feat: BCBS AI column claim fills ADA form, saves to Documents; form fixes
- Claim for column with AI: BCBS patients auto-generate the 2024 ADA form (no tab) and save it to the patient's Documents > Claims folder; the manual BCBS button saves there too (new POST /api/claims/:id/ada-form) - Saved BCBS form sets the claim to REVIEW; appointments with a claim number or REVIEW/APPROVED status show as claimed (dark gray) - CDT lookup: "comp on #18 O, 20 O, 21 O" applies composite to every tooth - BCBS fee schedule (procedureCodesBCBS.json, copied from DDMA prices) - Office Contact: Legal Name field; "Dental Office Name (DBA)" label - ADA form: 48 = legal name, DBA, address; 56 = address only; 53 date = claim date; 23 and 26 left blank; 43 = No unless appointment notes say a prosthesis is replaced (then Yes, with 44 prior date when given) Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>
This commit is contained in:
Claude Opus 5.5
@@ -599,6 +599,37 @@ function matchOne(input: string): CdtMatch | null {
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return { code: bestEntry.code, description: bestEntry.description, input };
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}
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const TOOTH_SURFACE_RE = /#?\s*(\d{1,2})\s+([OMDBLFIV]{1,5})\b/gi;
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const BARE_TOOTH_SURFACE_RE = /^#?\s*(\d{1,2})\s+([OMDBLFIV]{1,5})$/i;
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/**
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* Composite lists often give the "#" only on the first tooth:
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* "comp on #18 O, 20 O, 21 O" → ["comp #18 O", "comp #20 O", "comp #21 O"].
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* Also handles the LLM splitting that list into ["comp on #18 O", "20 O", ...]:
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* a bare "20 O" right after a composite entry is another composite.
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*/
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function expandCompositeLists(procedureNames: string[]): string[] {
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const out: string[] = [];
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let prevComposite = false;
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for (const name of procedureNames) {
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const s = name.trim();
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if (prevComposite && BARE_TOOTH_SURFACE_RE.test(s)) {
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const m = s.match(BARE_TOOTH_SURFACE_RE)!;
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out.push(`comp #${m[1]} ${m[2]}`);
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continue;
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}
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const isComposite = /^(comp|composite|resin|filling)\b/i.test(s) || /^#\s*\d{1,2}\s+[OMDBLFIV]{1,5}\b/i.test(s);
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const teeth = isComposite ? [...s.matchAll(TOOTH_SURFACE_RE)] : [];
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if (teeth.length > 1) {
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for (const m of teeth) out.push(`comp #${m[1]} ${m[2]}`);
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} else {
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out.push(name);
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}
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prevComposite = teeth.length > 0;
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}
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return out;
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}
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/**
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* Map an array of free-text procedure names to CDT codes.
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* customAliases (from DB) are checked before the hardcoded ALIAS_MAP.
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@@ -617,7 +648,7 @@ export function lookupCdtCodes(
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// Pontics with no stated material — re-coded below to match the crowns
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const inferredPontics: CdtMatch[] = [];
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const results = procedureNames.flatMap((name): (CdtMatch | { code: null; description: string; input: string })[] => {
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const results = expandCompositeLists(procedureNames).flatMap((name): (CdtMatch | { code: null; description: string; input: string })[] => {
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const cleaned = name.trim().toLowerCase();
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// If the LLM emitted a bare tooth-number token like "# 32" or "#32" with no procedure,
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@@ -166,8 +166,12 @@ Rules:
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"with the scan", "with the photo", "with the document", or any variation meaning an uploaded/attached file,
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do NOT include it in procedureNames. It refers to a file attachment, not a billable procedure.
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Only include actual clinical procedures in procedureNames.
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- Replacement wording and prior placement dates are claim-form details, not procedures:
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"replace old crown #3" → ["crown #3"]; "bridge #3-5 replacement, placed 5/2/18" → ["bridge #3-5"]
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- For composite fillings with a tooth number, preserve the EXACT notation including tooth# and surfaces:
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e.g. "composite #29 O", "#8 MO", "composite #11 MOD", "# 10 DL", "# 11 ML", "#8 ml", "comp #8 ml" — keep the #number and surface letters together as one entry
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A tooth list after one composite keeps the composite for every tooth: "comp on #18 O, 20 O, 21 O" →
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["comp #18 O", "comp #20 O", "comp #21 O"]
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Note: "comp" is short for "composite". "# 10 DL", "composite on # 10 DL", and "comp # 10 DL" are all the same — preserve the space-after-# as-is
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IMPORTANT: Any letter(s) immediately after a tooth number are DENTAL SURFACE abbreviations indicating a composite filling:
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M = Mesial, D = Distal, L = Lingual, F = Facial, B = Buccal, O = Occlusal, V = Vestibular, I = Incisal
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@@ -1230,56 +1230,104 @@ router.get("/all", async (req: Request, res: Response) => {
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}
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});
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// Get a single claim by ID
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// GET /api/claims/:id/ada-form?payer=BCBS_MA
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// Paper claim: returns the 2024 ADA Dental Claim Form filled from the saved claim.
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// Paper claim: the 2024 ADA Dental Claim Form filled from a saved claim.
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type AdaFormResult =
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| { ok: false; status: number; error: string }
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| {
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ok: true;
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pdf: Buffer;
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filename: string;
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claimId: number;
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claimStatus: string;
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patient: { id: number; firstName: string; lastName: string };
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};
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async function buildAdaFormForRequest(req: Request): Promise<AdaFormResult> {
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const claimId = parseInt(String(req.params.id), 10);
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if (isNaN(claimId)) return { ok: false, status: 400, error: "Invalid claim ID" };
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const payerKey = String(req.query.payer || "BCBS_MA").toUpperCase();
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const payer = ADA_PAYERS[payerKey];
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if (!payer) return { ok: false, status: 400, error: `Unknown payer "${payerKey}"` };
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const { prisma: db } = await import("@repo/db/client");
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const claim = await db.claim.findUnique({
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where: { id: claimId },
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include: {
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serviceLines: { orderBy: { id: "asc" } },
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patient: true,
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npiProvider: true,
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appointment: { select: { notes: true } },
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},
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});
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if (!claim || claim.userId !== req.user!.id) {
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return { ok: false, status: 404, error: "Claim not found" };
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}
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const office = await storage.getOfficeContact(req.user!.id);
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// Fall back to the default (first) NPI provider when the claim has none
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const treatingProvider =
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claim.npiProvider ?? (await storage.getNpiProvidersByUser(req.user!.id))[0] ?? null;
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const pdf = await buildAdaClaimPdf({
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claim,
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patient: claim.patient,
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office,
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treatingProvider,
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payer,
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appointmentNotes: claim.appointment?.notes ?? null,
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});
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const filename = `ADA_Claim_${claim.patient.lastName}_${claim.patient.firstName}_${claimId}.pdf`
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.replace(/[^\w.-]+/g, "_");
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return { ok: true, pdf: Buffer.from(pdf), filename, claimId, claimStatus: claim.status, patient: claim.patient };
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}
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// GET /api/claims/:id/ada-form?payer=BCBS_MA — view/print only
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router.get("/:id/ada-form", async (req: Request, res: Response): Promise<any> => {
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try {
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if (!req.user?.id) return res.status(401).json({ message: "Unauthorized" });
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const claimId = parseInt(String(req.params.id), 10);
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if (isNaN(claimId)) return res.status(400).json({ error: "Invalid claim ID" });
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const payerKey = String(req.query.payer || "BCBS_MA").toUpperCase();
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const payer = ADA_PAYERS[payerKey];
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if (!payer) return res.status(400).json({ error: `Unknown payer "${payerKey}"` });
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const { prisma: db } = await import("@repo/db/client");
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const claim = await db.claim.findUnique({
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where: { id: claimId },
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include: {
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serviceLines: { orderBy: { id: "asc" } },
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patient: true,
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npiProvider: true,
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},
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});
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if (!claim || claim.userId !== req.user.id) {
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return res.status(404).json({ message: "Claim not found" });
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}
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const office = await storage.getOfficeContact(req.user.id);
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// Fall back to the default (first) NPI provider when the claim has none
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const treatingProvider =
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claim.npiProvider ?? (await storage.getNpiProvidersByUser(req.user.id))[0] ?? null;
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const pdf = await buildAdaClaimPdf({
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claim,
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patient: claim.patient,
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office,
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treatingProvider,
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payer,
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});
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const filename = `ADA_Claim_${claim.patient.lastName}_${claim.patient.firstName}_${claimId}.pdf`
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.replace(/[^\w.-]+/g, "_");
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const result = await buildAdaFormForRequest(req);
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if (!result.ok) return res.status(result.status).json({ message: result.error });
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res.setHeader("Content-Type", "application/pdf");
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res.setHeader("Content-Disposition", `inline; filename="${filename}"`);
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return res.send(Buffer.from(pdf));
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res.setHeader("Content-Disposition", `inline; filename="${result.filename}"`);
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return res.send(result.pdf);
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} catch (error) {
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console.error("[ada-form] failed:", error);
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return res.status(500).json({ message: "Failed to generate ADA claim form", details: String(error) });
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}
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});
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// POST /api/claims/:id/ada-form?payer=BCBS_MA — also saves the PDF to the
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// patient's Documents "Claims" folder, then returns it
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router.post("/:id/ada-form", async (req: Request, res: Response): Promise<any> => {
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try {
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if (!req.user?.id) return res.status(401).json({ message: "Unauthorized" });
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const result = await buildAdaFormForRequest(req);
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if (!result.ok) return res.status(result.status).json({ message: result.error });
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const { patient } = result;
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await storage.savePdfToCloudStorage(
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req.user.id,
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patient.id,
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`${patient.firstName} ${patient.lastName}`,
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"Claims",
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result.filename,
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result.pdf,
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);
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// The form is the submission: mark it submitted so the appointment shows as claimed
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if (result.claimStatus === "PENDING") {
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await storage.updateClaimStatus(result.claimId, "REVIEW");
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}
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res.setHeader("Content-Type", "application/pdf");
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res.setHeader("Content-Disposition", `inline; filename="${result.filename}"`);
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return res.send(result.pdf);
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} catch (error) {
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console.error("[ada-form] failed:", error);
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return res.status(500).json({ message: "Failed to generate ADA claim form", details: String(error) });
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}
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});
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// Get a single claim by ID
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router.get("/:id", async (req: Request, res: Response): Promise<any> => {
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try {
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const idParam = Array.isArray(req.params.id) ? req.params.id[0] : req.params.id;
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@@ -9,6 +9,8 @@ const SCHEDULE_FILES: Record<string, string> = {
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MASSHEALTH: "procedureCodesMH.json",
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CCA: "procedureCodesCCA.json",
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DDMA: "procedureCodesDDMA.json",
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BCBS: "procedureCodesBCBS.json",
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BCBS_MA: "procedureCodesBCBS.json",
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TUFTSSCO: "procedureCodesTuftsSCO.json",
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TUFTS_SCO: "procedureCodesTuftsSCO.json",
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UNITEDDH: "procedureCodesUnitedDH.json",
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@@ -23,10 +23,11 @@ router.put("/", async (req: Request, res: Response): Promise<any> => {
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if (!userId) return res.status(401).json({ message: "Unauthorized" });
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const {
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officeName, receptionistName, dentistName, phoneNumber, email, fax, streetAddress, city, state, zipCode,
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legalName, officeName, receptionistName, dentistName, phoneNumber, email, fax, streetAddress, city, state, zipCode,
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billingName, billingNpi, billingLicense, billingTaxId,
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} = req.body;
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const record = await storage.upsertOfficeContact(userId, {
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legalName: legalName ?? undefined,
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officeName: officeName ?? undefined,
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receptionistName: receptionistName ?? undefined,
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dentistName: dentistName ?? undefined,
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@@ -5,7 +5,7 @@ import { PDFDocument, PDFFont, PDFForm, StandardFonts } from "pdf-lib";
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/**
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* Fills the 2024 ADA Dental Claim Form (J43024) for payers that only accept
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* paper claims (e.g. BCBS MA). Field names come from the template's AcroForm;
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* signatures and their dates are intentionally left blank for wet signing.
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* signatures are left blank for wet signing; only item 53's date is filled (claim date).
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*/
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const TEMPLATE_PATH = path.join(__dirname, "../data/templates/ada-claim-form-2024.pdf");
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@@ -33,6 +33,7 @@ export const ADA_PAYERS: Record<string, AdaPayer> = {
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export type AdaClaimInput = {
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claim: {
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id: number;
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createdAt?: Date | string | null;
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memberId?: string | null;
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remarks?: string | null;
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status?: string | null;
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@@ -63,6 +64,7 @@ export type AdaClaimInput = {
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policyHolder?: string | null;
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};
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office: {
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legalName?: string | null;
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officeName?: string | null;
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phoneNumber?: string | null;
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streetAddress?: string | null;
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@@ -79,6 +81,8 @@ export type AdaClaimInput = {
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licenseNumber?: string | null;
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} | null;
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payer: AdaPayer;
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/** Appointment notes — item 43/44 (replacement of prosthesis) */
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appointmentNotes?: string | null;
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};
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let descriptionByCode: Map<string, string> | null = null;
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@@ -107,6 +111,39 @@ function fmtDate(d: Date | string | null | undefined): string {
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return `${mm}/${dd}/${date.getUTCFullYear()}`;
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}
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/** A timestamp as the office's local calendar date (fmtDate is for date-only values stored as UTC midnight). */
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function fmtLocalDate(d: Date | string | null | undefined): string {
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if (!d) return "";
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const date = d instanceof Date ? d : new Date(d);
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if (isNaN(date.getTime())) return "";
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const mm = String(date.getMonth() + 1).padStart(2, "0");
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const dd = String(date.getDate()).padStart(2, "0");
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return `${mm}/${dd}/${date.getFullYear()}`;
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}
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const PROSTHESIS_WORDS = "crowns?|bridges?|dentures?|partials?|prosthes[ie]s|prosthetics?|pontics?|veneers?|onlays?|inlays?|fpd|rpd|implants?";
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const REPLACE_WORDS = "replac(?:e|ed|es|ing|ement)|remake|re-make|redo|re-do";
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/**
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* Item 43/44: does the note say an existing prosthesis is being replaced
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* (e.g. "replace old crown #3", "bridge replacement", "replacement of prosthesis")?
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* Returns the prior placement date when the note gives one as MM/DD/YYYY.
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*/
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export function prosthesisReplacement(notes?: string | null): { replacement: boolean; priorDate?: string } {
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const s = (notes ?? "").toLowerCase();
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const replaceThenProsthesis = new RegExp(`\\b(?:${REPLACE_WORDS})\\b[^.;\\n]{0,30}?\\b(?:${PROSTHESIS_WORDS})\\b`);
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const prosthesisThenReplace = new RegExp(`\\b(?:${PROSTHESIS_WORDS})\\b[^.;\\n]{0,15}?\\b(?:${REPLACE_WORDS})\\b`);
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// "replace missing #19 with bridge" is a new prosthesis for a lost tooth, not a replacement
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const hit = [s.match(replaceThenProsthesis), s.match(prosthesisThenReplace)].find(
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(m) => m && !/\b(?:missing|extracted|lost)\b/.test(m[0]),
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);
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if (!hit) return { replacement: false };
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const m = s.match(/\b(\d{1,2})[/-](\d{1,2})[/-](\d{4}|\d{2})\b/);
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if (!m) return { replacement: true };
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const year = m[3]!.length === 2 ? `20${m[3]}` : m[3]!;
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return { replacement: true, priorDate: `${m[1]!.padStart(2, "0")}/${m[2]!.padStart(2, "0")}/${year}` };
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}
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function fmtMoney(v: unknown): string {
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const n = Number(v ?? 0);
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return isNaN(n) ? "" : n.toFixed(2);
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@@ -244,7 +281,6 @@ async function fillOnePage(
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setText(form, "20 City, State, Zip", patientCsz);
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setText(form, "21 Date of Birth MMDDCCYY", dob);
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check(form, `22 ${genderBox}`);
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setText(form, "23 Patient IDAccount Assigned by Dentist", String(patient.id));
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// 24-31. Service lines
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let total = 0;
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@@ -253,7 +289,6 @@ async function fillOnePage(
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const tooth = (line.toothNumber ?? "").trim();
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setText(form, `24 Procedure Date MMDDCCYY${s}`, fmtDate(line.procedureDate));
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setText(form, `25 Area of Oral Cavity${s}`, oralCavityArea(line.quad, line.arch));
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setText(form, `26 Tooth System${s}`, tooth ? "JP" : "");
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setText(form, `27 Tooth Numbers or Letters${s}`, tooth);
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setText(form, `28 Tooth Surface${s}`, (line.toothSurface ?? "").trim());
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setText(form, `29 Procedure Code${s}`, line.procedureCode.trim().toUpperCase());
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@@ -277,15 +312,24 @@ async function fillOnePage(
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// 38-40. Ancillary
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setText(form, "38 Place of Treatment", "11");
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check(form, "40 Check Box1");
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// 43-44. Replacement of prosthesis: Yes only when the appointment notes say so
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const replacement = prosthesisReplacement(input.appointmentNotes);
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if (replacement.replacement) {
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check(form, "43 Check Box2");
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setText(form, "44 Date of Prior Placement MMDDCCYY", replacement.priorDate);
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} else {
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check(form, "43 Check Box1");
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}
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// 48-52. Billing dentist (office NPI)
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// 48-52. Billing dentist: legal name, office name (DBA) and address (Settings > Office Contact)
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const officeCsz = cityStateZip(office?.city, office?.state, office?.zipCode);
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const officeLines = [office?.billingName, office?.officeName, office?.streetAddress]
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.map((v) => v?.trim())
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.filter(Boolean) as string[];
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setText(form, "48 Name", officeLines[0]);
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setText(form, "48 Address", officeLines[1]);
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setText(form, "48 Address 2", officeLines[2]);
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const legalName = (office?.legalName || office?.billingName || "").trim();
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const dbaName = office?.officeName?.trim() ?? "";
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const street = office?.streetAddress?.trim() ?? "";
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const billingLines = [legalName, dbaName !== legalName ? dbaName : "", street].filter(Boolean);
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setText(form, "48 Name", billingLines[0]);
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setText(form, "48 Address", billingLines[1]);
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setText(form, "48 Address 2", billingLines[2]);
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setText(form, "48 City, State, Zip", officeCsz);
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setText(form, "49 NPI", office?.billingNpi);
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setText(form, "50 License Number", office?.billingLicense);
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@@ -300,11 +344,15 @@ async function fillOnePage(
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}
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}
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// 53. Signature stays blank; date = claim date (when the claim was made)
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setText(form, "53 Date", fmtLocalDate(claim.createdAt ?? new Date()));
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// 54-56. Treating dentist and location
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setText(form, "54 NPI", treatingProvider?.npiNumber);
|
||||
setText(form, "55 License Number", treatingProvider?.licenseNumber || office?.billingLicense);
|
||||
setText(form, "56 Address 1", office?.streetAddress);
|
||||
setText(form, "56 Address 2", officeCsz);
|
||||
// 56. Treatment location: office address only
|
||||
setFittedText(form, helvetica, "56 Address 1", street);
|
||||
setFittedText(form, helvetica, "56 Address 2", officeCsz);
|
||||
|
||||
form.updateFieldAppearances(helvetica);
|
||||
form.flatten();
|
||||
|
||||
@@ -126,10 +126,15 @@ export const claimsStorage: IStorage = {
|
||||
async getAppointmentIdsWithClaimNumbers(ids: number[]): Promise<Set<number>> {
|
||||
if (!ids.length) return new Set();
|
||||
const rows = await db.claim.findMany({
|
||||
where: { appointmentId: { in: ids }, claimNumber: { not: null } },
|
||||
// Same "already submitted" rule as batch-column: a claim number, or REVIEW/APPROVED
|
||||
// (paper claims like BCBS have no claim number and are set to REVIEW once the form is saved)
|
||||
where: {
|
||||
appointmentId: { in: ids },
|
||||
OR: [{ claimNumber: { not: null } }, { status: { in: ["REVIEW", "APPROVED"] as ClaimStatus[] } }],
|
||||
},
|
||||
select: { appointmentId: true },
|
||||
distinct: ["appointmentId"],
|
||||
});
|
||||
return new Set(rows.map((r) => r.appointmentId));
|
||||
return new Set(rows.map((r: { appointmentId: number | null }) => r.appointmentId));
|
||||
},
|
||||
};
|
||||
|
||||
@@ -6,6 +6,7 @@ export const officeContactStorage = {
|
||||
},
|
||||
|
||||
async upsertOfficeContact(userId: number, data: {
|
||||
legalName?: string;
|
||||
officeName?: string;
|
||||
receptionistName?: string;
|
||||
dentistName?: string;
|
||||
|
||||
@@ -0,0 +1,209 @@
|
||||
[
|
||||
{ "Procedure Code": "D0120", "Description": "Periodic oral evaluation - established patient", "Price": 105 },
|
||||
{ "Procedure Code": "D0140", "Description": "Limited oral evaluation - problem focused", "Price": 90 },
|
||||
{ "Procedure Code": "D0145", "Description": "Oral evaluation for a patient under three years of age and counseling with primary caregiver", "Price": "NC" },
|
||||
{ "Procedure Code": "D0150", "Description": "Comprehensive oral evaluation - new or established patient", "Price": 120 },
|
||||
{ "Procedure Code": "D0180", "Description": "Comprehensive periodontal evaluation - new or established patient", "Price": 37 },
|
||||
{ "Procedure Code": "D0190", "Description": "Screening of a patient (PHDH only)", "Price": 20 },
|
||||
{ "Procedure Code": "D0191", "Description": "Assessment of a patient (PHDH only)", "Price": 20 },
|
||||
{ "Procedure Code": "D0210", "Description": "Intraoral - complete series of radiographic images", "Price": 120 },
|
||||
{ "Procedure Code": "D0220", "Description": "Intraoral - periapical, first radiographic image", "Price": 60 },
|
||||
{ "Procedure Code": "D0230", "Description": "Intraoral - periapical, each additional radiographic image", "Price": 50 },
|
||||
{ "Procedure Code": "D0240", "Description": "Intraoral - occlusal radiographic image", "Price": "NC" },
|
||||
{ "Procedure Code": "D0270", "Description": "Bitewing - single radiographic image", "Price": 14 },
|
||||
{ "Procedure Code": "D0272", "Description": "Bitewings - two radiographic images", "Price": 80 },
|
||||
{ "Procedure Code": "D0273", "Description": "Bitewings - three radiographic images", "Price": 27 },
|
||||
{ "Procedure Code": "D0274", "Description": "Bitewings - four radiographic images", "Price": 160 },
|
||||
{ "Procedure Code": "D0330", "Description": "Panoramic radiographic image", "Price": 150 },
|
||||
{ "Procedure Code": "D0340", "Description": "Cephalometric radiograph image (Oral surgeon only)", "Price": 74 },
|
||||
{ "Procedure Code": "D0364", "Description": "CBCT - less than one jaw (interpret)", "Price": 350 },
|
||||
{ "Procedure Code": "D0365", "Description": "CBCT - mandible (interpret)", "Price": 350 },
|
||||
{ "Procedure Code": "D0366", "Description": "CBCT - maxilla (interpret)", "Price": 350 },
|
||||
{ "Procedure Code": "D0367", "Description": "CBCT - both jaws (interpret)", "Price": 400 },
|
||||
{ "Procedure Code": "D0368", "Description": "CBCT - include TMJ (interpret)", "Price": 375 },
|
||||
{ "Procedure Code": "D0380", "Description": "CBCT - less than one jaw (capture only)", "Price": 300 },
|
||||
{ "Procedure Code": "D0381", "Description": "CBCT - mandible (capture only)", "Price": 300 },
|
||||
{ "Procedure Code": "D0382", "Description": "CBCT - maxilla (capture only)", "Price": 300 },
|
||||
{ "Procedure Code": "D0383", "Description": "CBCT - both jaws / include TMJ (capture only)", "Price": 350 },
|
||||
{ "Procedure Code": "D1110", "Description": "Prophylaxis - adult, 14 yo or older", "Price": 150 },
|
||||
{ "Procedure Code": "D1120", "Description": "Prophylaxis - child, 0-13 yo", "Price": 120 },
|
||||
{ "Procedure Code": "D1206", "Description": "Topical application of fluoride varnish", "Price": 26 },
|
||||
{ "Procedure Code": "D1208", "Description": "Topical application of fluoride - excluding varnish", "Price": 90 },
|
||||
{ "Procedure Code": "D1351", "Description": "Sealant - per tooth", "Price": 80 },
|
||||
{ "Procedure Code": "D1354", "Description": "Application of caries arresting medicament - per tooth", "Price": 15 },
|
||||
{ "Procedure Code": "D1510", "Description": "Space maintainer - fixed, unilateral - per quadrant", "Price": "NC" },
|
||||
{ "Procedure Code": "D1516", "Description": "Space maintainer - fixed, bilateral, maxillary", "Price": "NC" },
|
||||
{ "Procedure Code": "D1517", "Description": "Space maintainer - fixed, bilateral, mandibular", "Price": "NC" },
|
||||
{ "Procedure Code": "D1520", "Description": "Space maintainer - removable, unilateral, per quadrant", "Price": "NC" },
|
||||
{ "Procedure Code": "D1526", "Description": "Space maintainer - removable, bilateral, maxillary", "Price": "NC" },
|
||||
{ "Procedure Code": "D1527", "Description": "Space maintainer - removable, bilateral, mandibular", "Price": "NC" },
|
||||
{ "Procedure Code": "D1575", "Description": "Distal shoe space maintainer - fixed, unilateral, per quadrant", "Price": "NC" },
|
||||
{ "Procedure Code": "D1701", "Description": "Pfizer-BioNTech Covid-19 vaccine - first dose", "Price": 45.87 },
|
||||
{ "Procedure Code": "D1702", "Description": "Pfizer-BioNTech Covid-19 vaccine - second dose", "Price": 45.87 },
|
||||
{ "Procedure Code": "D1707", "Description": "Janssen Covid-19 vaccine - single dose", "Price": 45.87 },
|
||||
{ "Procedure Code": "D1708", "Description": "Pfizer-BioNTech Covid-19 vaccine - third dose", "Price": 45.87 },
|
||||
{ "Procedure Code": "D1709", "Description": "Pfizer-BioNTech Covid-19 vaccine - booster dose", "Price": 45.87 },
|
||||
{ "Procedure Code": "D1712", "Description": "Janssen Covid-19 vaccine - booster dose", "Price": 45.87 },
|
||||
{ "Procedure Code": "D1713", "Description": "Pfizer-BioNTech Covid-19 vaccine pediatric - first dose", "Price": 45.87 },
|
||||
{ "Procedure Code": "D1714", "Description": "Pfizer-BioNTech Covid-19 vaccine pediatric - second dose", "Price": 45.87 },
|
||||
{ "Procedure Code": "D1999", "Description": "Unspecified preventive procedure, by report", "Price": 50 },
|
||||
{ "Procedure Code": "D2140", "Description": "Amalgam - one surface, primary or permanent", "Price": 150 },
|
||||
{ "Procedure Code": "D2150", "Description": "Amalgam - two surfaces, primary or permanent", "Price": 200 },
|
||||
{ "Procedure Code": "D2160", "Description": "Amalgam - three surfaces, primary or permanent", "Price": 92 },
|
||||
{ "Procedure Code": "D2161", "Description": "Amalgam - four or more surfaces, primary or permanent", "Price": 116 },
|
||||
{ "Procedure Code": "D2330", "Description": "Resin-based composite - one surface, anterior", "Price": 180 },
|
||||
{ "Procedure Code": "D2331", "Description": "Resin-based composite - two surfaces, anterior", "Price": 220 },
|
||||
{ "Procedure Code": "D2332", "Description": "Resin-based composite - three surfaces, anterior", "Price": 280 },
|
||||
{ "Procedure Code": "D2335", "Description": "Resin-based composite - four or more surfaces or involving incisal angle (anterior)", "Price": 350 },
|
||||
{ "Procedure Code": "D2390", "Description": "Resin-based composite crown, anterior", "Price": "NC" },
|
||||
{ "Procedure Code": "D2391", "Description": "Resin-based composite - one surface, posterior", "Price": 200 },
|
||||
{ "Procedure Code": "D2392", "Description": "Resin-based composite - two surfaces, posterior", "Price": 250 },
|
||||
{ "Procedure Code": "D2393", "Description": "Resin-based composite - three surfaces, posterior", "Price": 280 },
|
||||
{ "Procedure Code": "D2394", "Description": "Resin-based composite - four or more surfaces, posterior", "Price": 320 },
|
||||
{ "Procedure Code": "D2710", "Description": "Crown - resin-based composite (indirect)", "Price": "NC" },
|
||||
{ "Procedure Code": "D2740", "Description": "Crown - porcelain/ceramic", "Price": 1300 },
|
||||
{ "Procedure Code": "D2750", "Description": "Crown - porcelain fused to high noble metal", "Price": 1300 },
|
||||
{ "Procedure Code": "D2751", "Description": "Crown - porcelain fused to predominantly base metal", "Price": 1200 },
|
||||
{ "Procedure Code": "D2752", "Description": "Crown - porcelain fused to noble metal", "Price": 1200 },
|
||||
{ "Procedure Code": "D2790", "Description": "Crown - full cast high noble metal", "Price": "NC" },
|
||||
{ "Procedure Code": "D2910", "Description": "Re-cement or re-bond inlay, onlay or partial coverage restoration", "Price": 57 },
|
||||
{ "Procedure Code": "D2920", "Description": "Re-cement or re-bond crown", "Price": 120 },
|
||||
{ "Procedure Code": "D2929", "Description": "Prefabricated porcelain/ceramic crown - primary tooth", "Price": "NC" },
|
||||
{ "Procedure Code": "D2930", "Description": "Prefabricated stainless steel crown - primary tooth", "Price": "NC" },
|
||||
{ "Procedure Code": "D2931", "Description": "Prefabricated stainless steel crown - permanent tooth", "Price": 171 },
|
||||
{ "Procedure Code": "D2932", "Description": "Prefabricated resin crown", "Price": "NC" },
|
||||
{ "Procedure Code": "D2934", "Description": "Prefabricated esthetic coated stainless steel crown - primary tooth", "Price": "NC" },
|
||||
{ "Procedure Code": "D2950", "Description": "Core buildup, including any pins when required", "Price": 350 },
|
||||
{ "Procedure Code": "D2951", "Description": "Pin retention - per tooth, in addition to restoration", "Price": 27 },
|
||||
{ "Procedure Code": "D2954", "Description": "Prefabricated post and core in addition to crown", "Price": 450 },
|
||||
{ "Procedure Code": "D2955", "Description": "Post removal", "Price": 350 },
|
||||
{ "Procedure Code": "D2980", "Description": "Crown repair necessitated by restorative material failure", "Price": 115 },
|
||||
{ "Procedure Code": "D2999", "Description": "Unspecified restorative procedure, by report", "Price": "IC" },
|
||||
{ "Procedure Code": "D3120", "Description": "Pulp cap - indirect (excluding final restoration)", "Price": 34 },
|
||||
{ "Procedure Code": "D3220", "Description": "Therapeutic pulpotomy (excluding final restoration)", "Price": "NC" },
|
||||
{ "Procedure Code": "D3230", "Description": "Pulpal therapy (resorbable filling) - anterior, primary tooth", "Price": 280 },
|
||||
{ "Procedure Code": "D3240", "Description": "Pulpal therapy (resorbable filling) - posterior, primary tooth", "Price": 490 },
|
||||
{ "Procedure Code": "D3310", "Description": "Endodontic therapy, anterior tooth (excluding final restoration)", "Price": 900 },
|
||||
{ "Procedure Code": "D3320", "Description": "Endodontic therapy, premolar tooth (excluding final restoration)", "Price": 1050 },
|
||||
{ "Procedure Code": "D3330", "Description": "Endodontic therapy, molar tooth (excluding final restoration)", "Price": 1250 },
|
||||
{ "Procedure Code": "D3346", "Description": "Retreatment of previous root canal therapy - anterior", "Price": 950 },
|
||||
{ "Procedure Code": "D3347", "Description": "Retreatment of previous root canal therapy - premolar", "Price": 1100 },
|
||||
{ "Procedure Code": "D3348", "Description": "Retreatment of previous root canal therapy - molar", "Price": 1500 },
|
||||
{ "Procedure Code": "D3410", "Description": "Apicoectomy - anterior", "Price": 407 },
|
||||
{ "Procedure Code": "D3421", "Description": "Apicoectomy - premolar (first root)", "Price": 460 },
|
||||
{ "Procedure Code": "D3425", "Description": "Apicoectomy - molar (first root)", "Price": 598 },
|
||||
{ "Procedure Code": "D3426", "Description": "Apicoectomy (each additional root)", "Price": 230 },
|
||||
{ "Procedure Code": "D4210", "Description": "Gingivectomy or gingivoplasty - four or more contiguous teeth per quadrant", "Price": 307 },
|
||||
{ "Procedure Code": "D4211", "Description": "Gingivectomy or gingivoplasty - one to three contiguous teeth per quadrant", "Price": 111 },
|
||||
{ "Procedure Code": "D4341", "Description": "Periodontal scaling and root planing - four or more teeth per quadrant", "Price": 250 },
|
||||
{ "Procedure Code": "D4342", "Description": "Periodontal scaling and root planing - one to three teeth, per quadrant", "Price": 90 },
|
||||
{ "Procedure Code": "D4346", "Description": "Scaling in presence of generalized moderate or severe gingival inflammation - full mouth", "Price": 60 },
|
||||
{ "Procedure Code": "D4910", "Description": "Periodontal maintenance", "Price": 250 },
|
||||
{ "Procedure Code": "D5110", "Description": "Complete denture - maxillary", "Price": 1700 },
|
||||
{ "Procedure Code": "D5120", "Description": "Complete denture - mandibular", "Price": 1700 },
|
||||
{ "Procedure Code": "D5130", "Description": "Immediate denture - maxillary", "Price": "NC" },
|
||||
{ "Procedure Code": "D5140", "Description": "Immediate denture - mandibular", "Price": "NC" },
|
||||
{ "Procedure Code": "D5211", "Description": "Maxillary partial denture - resin base", "Price": 1300 },
|
||||
{ "Procedure Code": "D5212", "Description": "Mandibular partial denture - resin base", "Price": 1300 },
|
||||
{ "Procedure Code": "D5213", "Description": "Maxillary partial denture - cast metal framework with resin denture bases", "Price": 1700 },
|
||||
{ "Procedure Code": "D5214", "Description": "Mandibular partial denture - cast metal framework with resin denture bases", "Price": 1700 },
|
||||
{ "Procedure Code": "D5225", "Description": "Maxillary partial denture - flexible base", "Price": "NC" },
|
||||
{ "Procedure Code": "D5226", "Description": "Mandibular partial denture - flexible base", "Price": "NC" },
|
||||
{ "Procedure Code": "D5510", "Description": "Repair broken complete denture base (QUAD)", "Price": 400 },
|
||||
{ "Procedure Code": "D5511", "Description": "Repair broken complete denture base, mandibular", "Price": 85 },
|
||||
{ "Procedure Code": "D5512", "Description": "Repair broken complete denture base, maxillary", "Price": 85 },
|
||||
{ "Procedure Code": "D5520", "Description": "Replace missing or broken teeth - complete denture (each tooth)", "Price": 200 },
|
||||
{ "Procedure Code": "D5611", "Description": "Repair broken resin partial denture base, mandibular", "Price": 77 },
|
||||
{ "Procedure Code": "D5612", "Description": "Repair broken resin partial denture base, maxillary", "Price": 77 },
|
||||
{ "Procedure Code": "D5621", "Description": "Repair broken cast partial denture base, mandibular", "Price": 104 },
|
||||
{ "Procedure Code": "D5622", "Description": "Repair broken cast partial denture base, maxillary", "Price": 104 },
|
||||
{ "Procedure Code": "D5630", "Description": "Repair or replace broken retentive/clasping materials - per tooth", "Price": 99 },
|
||||
{ "Procedure Code": "D5640", "Description": "Replace broken teeth - per tooth", "Price": 77 },
|
||||
{ "Procedure Code": "D5650", "Description": "Add tooth to existing partial denture", "Price": 92 },
|
||||
{ "Procedure Code": "D5660", "Description": "Add clasp to existing partial denture per tooth", "Price": 98 },
|
||||
{ "Procedure Code": "D5730", "Description": "Reline complete maxillary denture (chairside)", "Price": 500 },
|
||||
{ "Procedure Code": "D5731", "Description": "Reline complete mandibular denture (chairside)", "Price": 500 },
|
||||
{ "Procedure Code": "D5740", "Description": "Reline maxillary partial denture (chairside)", "Price": "NC" },
|
||||
{ "Procedure Code": "D5741", "Description": "Reline mandibular partial denture (chairside)", "Price": "NC" },
|
||||
{ "Procedure Code": "D5750", "Description": "Reline complete maxillary denture (laboratory)", "Price": 600 },
|
||||
{ "Procedure Code": "D5751", "Description": "Reline complete mandibular denture (laboratory)", "Price": 600 },
|
||||
{ "Procedure Code": "D5760", "Description": "Reline maxillary partial denture (laboratory)", "Price": "NC" },
|
||||
{ "Procedure Code": "D5761", "Description": "Reline mandibular partial denture (laboratory)", "Price": "NC" },
|
||||
{ "Procedure Code": "D6010", "Description": "Surgical placement of implant body", "Price": 1600 },
|
||||
{ "Procedure Code": "D6056", "Description": "Prefabricated abutment", "Price": 750 },
|
||||
{ "Procedure Code": "D6057", "Description": "Custom abutment", "Price": 800 },
|
||||
{ "Procedure Code": "D6058", "Description": "Implant crown - porcelain/ceramic", "Price": 1400 },
|
||||
{ "Procedure Code": "D6059", "Description": "Implant crown - PFM", "Price": 1400 },
|
||||
{ "Procedure Code": "D6100", "Description": "Surgical removal of implant body", "Price": 320 },
|
||||
{ "Procedure Code": "D6110", "Description": "Implant/abutment supported removable denture - maxillary", "Price": 1600 },
|
||||
{ "Procedure Code": "D6111", "Description": "Implant/abutment supported removable denture - mandibular", "Price": 1600 },
|
||||
{ "Procedure Code": "D6241", "Description": "Pontic - porcelain fused to metal", "Price": "NC" },
|
||||
{ "Procedure Code": "D6242", "Description": "Pontic - noble metal", "Price": 1400 },
|
||||
{ "Procedure Code": "D6245", "Description": "Pontic - porcelain/ceramic", "Price": 1400 },
|
||||
{ "Procedure Code": "D6751", "Description": "Retainer crown - porcelain fused to metal", "Price": "NC" },
|
||||
{ "Procedure Code": "D6930", "Description": "Re-cement or re-bond fixed partial denture", "Price": "NC" },
|
||||
{ "Procedure Code": "D6980", "Description": "Fixed partial denture repair", "Price": "NC" },
|
||||
{ "Procedure Code": "D6999", "Description": "Fixed prosthodontic procedure, by report", "Price": "IC" },
|
||||
{ "Procedure Code": "D7111", "Description": "Extraction, coronal remnants - primary tooth", "Price": 120 },
|
||||
{ "Procedure Code": "D7140", "Description": "Extraction, erupted tooth or exposed root (simple)", "Price": 150 },
|
||||
{ "Procedure Code": "D7210", "Description": "Extraction, erupted tooth requiring removal of bone and/or sectioning (surgical)", "Price": 280 },
|
||||
{ "Procedure Code": "D7220", "Description": "Removal of impacted tooth - soft tissue", "Price": 380 },
|
||||
{ "Procedure Code": "D7230", "Description": "Removal of impacted tooth - partially bony", "Price": 450 },
|
||||
{ "Procedure Code": "D7240", "Description": "Removal of impacted tooth - completely bony", "Price": 550 },
|
||||
{ "Procedure Code": "D7250", "Description": "Surgical removal of residual tooth roots", "Price": 280 },
|
||||
{ "Procedure Code": "D7251", "Description": "Coronectomy - intentional partial tooth removal, impacted teeth only", "Price": 134 },
|
||||
{ "Procedure Code": "D7270", "Description": "Tooth reimplantation and/or stabilization of accidentally evulsed or displaced tooth", "Price": 106 },
|
||||
{ "Procedure Code": "D7280", "Description": "Surgical access of an unerupted tooth", "Price": "NC" },
|
||||
{ "Procedure Code": "D7283", "Description": "Placement of device to facilitate eruption of impacted tooth", "Price": "NC" },
|
||||
{ "Procedure Code": "D7310", "Description": "Alveoloplasty in conjunction with extractions - four or more teeth per quadrant", "Price": 142 },
|
||||
{ "Procedure Code": "D7311", "Description": "Alveoloplasty in conjunction with extractions - one to three teeth per quadrant", "Price": 128 },
|
||||
{ "Procedure Code": "D7320", "Description": "Alveoloplasty not in conjunction with extractions - four or more teeth per quadrant", "Price": 187 },
|
||||
{ "Procedure Code": "D7321", "Description": "Alveoloplasty not in conjunction with extractions - one to three teeth per quadrant", "Price": 149 },
|
||||
{ "Procedure Code": "D7340", "Description": "Vestibuloplasty - ridge extension (second epithelialization)", "Price": 747 },
|
||||
{ "Procedure Code": "D7350", "Description": "Vestibuloplasty - ridge extension (Oral surgeon only)", "Price": 943 },
|
||||
{ "Procedure Code": "D7410", "Description": "Excision of benign lesion - diameter up to 1.25 cm", "Price": 115 },
|
||||
{ "Procedure Code": "D7411", "Description": "Excision of benign lesion - diameter greater than 1.25 cm", "Price": 208 },
|
||||
{ "Procedure Code": "D7450", "Description": "Removal of benign odontogenic cyst or tumor - up to 1.25 cm", "Price": 248 },
|
||||
{ "Procedure Code": "D7451", "Description": "Removal of benign odontogenic cyst or tumor - greater than 1.25 cm", "Price": 288 },
|
||||
{ "Procedure Code": "D7460", "Description": "Removal of benign nonodontogenic cyst or tumor - up to 1.25 cm", "Price": 121 },
|
||||
{ "Procedure Code": "D7461", "Description": "Removal of benign nonodontogenic cyst or tumor - greater than 1.25 cm", "Price": 143 },
|
||||
{ "Procedure Code": "D7471", "Description": "Removal of lateral exostosis (maxilla or mandible)", "Price": 143 },
|
||||
{ "Procedure Code": "D7472", "Description": "Removal of torus palatinus", "Price": 143 },
|
||||
{ "Procedure Code": "D7473", "Description": "Removal of torus mandibularis", "Price": 143 },
|
||||
{ "Procedure Code": "D7910", "Description": "Suture of recent small wounds up to 5 cm", "Price": 400 },
|
||||
{ "Procedure Code": "D7950", "Description": "Bone graft - maxilla/mandible", "Price": 800 },
|
||||
{ "Procedure Code": "D7953", "Description": "Bone graft for socket preservation after extraction", "Price": 800 },
|
||||
{ "Procedure Code": "D7961", "Description": "Buccal/labial frenectomy (frenulectomy)", "Price": 107 },
|
||||
{ "Procedure Code": "D7962", "Description": "Lingual frenectomy (frenulectomy)", "Price": 107 },
|
||||
{ "Procedure Code": "D7963", "Description": "Frenuloplasty", "Price": 416 },
|
||||
{ "Procedure Code": "D7970", "Description": "Excision of hyperplastic tissue - per arch", "Price": 246 },
|
||||
{ "Procedure Code": "D7999", "Description": "Unspecified oral surgery procedure, by report", "Price": "IC" },
|
||||
{ "Procedure Code": "D8010", "Description": "Limited orthodontic treatment of the primary dentition (Orthodontist only)", "Price": "NC" },
|
||||
{ "Procedure Code": "D8020", "Description": "Limited orthodontic treatment of the transitional dentition (Orthodontist only)", "Price": "NC" },
|
||||
{ "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" },
|
||||
{ "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" },
|
||||
{ "Procedure Code": "D8670", "Description": "Periodic orthodontic treatment visit (Orthodontist only)", "Price": 215 },
|
||||
{ "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" }
|
||||
]
|
||||
@@ -66,7 +66,7 @@ import {
|
||||
} from "@/components/procedure/procedure-combo-buttons";
|
||||
import { inferTypeFromProcedureCodes, getAppointmentTypeLabel } from "@/utils/appointmentTypeUtils";
|
||||
import { Switch } from "@/components/ui/switch";
|
||||
import { openPendingTab, showAdaClaimForm } from "@/utils/adaClaimForm";
|
||||
import { openPendingTab, saveAdaClaimForm, showAdaClaimForm } from "@/utils/adaClaimForm";
|
||||
import {
|
||||
AlertDialog,
|
||||
AlertDialogAction,
|
||||
@@ -1564,7 +1564,7 @@ export function ClaimForm({
|
||||
} else if (siteKey === "UNITEDUCARD" || siteKey === "UNITED_UCARD") {
|
||||
runWithPriceCheck(handleUnitedUcardClaim);
|
||||
} else if (siteKey === "BCBS" || siteKey === "BCBS_MA") {
|
||||
runWithPriceCheck(handleBCBSClaim);
|
||||
runWithPriceCheck(() => handleBCBSClaim());
|
||||
} else {
|
||||
toast({
|
||||
title: "No automated claim for this insurance",
|
||||
@@ -1893,10 +1893,15 @@ export function ClaimForm({
|
||||
// No Selenium action — works like a real MassHealth claim for payment/report tracking.
|
||||
// BCBS MA has no online claim submission: save the claim, then open the filled
|
||||
// 2024 ADA paper form to print, sign and mail.
|
||||
const handleBCBSClaim = async () => {
|
||||
// `auto` (AI claim queue): no tab — just save the filled form to Documents > Claims.
|
||||
const handleBCBSClaim = async (
|
||||
formToUse?: ClaimFormData & { uploadedFiles?: File[] },
|
||||
{ auto = false }: { auto?: boolean } = {},
|
||||
) => {
|
||||
const f = formToUse ?? form;
|
||||
const missingFields: string[] = [];
|
||||
if (!form.memberId?.trim()) missingFields.push("Member ID");
|
||||
if (!form.dateOfBirth?.trim()) missingFields.push("Date of Birth");
|
||||
if (!f.memberId?.trim()) missingFields.push("Member ID");
|
||||
if (!f.dateOfBirth?.trim()) missingFields.push("Date of Birth");
|
||||
if (!patient?.firstName?.trim()) missingFields.push("First Name");
|
||||
if (missingFields.length > 0) {
|
||||
toast({
|
||||
@@ -1907,7 +1912,7 @@ export function ClaimForm({
|
||||
return;
|
||||
}
|
||||
|
||||
const filteredServiceLines = form.serviceLines.filter(
|
||||
const filteredServiceLines = (f.serviceLines || []).filter(
|
||||
(line) => (line.procedureCode ?? "").trim() !== "",
|
||||
);
|
||||
if (filteredServiceLines.length === 0) {
|
||||
@@ -1920,10 +1925,10 @@ export function ClaimForm({
|
||||
}
|
||||
|
||||
// Open the tab before any await so the browser doesn't block it
|
||||
const tab = openPendingTab();
|
||||
const tab = auto ? null : openPendingTab();
|
||||
|
||||
const appointmentIdToUse = appointmentId ?? null;
|
||||
const { uploadedFiles, insuranceSiteKey, npiProvider, ...formToCreateClaim } = form;
|
||||
const { uploadedFiles, insuranceSiteKey, npiProvider, ...formToCreateClaim } = f;
|
||||
|
||||
try {
|
||||
const claimFilesMeta: ClaimFileMeta[] = mergeWithExistingAttachments(
|
||||
@@ -1945,10 +1950,16 @@ export function ClaimForm({
|
||||
...(selectedNpiProviderId ? { npiProviderId: selectedNpiProviderId } : {}),
|
||||
});
|
||||
|
||||
await showAdaClaimForm(createdClaim.id!, tab);
|
||||
if (auto) {
|
||||
await saveAdaClaimForm(createdClaim.id!);
|
||||
} else {
|
||||
await showAdaClaimForm(createdClaim.id!, tab, "BCBS_MA", { save: true });
|
||||
}
|
||||
// Saving the form marks the claim submitted — show the appointment as claimed
|
||||
queryClient.invalidateQueries({ queryKey: ["appointments", "day"] });
|
||||
toast({
|
||||
title: "BCBS claim form ready",
|
||||
description: "Claim saved. Print the ADA form, sign it, and mail it to BCBS MA.",
|
||||
description: "Claim saved and ADA form added to the patient's Documents > Claims. Print, sign, and mail it to BCBS MA.",
|
||||
});
|
||||
onClose();
|
||||
} catch (err: any) {
|
||||
@@ -2106,6 +2117,8 @@ export function ClaimForm({
|
||||
handleUnitedDHClaim(pricedForm);
|
||||
} else if (key === "united_ucard" || key === "uniteducard" || key === "ucard") {
|
||||
handleUnitedUcardClaim(pricedForm);
|
||||
} else if (key === "bcbs" || key === "bcbs_ma") {
|
||||
handleBCBSClaim(pricedForm, { auto: true });
|
||||
} else {
|
||||
handleMHSubmit(pricedForm);
|
||||
}
|
||||
@@ -2773,7 +2786,7 @@ export function ClaimForm({
|
||||
</Button>
|
||||
<Button
|
||||
className="w-44 bg-sky-700 hover:bg-sky-800 text-white"
|
||||
onClick={() => runWithPriceCheck(handleBCBSClaim)}
|
||||
onClick={() => runWithPriceCheck(() => handleBCBSClaim())}
|
||||
title="Save the claim and open a filled ADA paper form to print and mail"
|
||||
>
|
||||
BCBS Claim (ADA Form)
|
||||
|
||||
@@ -6,6 +6,7 @@ import { apiRequest, queryClient } from "@/lib/queryClient";
|
||||
|
||||
type OfficeContact = {
|
||||
id?: number;
|
||||
legalName?: string | null;
|
||||
officeName?: string | null;
|
||||
receptionistName?: string | null;
|
||||
dentistName?: string | null;
|
||||
@@ -21,6 +22,7 @@ type OfficeContact = {
|
||||
export function OfficeContactCard() {
|
||||
const { toast } = useToast();
|
||||
|
||||
const [legalName, setLegalName] = useState("");
|
||||
const [officeName, setOfficeName] = useState("");
|
||||
const [receptionistName, setReceptionistName] = useState("");
|
||||
const [dentistName, setDentistName] = useState("");
|
||||
@@ -43,6 +45,7 @@ export function OfficeContactCard() {
|
||||
|
||||
useEffect(() => {
|
||||
if (contact) {
|
||||
setLegalName(contact.legalName ?? "");
|
||||
setOfficeName(contact.officeName ?? "");
|
||||
setReceptionistName(contact.receptionistName ?? "");
|
||||
setDentistName(contact.dentistName ?? "");
|
||||
@@ -76,7 +79,7 @@ export function OfficeContactCard() {
|
||||
|
||||
const handleSubmit = (e: React.FormEvent) => {
|
||||
e.preventDefault();
|
||||
saveMutation.mutate({ officeName, receptionistName, dentistName, phoneNumber, email, fax, streetAddress, city, state, zipCode });
|
||||
saveMutation.mutate({ legalName, officeName, receptionistName, dentistName, phoneNumber, email, fax, streetAddress, city, state, zipCode });
|
||||
};
|
||||
|
||||
return (
|
||||
@@ -94,7 +97,18 @@ export function OfficeContactCard() {
|
||||
) : (
|
||||
<form className="space-y-4" onSubmit={handleSubmit}>
|
||||
<div>
|
||||
<label className="block text-sm font-medium">Dental Office Name</label>
|
||||
<label className="block text-sm font-medium">Legal Name</label>
|
||||
<input
|
||||
type="text"
|
||||
value={legalName}
|
||||
onChange={(e) => setLegalName(e.target.value)}
|
||||
className="mt-1 p-2 border rounded w-full text-sm"
|
||||
placeholder="e.g. Kai Gao DMD LLC"
|
||||
/>
|
||||
</div>
|
||||
|
||||
<div>
|
||||
<label className="block text-sm font-medium">Dental Office Name (DBA)</label>
|
||||
<input
|
||||
type="text"
|
||||
value={officeName}
|
||||
|
||||
@@ -11,18 +11,30 @@ export function openPendingTab(): Window | null {
|
||||
return tab;
|
||||
}
|
||||
|
||||
async function fetchAdaClaimForm(claimId: number, payer: string, save: boolean): Promise<Blob> {
|
||||
const res = await apiRequest(save ? "POST" : "GET", `/api/claims/${claimId}/ada-form?payer=${payer}`);
|
||||
if (!res.ok) {
|
||||
const err = await res.json().catch(() => null);
|
||||
throw new Error(err?.message || "Failed to generate ADA claim form");
|
||||
}
|
||||
return res.blob();
|
||||
}
|
||||
|
||||
/** Fills the ADA form and saves it to the patient's Documents "Claims" folder, without opening it. */
|
||||
export async function saveAdaClaimForm(claimId: number, payer = "BCBS_MA"): Promise<void> {
|
||||
await fetchAdaClaimForm(claimId, payer, true);
|
||||
}
|
||||
|
||||
/** `save` also stores the PDF in the patient's Documents "Claims" folder. */
|
||||
export async function showAdaClaimForm(
|
||||
claimId: number,
|
||||
tab: Window | null = null,
|
||||
payer = "BCBS_MA",
|
||||
{ save = false }: { save?: boolean } = {},
|
||||
): Promise<void> {
|
||||
try {
|
||||
const res = await apiRequest("GET", `/api/claims/${claimId}/ada-form?payer=${payer}`);
|
||||
if (!res.ok) {
|
||||
const err = await res.json().catch(() => null);
|
||||
throw new Error(err?.message || "Failed to generate ADA claim form");
|
||||
}
|
||||
const url = URL.createObjectURL(await res.blob());
|
||||
const blob = await fetchAdaClaimForm(claimId, payer, save);
|
||||
const url = URL.createObjectURL(blob);
|
||||
if (tab && !tab.closed) {
|
||||
tab.location.href = url;
|
||||
} else {
|
||||
|
||||
@@ -7,6 +7,7 @@ import rawUnitedDHCodeTable from "@/assets/data/procedureCodesUnitedDH.json";
|
||||
import rawUnitedUcardCodeTable from "@/assets/data/procedureCodesUnitedUcard.json";
|
||||
import rawTuftsSCOCodeTable from "@/assets/data/procedureCodesTuftsSCO.json";
|
||||
import rawDeltainsCodeTable from "@/assets/data/procedureCodesDeltains.json";
|
||||
import rawBCBSCodeTable from "@/assets/data/procedureCodesBCBS.json";
|
||||
import { PROCEDURE_COMBOS } from "./procedureCombos";
|
||||
|
||||
/* ----------------------------- Types ----------------------------- */
|
||||
@@ -25,6 +26,7 @@ const UNITEDDH_CODE_TABLE = rawUnitedDHCodeTable as CodeRow[];
|
||||
const UNITEDUCARD_CODE_TABLE = rawUnitedUcardCodeTable as CodeRow[];
|
||||
const TUFTSSCO_CODE_TABLE = rawTuftsSCOCodeTable as CodeRow[];
|
||||
const DELTAINS_CODE_TABLE = rawDeltainsCodeTable as CodeRow[];
|
||||
const BCBS_CODE_TABLE = rawBCBSCodeTable as CodeRow[];
|
||||
|
||||
export type ClaimFormLike = {
|
||||
serviceDate: string; // form-level service date
|
||||
@@ -76,6 +78,15 @@ const DDMA_CODE_MAP: Map<string, CodeRow> = (() => {
|
||||
return m;
|
||||
})();
|
||||
|
||||
const BCBS_CODE_MAP: Map<string, CodeRow> = (() => {
|
||||
const m = new Map<string, CodeRow>();
|
||||
for (const r of BCBS_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) {
|
||||
@@ -117,6 +128,7 @@ function getCodeMap(insuranceSiteKey?: string): Map<string, CodeRow> {
|
||||
const k = (insuranceSiteKey ?? "").replace(/_/g, "").toLowerCase();
|
||||
if (k === "cca") return CCA_CODE_MAP;
|
||||
if (k === "ddma") return DDMA_CODE_MAP;
|
||||
if (k === "bcbs" || k === "bcbsma") return BCBS_CODE_MAP;
|
||||
if (k === "deltains") return DELTAINS_CODE_MAP;
|
||||
if (k === "unitedsco" || k === "uniteddh" || k === "dentalhub") return UNITEDDH_CODE_MAP;
|
||||
if (k === "uniteducard" || k === "ucard") return UNITEDUCARD_CODE_MAP;
|
||||
|
||||
Reference in New Issue
Block a user