label: "Delta Indiv", insuranceProvider: "Delta Dental Indiv", mailTo: "Delta Dental" },
|
||||
} as const;
|
||||
|
||||
const handleAdaPaperClaim = async (
|
||||
@@ -2093,6 +2097,11 @@ export function ClaimForm({
|
||||
opts?: { auto?: boolean; preauth?: boolean },
|
||||
) => handleAdaPaperClaim("ALTUS", formToUse, opts);
|
||||
|
||||
const handleDeltaIndivClaim = (
|
||||
formToUse?: ClaimFormData & { uploadedFiles?: File[] },
|
||||
opts?: { auto?: boolean; preauth?: boolean },
|
||||
) => handleAdaPaperClaim("DELTA_INDIV", formToUse, opts);
|
||||
|
||||
const handleClaimSaved = async () => {
|
||||
const missingFields: string[] = [];
|
||||
if (!form.memberId?.trim()) missingFields.push("Member ID");
|
||||
@@ -2244,6 +2253,8 @@ export function ClaimForm({
|
||||
handleBCBSClaim(pricedForm, { auto: true });
|
||||
} else if (key === "altus") {
|
||||
handleAltusClaim(pricedForm, { auto: true });
|
||||
} else if (key === "deltaindiv" || key === "delta_indiv") {
|
||||
handleDeltaIndivClaim(pricedForm, { auto: true });
|
||||
} else {
|
||||
handleMHSubmit(pricedForm);
|
||||
}
|
||||
@@ -2278,6 +2289,13 @@ export function ClaimForm({
|
||||
insuranceSiteKey: "altus",
|
||||
});
|
||||
handleAltusClaim(pricedForm, { auto: true, preauth: true });
|
||||
} else if (key === "deltaindiv" || key === "delta_indiv") {
|
||||
const pricedForm = mapPricesForForm({
|
||||
form: { ...form, insuranceSiteKey: "deltaindiv" },
|
||||
patientDOB: patient?.dateOfBirth ?? "",
|
||||
insuranceSiteKey: "deltaindiv",
|
||||
});
|
||||
handleDeltaIndivClaim(pricedForm, { auto: true, preauth: true });
|
||||
} else {
|
||||
// Re-apply fee-schedule prices with the now-loaded patient DOB before submitting —
|
||||
// the earlier chatbot-prefill pass may have run before `patient` finished loading,
|
||||
@@ -2421,6 +2439,7 @@ export function ClaimForm({
|
||||
<SelectItem value="CCA">CCA</SelectItem>
|
||||
<SelectItem value="DDMA">DDMA</SelectItem>
|
||||
<SelectItem value="DeltaIns">Delta Ins</SelectItem>
|
||||
<SelectItem value="DeltaIndiv">Delta Indiv</SelectItem>
|
||||
<SelectItem value="TuftsSCO">Tufts SCO</SelectItem>
|
||||
<SelectItem value="UnitedSCO">United SCO</SelectItem>
|
||||
<SelectItem value="BCBS">BCBS</SelectItem>
|
||||
@@ -2945,6 +2964,13 @@ export function ClaimForm({
|
||||
>
|
||||
Altus Claim (ADA Form)
|
||||
</Button>
|
||||
<Button
|
||||
className="w-44 bg-teal-700 hover:bg-teal-800 text-white"
|
||||
onClick={() => runWithPriceCheck(() => handleDeltaIndivClaim())}
|
||||
title="Save the claim and open a filled ADA paper form to print and mail to Delta Dental (P.O. Box 103, Stevens Point, WI)"
|
||||
>
|
||||
Delta Indiv Claim (ADA Form)
|
||||
</Button>
|
||||
<Button
|
||||
className="w-36 bg-emerald-600 hover:bg-emerald-700 text-white"
|
||||
onClick={() => runWithPriceCheck(handleClaimSaved)}
|
||||
@@ -3046,6 +3072,7 @@ export function ClaimForm({
|
||||
<SelectItem value="CCA">CCA</SelectItem>
|
||||
<SelectItem value="DDMA">DDMA</SelectItem>
|
||||
<SelectItem value="DeltaIns">Delta Ins</SelectItem>
|
||||
<SelectItem value="DeltaIndiv">Delta Indiv</SelectItem>
|
||||
<SelectItem value="TuftsSCO">Tufts SCO</SelectItem>
|
||||
<SelectItem value="UnitedSCO">United SCO</SelectItem>
|
||||
<SelectItem value="BCBS">BCBS</SelectItem>
|
||||
@@ -3494,6 +3521,13 @@ export function ClaimForm({
|
||||
>
|
||||
Altus PreAuth (ADA Form)
|
||||
</Button>
|
||||
<Button
|
||||
className="w-44 bg-teal-700 hover:bg-teal-800 text-white"
|
||||
onClick={() => handleDeltaIndivClaim(undefined, { preauth: true })}
|
||||
title="Save the preauth and open a filled ADA form (Request for Predetermination/Preauthorization) to print and mail to Delta Dental (P.O. Box 103, Stevens Point, WI)"
|
||||
>
|
||||
Delta Indiv PreAuth (ADA Form)
|
||||
</Button>
|
||||
</div>
|
||||
</div>
|
||||
</div>
|
||||
|
||||
@@ -354,7 +354,7 @@ export default function ClaimViewModal({
|
||||
<Button variant="outline" onClick={() => onOpenChange(false)}>
|
||||
Close
|
||||
</Button>
|
||||
{/bcbs|blue cross|altus/i.test(claim.insuranceProvider ?? "") && (
|
||||
{/bcbs|blue cross|altus|indiv/i.test(claim.insuranceProvider ?? "") && (
|
||||
<Button
|
||||
variant="outline"
|
||||
onClick={() => {
|
||||
@@ -362,7 +362,11 @@ export default function ClaimViewModal({
|
||||
showAdaClaimForm(
|
||||
claim.id!,
|
||||
tab,
|
||||
/altus/i.test(claim.insuranceProvider ?? "") ? "ALTUS" : "BCBS_MA",
|
||||
/altus/i.test(claim.insuranceProvider ?? "")
|
||||
? "ALTUS"
|
||||
: /indiv/i.test(claim.insuranceProvider ?? "")
|
||||
? "DELTA_INDIV"
|
||||
: "BCBS_MA",
|
||||
).catch((err) =>
|
||||
toast({
|
||||
title: "ADA form failed",
|
||||
|
||||
@@ -194,7 +194,7 @@ export function AltusEligibilityButton({
|
||||
) : (
|
||||
<>
|
||||
<CheckCircle className="h-4 w-4 mr-2" />
|
||||
Altus
|
||||
Altus (ID, First name, DOB)
|
||||
</>
|
||||
)}
|
||||
</Button>
|
||||
|
||||
@@ -116,10 +116,10 @@ export function DeltaIndivEligibilityButton({
|
||||
// ── Socket event handlers ─────────────────────────────────────────────────
|
||||
|
||||
const handleDeltaIndivStart = async () => {
|
||||
if (!memberId || !dateOfBirth) {
|
||||
if (!lastName || !dateOfBirth) {
|
||||
toast({
|
||||
title: "Missing fields",
|
||||
description: "Member ID and Date of Birth are required.",
|
||||
description: "Last Name and Date of Birth are required.",
|
||||
variant: "destructive",
|
||||
});
|
||||
return;
|
||||
@@ -419,7 +419,7 @@ export function DeltaIndivEligibilityButton({
|
||||
) : (
|
||||
<>
|
||||
<CheckCircle className="h-4 w-4 mr-2" />
|
||||
Delta Indiv
|
||||
Delta Indiv (Last name, DOB or ID)
|
||||
</>
|
||||
)}
|
||||
</Button>
|
||||
|
||||
@@ -355,7 +355,7 @@ export function MetLifeEligibilityButton({
|
||||
) : (
|
||||
<>
|
||||
<CheckCircle className="h-4 w-4 mr-2" />
|
||||
Metlife Dental
|
||||
Metlife Dental (ID or SSN)
|
||||
</>
|
||||
)}
|
||||
</Button>
|
||||
|
||||
@@ -137,6 +137,7 @@ const INSURANCE_TYPE_OPTIONS: { value: string; label: string }[] = [
|
||||
{ value: "mh", label: "MassHealth" },
|
||||
{ value: "ddma", label: "DDMA" },
|
||||
{ value: "delta-ins", label: "Deltains" },
|
||||
{ value: "delta-indiv", label: "Delta Indiv" },
|
||||
{ value: "united-sco", label: "United SCO" },
|
||||
{ value: "united-ucard", label: "United Ucard" },
|
||||
{ value: "tufts-sco", label: "Tufts SCO" },
|
||||
@@ -601,13 +602,17 @@ export function ChatbotButton() {
|
||||
if (!eligibilityIdData) return;
|
||||
addMsg("user", "Check eligibility now");
|
||||
addMsg("bot", "Opening the eligibility check page...");
|
||||
if (eligibilityIdData.memberId) {
|
||||
await syncEditedPatientFields(eligibilityIdData.memberId, eligibilityIdData.dob, eligibilityIdData.patient?.id);
|
||||
let { memberId, firstName, lastName } = eligibilityIdData;
|
||||
// Delta Indiv searches by last name + DOB: a letters-only "Member ID"
|
||||
// (e.g. "MOUSSAID 01/22/1991") is really the last name.
|
||||
if (eligibilityIdData.autoCheck === "delta-indiv" && /^[A-Za-z'\- ]+$/.test(memberId) && !lastName) {
|
||||
lastName = memberId;
|
||||
memberId = "";
|
||||
}
|
||||
prefillAndNavigate(eligibilityIdData.memberId, eligibilityIdData.dob, eligibilityIdData.autoCheck, {
|
||||
firstName: eligibilityIdData.firstName,
|
||||
lastName: eligibilityIdData.lastName,
|
||||
});
|
||||
if (memberId) {
|
||||
await syncEditedPatientFields(memberId, eligibilityIdData.dob, eligibilityIdData.patient?.id);
|
||||
}
|
||||
prefillAndNavigate(memberId, eligibilityIdData.dob, eligibilityIdData.autoCheck, { firstName, lastName });
|
||||
};
|
||||
|
||||
const handleBatchEligibilityRun = () => {
|
||||
@@ -1186,7 +1191,15 @@ export function ChatbotButton() {
|
||||
<Select
|
||||
value={eligibilityIdData.autoCheck}
|
||||
onValueChange={(value) =>
|
||||
setEligibilityIdData((prev) => (prev ? { ...prev, autoCheck: value } : prev))
|
||||
setEligibilityIdData((prev) => {
|
||||
if (!prev) return prev;
|
||||
// Delta Indiv searches by last name + DOB: a letters-only "Member ID"
|
||||
// (e.g. "MOUSSAID 01/22/1991") is really the last name.
|
||||
if (value === "delta-indiv" && /^[A-Za-z'\- ]+$/.test(prev.memberId) && !prev.lastName) {
|
||||
return { ...prev, autoCheck: value, lastName: prev.memberId, firstName: prev.firstName ?? "", memberId: "" };
|
||||
}
|
||||
return { ...prev, autoCheck: value };
|
||||
})
|
||||
}
|
||||
>
|
||||
<SelectTrigger className="h-7 text-xs bg-white">
|
||||
|
||||
@@ -89,6 +89,7 @@ export const PatientForm = forwardRef<PatientFormRef, PatientFormProps>(
|
||||
const p = (val || "").toLowerCase().trim();
|
||||
if (p.includes("masshealth") || p === "mh" || p === "mass health" || p.includes("cmsp")) return "MassHealth";
|
||||
if (p.includes("commonwealth care alliance") || p === "cca") return "CCA";
|
||||
if (p.includes("indiv")) return "Delta Dental Indiv";
|
||||
if (p.includes("ddma")) return "DDMA";
|
||||
if (p.includes("delta dental") || p.includes("delta ins") || p === "deltains") return "DeltaIns";
|
||||
if (p.includes("tufts") || p.includes("dentaquest") || p === "tuftssco") return "TuftsSCO";
|
||||
@@ -504,6 +505,7 @@ export const PatientForm = forwardRef<PatientFormRef, PatientFormProps>(
|
||||
<SelectItem value="CCA">CCA</SelectItem>
|
||||
<SelectItem value="DDMA">DDMA</SelectItem>
|
||||
<SelectItem value="DeltaIns">Delta Ins</SelectItem>
|
||||
<SelectItem value="Delta Dental Indiv">Delta Indiv</SelectItem>
|
||||
<SelectItem value="TuftsSCO">Tufts SCO</SelectItem>
|
||||
<SelectItem value="UnitedSCO">United SCO</SelectItem>
|
||||
<SelectItem value="BCBS">BCBS</SelectItem>
|
||||
|
||||
@@ -122,6 +122,7 @@ const PREAUTH_SITE_KEYS: Record<string, string> = {
|
||||
BCBS: "BCBS", // paper ADA form, filled and saved to Documents > PreAuth
|
||||
BCBSMA: "BCBS",
|
||||
ALTUS: "ALTUS", // paper ADA form, like BCBS
|
||||
DELTAINDIV: "DELTA_INDIV", // paper ADA form, like BCBS
|
||||
};
|
||||
const toPreauthSiteKey = (siteKey: string): string | undefined =>
|
||||
PREAUTH_SITE_KEYS[siteKey.replace(/_/g, "").toUpperCase()];
|
||||
@@ -131,6 +132,7 @@ function deriveInsuranceSiteKey(provider: string | null | undefined): string {
|
||||
if (!p) return "";
|
||||
if (p.includes("masshealth") || p === "mh" || p === "mass health" || p.includes("cmsp")) return "MH";
|
||||
if (p.includes("commonwealth care alliance") || p === "cca") return "CCA";
|
||||
if (p.includes("indiv")) return "DeltaIndiv";
|
||||
if (p.includes("ddma") || p.includes("delta dental ma")) return "DDMA";
|
||||
if (p.includes("delta ins") || p === "deltains") return "DeltaIns";
|
||||
if (p.includes("tufts") || p.includes("dentaquest") || p === "tuftssco") return "TuftsSCO";
|
||||
@@ -1187,6 +1189,8 @@ export default function AppointmentsPage() {
|
||||
if (m < 0 || (m === 0 && today.getDate() < dobDate.getDate())) age--;
|
||||
}
|
||||
autoCheck = age !== null && age >= 21 ? "mh-history" : "cmsp";
|
||||
} else if (p.includes("indiv")) {
|
||||
autoCheck = "delta-indiv";
|
||||
} else if (p.includes("delta dental ma")) {
|
||||
autoCheck = "ddma";
|
||||
} else if (p.includes("delta dental ins")) {
|
||||
@@ -1743,8 +1747,8 @@ export default function AppointmentsPage() {
|
||||
autoSubmit: true,
|
||||
}));
|
||||
}
|
||||
// BCBS / Altus are paper forms filled and saved in the background — come straight back here
|
||||
if (/^(bcbs|altus)/i.test(siteKey)) sessionStorage.setItem("ai_claim_return_to_schedule", "1");
|
||||
// BCBS / Altus / Delta Indiv are paper forms filled and saved in the background — come straight back here
|
||||
if (/^(bcbs|altus|delta_?indiv)/i.test(siteKey)) sessionStorage.setItem("ai_claim_return_to_schedule", "1");
|
||||
else sessionStorage.removeItem("ai_claim_return_to_schedule");
|
||||
setAiClaimModalOpen(false);
|
||||
setLocation(`/claims?appointmentId=${appointmentId}`);
|
||||
|
||||
@@ -120,6 +120,8 @@ export default function InsuranceStatusPage() {
|
||||
const isFormIncomplete = !memberId || !dateOfBirth;
|
||||
// United Ucard can also search by first name + last name + DOB when there's no member ID.
|
||||
const isUcardFormIncomplete = !dateOfBirth || (!memberId && !(firstName && lastName));
|
||||
// Delta Indiv portal searches by last name + DOB (member ID not needed)
|
||||
const isDeltaIndivFormIncomplete = !dateOfBirth || !lastName;
|
||||
// Altus searches by Member ID, or by Subscriber Last Name when the ID is unknown; First Name + DOB always required.
|
||||
const isAltusFormIncomplete = !dateOfBirth || !firstName?.trim() || (!memberId && !lastName?.trim());
|
||||
const [isCheckingEligibilityStatus, setIsCheckingEligibilityStatus] =
|
||||
@@ -194,8 +196,15 @@ export default function InsuranceStatusPage() {
|
||||
if (!raw) return;
|
||||
try {
|
||||
const { memberId: id, dob, autoCheck: ac, firstName: fn, lastName: ln } = JSON.parse(raw);
|
||||
if (id) setMemberId(id);
|
||||
if (fn) setFirstName(fn);
|
||||
if (ac === "delta-indiv") {
|
||||
// Delta Indiv can search by last name + DOB alone — clear any stale
|
||||
// member ID / first name left over from a previous patient.
|
||||
setMemberId(id ?? "");
|
||||
setFirstName(fn ?? "");
|
||||
} else {
|
||||
if (id) setMemberId(id);
|
||||
if (fn) setFirstName(fn);
|
||||
}
|
||||
if (ln) setLastName(ln);
|
||||
if (dob) {
|
||||
// dob may arrive as MM/DD/YYYY or YYYY-MM-DD — normalize to YYYY-MM-DD.
|
||||
@@ -759,7 +768,11 @@ export default function InsuranceStatusPage() {
|
||||
// Auto-trigger after prefill (from chatbot or schedule page "Check Eligibility")
|
||||
useEffect(() => {
|
||||
if (!pendingAutoCheck.current || !dateOfBirth) return;
|
||||
if (!memberId && !((pendingAutoCheck.current === "united-ucard" || pendingAutoCheck.current === "altus") && firstName && lastName)) return;
|
||||
if (
|
||||
!memberId &&
|
||||
!((pendingAutoCheck.current === "united-ucard" || pendingAutoCheck.current === "altus") && firstName && lastName) &&
|
||||
!(pendingAutoCheck.current === "delta-indiv" && lastName)
|
||||
) return;
|
||||
const check = pendingAutoCheck.current;
|
||||
pendingAutoCheck.current = null;
|
||||
if (check === "mh" || check === "mh-history") {
|
||||
@@ -1124,7 +1137,7 @@ export default function InsuranceStatusPage() {
|
||||
dateOfBirth={dateOfBirth}
|
||||
firstName={firstName}
|
||||
lastName={lastName}
|
||||
isFormIncomplete={isFormIncomplete}
|
||||
isFormIncomplete={isDeltaIndivFormIncomplete}
|
||||
autoTrigger={triggerTarget === "delta-indiv"}
|
||||
onAutoTriggered={() => setTriggerTarget(null)}
|
||||
onPdfReady={async (pdfId, fallbackFilename) => {
|
||||
|
||||
@@ -9,6 +9,7 @@ import rawTuftsSCOCodeTable from "@/assets/data/procedureCodesTuftsSCO.json";
|
||||
import rawDeltainsCodeTable from "@/assets/data/procedureCodesDeltains.json";
|
||||
import rawBCBSCodeTable from "@/assets/data/procedureCodesBCBS.json";
|
||||
import rawAltusCodeTable from "@/assets/data/procedureCodesAltus.json";
|
||||
import rawDeltaIndivCodeTable from "@/assets/data/procedureCodesDeltaIndiv.json";
|
||||
import rawMetLifeCodeTable from "@/assets/data/procedureCodesMetLife.json";
|
||||
import { PROCEDURE_COMBOS } from "./procedureCombos";
|
||||
|
||||
@@ -30,6 +31,7 @@ const TUFTSSCO_CODE_TABLE = rawTuftsSCOCodeTable as CodeRow[];
|
||||
const DELTAINS_CODE_TABLE = rawDeltainsCodeTable as CodeRow[];
|
||||
const BCBS_CODE_TABLE = rawBCBSCodeTable as CodeRow[];
|
||||
const ALTUS_CODE_TABLE = rawAltusCodeTable as CodeRow[];
|
||||
const DELTAINDIV_CODE_TABLE = rawDeltaIndivCodeTable as CodeRow[];
|
||||
const METLIFE_CODE_TABLE = rawMetLifeCodeTable as CodeRow[];
|
||||
|
||||
export type ClaimFormLike = {
|
||||
@@ -109,6 +111,15 @@ const METLIFE_CODE_MAP: Map<string, CodeRow> = (() => {
|
||||
return m;
|
||||
})();
|
||||
|
||||
const DELTAINDIV_CODE_MAP: Map<string, CodeRow> = (() => {
|
||||
const m = new Map<string, CodeRow>();
|
||||
for (const r of DELTAINDIV_CODE_TABLE) {
|
||||
const k = normalizeCode(String(r["Procedure Code"] || ""));
|
||||
if (k && !m.has(k)) m.set(k, r);
|
||||
}
|
||||
return m;
|
||||
})();
|
||||
|
||||
const UNITEDDH_CODE_MAP: Map<string, CodeRow> = (() => {
|
||||
const m = new Map<string, CodeRow>();
|
||||
for (const r of UNITEDDH_CODE_TABLE) {
|
||||
@@ -152,6 +163,7 @@ function getCodeMap(insuranceSiteKey?: string): Map<string, CodeRow> {
|
||||
if (k === "ddma") return DDMA_CODE_MAP;
|
||||
if (k === "bcbs" || k === "bcbsma") return BCBS_CODE_MAP;
|
||||
if (k === "altus") return ALTUS_CODE_MAP;
|
||||
if (k === "deltaindiv") return DELTAINDIV_CODE_MAP;
|
||||
if (k === "metlife" || k === "metlifedental") return METLIFE_CODE_MAP;
|
||||
if (k === "deltains") return DELTAINS_CODE_MAP;
|
||||
if (k === "unitedsco" || k === "uniteddh" || k === "dentalhub") return UNITEDDH_CODE_MAP;
|
||||
|
||||
Reference in New Issue
Block a user