feat: BCBS preauth via ADA form; preauth shows dark gray; claim/preauth download
- Preauth column: BCBS appointments fill the 2024 ADA form with box 1 "Request for Predetermination/Preauthorization" (claim saved as PREAUTH), saved to Documents > PreAuth as ADA_PreAuth_*.pdf, then back to schedule - Claim form PreAuth tab: "BCBS PreAuth (ADA Form)" button - Preauth forms list procedure dates 6 days after the preauth date - PREAUTH claims create no payment; saved BCBS preauths count as preauthorized - Schedule: appointments with a completed preauth show dark gray - "Download Filled Claim/Preauth Form" also zips the BCBS preauth forms Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
This commit is contained in:
Claude Opus 5.5
@@ -1899,10 +1899,13 @@ export function ClaimForm({
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// BCBS MA has no online claim submission: save the claim, then open the filled
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// 2024 ADA paper form to print, sign and mail.
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// `auto` (AI claim queue): no tab — just save the filled form to Documents > Claims.
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// `preauth`: same ADA form with box 1 "Request for Predetermination/Preauthorization"
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// ticked (claim saved as PREAUTH), saved to Documents > PreAuth.
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const handleBCBSClaim = async (
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formToUse?: ClaimFormData & { uploadedFiles?: File[] },
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{ auto = false }: { auto?: boolean } = {},
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{ auto = false, preauth = false }: { auto?: boolean; preauth?: boolean } = {},
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) => {
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const kind = preauth ? "preauth" : "claim";
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const f = formToUse ?? form;
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const missingFields: string[] = [];
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if (!f.memberId?.trim()) missingFields.push("Member ID");
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@@ -1923,7 +1926,7 @@ export function ClaimForm({
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if (filteredServiceLines.length === 0) {
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toast({
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title: "No procedure codes",
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description: "Please add at least one procedure code before creating the claim form.",
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description: `Please add at least one procedure code before creating the ${kind} form.`,
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variant: "destructive",
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});
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return;
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@@ -1953,7 +1956,8 @@ export function ClaimForm({
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appointmentId: appointmentIdToUse,
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claimFiles: claimFilesMeta,
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...(selectedNpiProviderId ? { npiProviderId: selectedNpiProviderId } : {}),
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});
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...(preauth ? { status: "PREAUTH" } : {}),
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} as any);
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if (auto) {
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await saveAdaClaimForm(createdClaim.id!);
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@@ -1963,15 +1967,17 @@ export function ClaimForm({
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// Saving the form marks the claim submitted — show the appointment as claimed
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queryClient.invalidateQueries({ queryKey: ["appointments", "day"] });
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toast({
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title: "BCBS claim form ready",
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description: "Claim saved and ADA form added to the patient's Documents > Claims. Print, sign, and mail it to BCBS MA.",
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title: preauth ? "BCBS preauth form ready" : "BCBS claim form ready",
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description: preauth
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? "PreAuth saved and ADA form added to the patient's Documents > PreAuth. Print, sign, and mail it to BCBS MA."
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: "Claim saved and ADA form added to the patient's Documents > Claims. Print, sign, and mail it to BCBS MA.",
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});
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onClose();
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} catch (err: any) {
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tab?.close();
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toast({
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title: "BCBS claim failed",
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description: err?.message ?? "Failed to create the ADA claim form.",
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title: preauth ? "BCBS preauth failed" : "BCBS claim failed",
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description: err?.message ?? `Failed to create the ADA ${kind} form.`,
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variant: "destructive",
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});
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}
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@@ -2144,6 +2150,13 @@ export function ClaimForm({
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handleCCAPreAuth();
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} else if (key === "united_sco" || key === "unitedco" || key === "dentalhub") {
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handleUnitedDHPreAuth();
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} else if (key === "bcbs" || key === "bcbs_ma") {
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const pricedForm = mapPricesForForm({
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form: { ...form, insuranceSiteKey: "bcbs" },
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patientDOB: patient?.dateOfBirth ?? "",
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insuranceSiteKey: "bcbs",
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});
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handleBCBSClaim(pricedForm, { auto: true, preauth: true });
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} else {
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// Re-apply fee-schedule prices with the now-loaded patient DOB before submitting —
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// the earlier chatbot-prefill pass may have run before `patient` finished loading,
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@@ -3331,6 +3344,13 @@ export function ClaimForm({
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>
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Tufts PreAuth
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</Button>
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<Button
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className="w-44 bg-sky-700 hover:bg-sky-800 text-white"
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onClick={() => handleBCBSClaim(undefined, { preauth: true })}
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title="Save the preauth and open a filled ADA form (Request for Predetermination/Preauthorization) to print and mail"
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>
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BCBS PreAuth (ADA Form)
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</Button>
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</div>
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</div>
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</div>
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@@ -119,6 +119,8 @@ const PREAUTH_SITE_KEYS: Record<string, string> = {
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CCA: "CCA",
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TUFTSSCO: "TUFTS_SCO",
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UNITEDSCO: "UNITED_SCO",
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BCBS: "BCBS", // paper ADA form, filled and saved to Documents > PreAuth
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BCBSMA: "BCBS",
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};
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const toPreauthSiteKey = (siteKey: string): string | undefined =>
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PREAUTH_SITE_KEYS[siteKey.replace(/_/g, "").toUpperCase()];
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@@ -144,7 +146,8 @@ function deriveInsuranceSiteKey(provider: string | null | undefined): string {
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}
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function appointmentCardColor(apt: ScheduledAppointment): string {
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if (apt.hasClaimWithNumber) return "bg-gray-500 text-white";
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// Claimed, or preauth done (e.g. BCBS preauth ADA form saved)
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if (apt.hasClaimWithNumber || apt.hasPreauth) return "bg-gray-500 text-white";
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if (apt.hasProcedures) return "bg-blue-500 text-white";
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return "bg-slate-100 text-gray-700 border-slate-300";
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}
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@@ -1537,12 +1540,12 @@ export default function AppointmentsPage() {
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const url = URL.createObjectURL(blob);
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const a = document.createElement("a");
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a.href = url;
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a.download = `filled_claim_forms_${formattedSelectedDate}.zip`;
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a.download = `filled_claim_preauth_forms_${formattedSelectedDate}.zip`;
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document.body.appendChild(a);
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a.click();
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document.body.removeChild(a);
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URL.revokeObjectURL(url);
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toast({ title: "Download started", description: `Filled claim forms for ${formattedSelectedDate} saved to your Downloads folder.` });
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toast({ title: "Download started", description: `Filled claim/preauth forms for ${formattedSelectedDate} saved to your Downloads folder.` });
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} catch (err: any) {
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toast({ title: "Download failed", description: err?.message ?? String(err), variant: "destructive" });
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} finally {
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@@ -1736,7 +1739,7 @@ export default function AppointmentsPage() {
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}));
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}
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// BCBS is a paper form filled and saved in the background — come straight back here
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if (!isPreauth && /^bcbs/i.test(siteKey)) sessionStorage.setItem("ai_claim_return_to_schedule", "1");
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if (/^bcbs/i.test(siteKey)) sessionStorage.setItem("ai_claim_return_to_schedule", "1");
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else sessionStorage.removeItem("ai_claim_return_to_schedule");
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setAiClaimModalOpen(false);
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setLocation(`/claims?appointmentId=${appointmentId}`);
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@@ -2129,7 +2132,7 @@ export default function AppointmentsPage() {
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</div>
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</div>
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{/* Download Filled Claim Form: ADA forms (e.g. BCBS) for the selected date */}
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{/* Download Filled Claim/Preauth Form: ADA forms (e.g. BCBS) for the selected date */}
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<div className="flex items-center gap-2 border rounded-md px-3 py-2 bg-white shadow-sm">
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<Button
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onClick={() => handleDownloadClaimPdfs()}
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@@ -2144,7 +2147,7 @@ export default function AppointmentsPage() {
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) : (
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<>
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<Download className="h-4 w-4 mr-1" />
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Download Filled Claim Form
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Download Filled Claim/Preauth Form
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</>
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)}
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</Button>
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