feat: United Ucard name+DOB eligibility search via chat, duplicate-record handling, Product ID as member ID

Co-Authored-By: Claude Sonnet 5 <noreply@anthropic.com>

apps/Backend/src/ai/internal-chat-graph.ts

@@ -5,6 +5,7 @@ import { getLlm, type AiProvider } from "./llm-factory";
 export type InternalChatIntent =
   | "check_eligibility"     // by patient name → look up in DB
   | "eligibility_by_id"     // by explicit memberId + dob (no name)
+  | "eligibility_by_name_dob" // by explicit first name + last name + dob (no memberId) — United Ucard name search
   | "batch_eligibility"     // multiple patients by memberId + dob
   | "batch_eligibility_by_name" // multiple patients by name (no memberId)
   | "batch_claim"           // claim same procedures for multiple patients by name
@@ -26,6 +27,8 @@ export interface ChatClassification {
   patientName?: string;       // for check_eligibility / find_patient / schedule_appointment
   memberId?: string;          // for eligibility_by_id / check_and_claim
   dob?: string;               // for eligibility_by_id / check_and_claim (MM/DD/YYYY)
+  firstName?: string;         // for eligibility_by_name_dob
+  lastName?: string;          // for eligibility_by_name_dob
   // --- batch eligibility (multiple patients) ---
   patients?: { memberId: string; dob: string }[];  // for batch_eligibility
   // --- batch claim (same procedures for multiple patients by name) ---
@@ -58,6 +61,8 @@ Respond ONLY with valid JSON (no markdown fences):
   "intent": "<intent>",
   "patientName": "<full name if mentioned by name>",
   "memberId": "<member/insurance ID if given explicitly or found in history>",
+  "firstName": "<first name, only for eligibility_by_name_dob>",
+  "lastName": "<last name, only for eligibility_by_name_dob>",
   "dob": "<date of birth in MM/DD/YYYY if given explicitly or found in history>",
   "patients": [{"memberId": "<id>", "dob": "<MM/DD/YYYY>"}, ...],
   "patientNames": ["<name1>", "<name2>", ...],
@@ -86,6 +91,10 @@ Intents:
                           e.g. "check mh for 100xxxx, 10/10/1988 and schedule on 4/10/2026"
                           e.g. "check mh for 100xxxx, 10/10/1988 and make appointment on 5/1/2026"
                           In these cases set appointmentDate to the mentioned date (YYYY-MM-DD)
+- eligibility_by_name_dob : user provides a first name, last name AND date of birth but NO member ID
+                          e.g. "check ucard Kai Gao 08/30/1997", "Kai Gao, 8/30/1997"
+                          e.g. "canin gomez, 08/30/1997, ucard" → firstName "canin", lastName "gomez" (ALWAYS: first word = first name, all remaining words = last name, e.g. "min ping wang" → firstName "min", lastName "ping wang")
+                          Set firstName, lastName and dob (MM/DD/YYYY). Set insuranceHint if stated (e.g. "ucard").
 - batch_eligibility     : user provides MULTIPLE member IDs with dates of birth in one message
                           e.g. "check mh for 100xxxx 10/10/1988 and 200xxxx 5/5/2000"
                           e.g. "check 100xxxx, 10/10/1988 and 200xxxx, 5/5/2000"
@@ -236,6 +245,19 @@ function parseBareIdDob(message: string): { memberId: string; dob: string } | nu
   return null;
 }
 
+// Deterministic fast-path for a bare "First Last DOB" (or "DOB First Last") message,
+// e.g. "Kai Gao 08/30/1997" or "Kai Gao, 8/30/1997". Two or more alphabetic words: first word = first name, the rest = last name.
+function parseBareNameDob(message: string): { firstName: string; lastName: string; dob: string } | null {
+  const text = message.trim();
+  const dob = "(\\d{1,2}[\\/\\-]\\d{1,2}[\\/\\-]\\d{4})";
+  const name = "([A-Za-z][A-Za-z'\\-]*)\\s+([A-Za-z][A-Za-z'\\-]*(?:\\s+[A-Za-z][A-Za-z'\\-]*)*)";
+  const nameThenDob = text.match(new RegExp(`^${name}[\\s,]+${dob}$`));
+  if (nameThenDob) return { firstName: nameThenDob[1]!, lastName: nameThenDob[2]!, dob: nameThenDob[3]!.replace(/-/g, "/") };
+  const dobThenName = text.match(new RegExp(`^${dob}[\\s,]+${name}$`));
+  if (dobThenName) return { firstName: dobThenName[2]!, lastName: dobThenName[3]!, dob: dobThenName[1]!.replace(/-/g, "/") };
+  return null;
+}
+
 export async function classifyInternalChat(
   message: string,
   apiKey: string,
@@ -261,6 +283,17 @@ export async function classifyInternalChat(
     };
   }
 
+  const bareName = parseBareNameDob(message);
+  if (bareName) {
+    return {
+      intent: "eligibility_by_name_dob",
+      firstName: bareName.firstName,
+      lastName: bareName.lastName,
+      dob: bareName.dob,
+      fallbackReply: `Checking eligibility for ${bareName.firstName} ${bareName.lastName}...`,
+    };
+  }
+
   if (!apiKey) return fallback;
 
   // Prefer the client's local date (avoids UTC midnight rollover for US timezones)

apps/Backend/src/ai/internal-chat-workflow.ts

@@ -324,6 +324,12 @@ export async function runInternalChatWorkflow(
     return await handleEligibilityById(classification, storage);
   }
 
+  // ── Eligibility by first name + last name + DOB (United Ucard name search) ─
+
+  if (intent === "eligibility_by_name_dob") {
+    return handleEligibilityByNameDob(classification);
+  }
+
   // ── Batch eligibility (multiple patients) ─────────────────────────────────
 
   if (intent === "batch_eligibility") {
@@ -458,6 +464,44 @@ async function handleEligibilityById(
   };
 }
 
+// ─── eligibility_by_name_dob ──────────────────────────────────────────────────
+
+// Only United Ucard supports searching by name + DOB (no member ID).
+function handleEligibilityByNameDob(c: ChatClassification): ChatResponse {
+  // Rule: first word = first name, everything after = last name ("min ping wang" → "min" / "ping wang").
+  // Re-split regardless of how the classifier divided it.
+  const fullName = (c.patientName?.trim() || `${c.firstName ?? ""} ${c.lastName ?? ""}`.trim());
+  const parts = fullName.split(/\s+/).filter(Boolean);
+  const firstName = parts[0];
+  const lastName = parts.length >= 2 ? parts.slice(1).join(" ") : undefined;
+  const dob = c.dob?.trim();
+  if (!firstName || !lastName || !dob) {
+    return { reply: "Please provide the first name, last name and Date of Birth (MM/DD/YYYY)." };
+  }
+
+  const hint = (c.insuranceHint ?? "").toLowerCase();
+  if (hint && !hint.includes("ucard") && !hint.includes("united")) {
+    return {
+      reply: "Searching by name + DOB is only supported for United Ucard. Please provide a Member ID for other plans.",
+    };
+  }
+
+  return {
+    reply: `Ready to check United Ucard eligibility for ${firstName} ${lastName} by name.`,
+    action: "eligibility_id_ready",
+    actionData: {
+      patient: null,
+      memberId: "",
+      firstName,
+      lastName,
+      dob,
+      siteKey: "UNITED_UCARD",
+      autoCheck: siteKeyToAutoCheck("UNITED_UCARD"),
+      appointmentDate: c.appointmentDate ?? null,
+    },
+  };
+}
+
 // ─── batch_eligibility ───────────────────────────────────────────────────────
 
 async function handleBatchEligibility(

apps/Backend/src/queue/processors/unitedUcardEligibilityProcessor.ts

@@ -66,12 +66,16 @@ export interface UnitedUcardEligibilityProcessorResult {
 
 async function processUnitedUcardResult(
   userId: number,
-  insuranceId: string,
+  searchedInsuranceId: string,
   formFirstName: string | undefined,
   formLastName: string | undefined,
   formDob: string | undefined,
   seleniumResult: any
 ): Promise<UnitedUcardEligibilityProcessorResult> {
+  // Name-search jobs have no member ID up front; the worker returns the page's Product ID instead.
+  const scrapedId =
+    typeof seleniumResult?.memberId === "string" ? seleniumResult.memberId.replace(/\s+/g, "") : "";
+  const insuranceId = searchedInsuranceId || scrapedId;
   const output: UnitedUcardEligibilityProcessorResult = {};
   let createdPdfFileId: number | string | null = null;
 
@@ -82,21 +86,50 @@ async function processUnitedUcardResult(
         ? seleniumResult.patientName.trim()
         : null;
 
-    const { firstName, lastName } = rawName
+    // Name-search jobs (no member ID) always use the names the user typed.
+    const { firstName, lastName } = rawName && searchedInsuranceId
       ? splitName(rawName)
       : { firstName: formFirstName ?? "", lastName: formLastName ?? "" };
 
-    // 2) Create / update patient
-    await createOrUpdatePatientByInsuranceId({
-      insuranceId,
-      firstName,
-      lastName,
-      dob: formDob,
-      userId,
-    });
-
-    // 3) Fetch patient
-    const patient = await storage.getPatientByInsuranceId(insuranceId);
+    // 2-3) Resolve the patient record.
+    // Name + DOB searches have no member ID (the portal masks it), so we can only
+    // update a patient that is already on file — match on first/last name + DOB.
+    let patient: any = null;
+    if (insuranceId) {
+      await createOrUpdatePatientByInsuranceId({
+        insuranceId,
+        firstName,
+        lastName,
+        dob: formDob,
+        userId,
+      });
+      patient = await storage.getPatientByInsuranceId(insuranceId);
+    } else {
+      const dobDate = formDob ? new Date(formDob) : null;
+      const matches = await storage.searchPatients({
+        filters: {
+          firstName: { equals: firstName, mode: "insensitive" },
+          lastName: { equals: lastName, mode: "insensitive" },
+          ...(dobDate && !isNaN(dobDate.getTime()) ? { dateOfBirth: dobDate } : {}),
+        },
+        limit: 1,
+        offset: 0,
+      });
+      patient = matches?.[0] ?? null;
+      if (!patient) {
+        // The portal masks the subscriber ID, so create the patient from the typed name + DOB
+        // (no insuranceId); the Member ID can be added later.
+        patient = await storage.createPatient({
+          firstName,
+          lastName,
+          dateOfBirth: dobDate && !isNaN(dobDate.getTime()) ? dobDate : null,
+          gender: "",
+          phone: "",
+          userId,
+        } as any);
+        log("uniteducard-processor", "created patient from name search", { patientId: patient?.id });
+      }
+    }
     if (!patient?.id) {
       output.patientUpdateStatus = "Patient not found; no update performed";
       return output;
@@ -115,7 +148,7 @@ async function processUnitedUcardResult(
       typeof seleniumResult?.memberId === "string"
         ? seleniumResult.memberId.replace(/\s+/g, "")
         : null;
-    if (scrapedMemberId && scrapedMemberId !== insuranceId) {
+    if (insuranceId && scrapedMemberId && scrapedMemberId !== insuranceId) {
       statusUpdates.insuranceId = scrapedMemberId;
       log("uniteducard-processor", "member ID changed, overwriting on patient record", {
         patientId: patient.id,