fix: BCBS MA — identify patient by member ID + DOB, prevent overwriting subscriber

- Added getPatientByInsuranceIdAndDob to storage
- Processor uses insuranceId + DOB as unique key instead of insuranceId alone
- Dependent with same subscriber ID but different DOB gets a new patient record
  (bypasses createOrUpdatePatientByInsuranceId which would overwrite subscriber)
- Name extraction anchored to "Relationship:" to scope Patient Info column only

Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>

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

@@ -63,10 +63,45 @@ async function processBcbsMaResult(
         ? seleniumResult.lastName.trim()
         : (formLastName ?? "");
 
-    await createOrUpdatePatientByInsuranceId({ insuranceId, firstName, lastName, dob: formDob, userId });
-
     const normalizedInsuranceId = insuranceId.replace(/\s+/g, "");
-    const patient = await storage.getPatientByInsuranceId(normalizedInsuranceId);
+
+    // Identify patient by member ID + DOB — not member ID alone.
+    // Dependents (e.g. Maria) share the subscriber's member ID but have a different DOB.
+    const dobDate = formDob ? new Date(formDob) : null;
+
+    let patient = dobDate
+      ? await storage.getPatientByInsuranceIdAndDob(normalizedInsuranceId, dobDate)
+      : await storage.getPatientByInsuranceId(normalizedInsuranceId);
+
+    if (patient) {
+      // Existing patient found by insuranceId + DOB — update name
+      log("bcbs-ma-processor", `Patient matched by insuranceId+DOB id=${patient.id}`);
+      await storage.updatePatient(patient.id, { firstName, lastName });
+    } else {
+      // No match — create a brand new patient record.
+      // Do NOT use createOrUpdatePatientByInsuranceId here because it looks up by
+      // insuranceId alone and would overwrite the subscriber (e.g. Hugo) instead of
+      // creating a new record for the dependent (e.g. Maria).
+      log("bcbs-ma-processor", "No patient matched by insuranceId+DOB — creating new patient record");
+      try {
+        await storage.createPatient({
+          firstName,
+          lastName,
+          insuranceId: normalizedInsuranceId,
+          dateOfBirth: dobDate ?? undefined,
+          gender: "",
+          phone: "",
+          userId,
+        } as any);
+      } catch (createErr: any) {
+        log("bcbs-ma-processor", `createPatient failed: ${createErr?.message}`, createErr);
+        throw createErr;
+      }
+      patient = dobDate
+        ? await storage.getPatientByInsuranceIdAndDob(normalizedInsuranceId, dobDate)
+        : await storage.getPatientByInsuranceId(normalizedInsuranceId);
+    }
+
     if (!patient?.id) {
       output.patientUpdateStatus = "Patient not found; no update performed";
       return output;

apps/Backend/src/storage/patients-storage.ts

@@ -10,6 +10,7 @@ export interface IStorage {
   // Patient methods
   getPatient(id: number): Promise<Patient | undefined>;
   getPatientByInsuranceId(insuranceId: string): Promise<Patient | null>;
+  getPatientByInsuranceIdAndDob(insuranceId: string, dob: Date): Promise<Patient | null>;
   getAllPatients(): Promise<Patient[]>;
   getRecentPatients(limit: number, offset: number): Promise<Patient[]>;
   getPatientsByIds(ids: number[]): Promise<Patient[]>;
@@ -60,6 +61,19 @@ export const patientsStorage: IStorage = {
     });
   },
 
+  async getPatientByInsuranceIdAndDob(insuranceId: string, dob: Date): Promise<Patient | null> {
+    const startOfDay = new Date(dob);
+    startOfDay.setHours(0, 0, 0, 0);
+    const endOfDay = new Date(dob);
+    endOfDay.setHours(23, 59, 59, 999);
+    return db.patient.findFirst({
+      where: {
+        insuranceId,
+        dateOfBirth: { gte: startOfDay, lte: endOfDay },
+      },
+    });
+  },
+
   async getRecentPatients(limit: number, offset: number): Promise<Patient[]> {
     return db.patient.findMany({
       skip: offset,