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feat: route batch-column claims by insurance type, fix eligibility UX

Browse Source 
- claims.ts: batch-column now routes each patient to the correct portal
  (MH/CCA/DDMA/TuftsSCO/UnitedSCO) based on patient.insuranceProvider
- appointments-page.tsx: eligibility badge falls back to patientStatus
  for all insurance types, not just MassHealth
- unitedDHClaimProcessor/ddmaClaimProcessor/tuftsSCOClaimProcessor:
  auto-save claim PDF when no socketId (batch-column path)
- unitedSCOEligibilityProcessor: unknown eligibility no longer stored as INACTIVE
- queues.ts: add tuftssco-claim-submit and uniteddh-claim-submit to SeleniumJobType
- selenium_UnitedSCO_eligibilityCheckWorker.py:
  - step1: add Select Insurance OK click with staleness wait; Provider &
    Location page just clicks Continue; skip first/last name input
  - step2: extract name from eligibility details tab (ALL CAPS → title case);
    skip "not available" guard; fix name regex to match only all-caps words
- .gitignore: ignore all chrome_profile_* directories

Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
This commit is contained in:
ff
2026-05-27 23:07:42 -04:00
parent 1b017177e9
commit 3e61bdec36
261 changed files with 331 additions and 119284 deletions
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24
apps/Backend/src/queue/processors/ddmaClaimProcessor.ts
View File

@@ -14,6 +14,8 @@ import {
} from "../../services/seleniumDDMAClaimClient";
import { io } from "../../socket";
import { storage } from "../../storage";
import axios from "axios";
import path from "path";
function log(tag: string, msg: string, ctx?: any) {
console.log(`${new Date().toISOString()} [${tag}] ${msg}`, ctx ?? "");
@@ -86,6 +88,21 @@ async function pollUntilDone(
throw new Error(`DDMA claim polling exhausted all attempts for session ${sessionId}`);
}
async function savePdfFromSelenium(pdf_url: string, patientId: number) {
try {
const filename = path.basename(new URL(pdf_url).pathname);
const seleniumPort = process.env.SELENIUM_PORT || "5002";
const localUrl = `http://localhost:${seleniumPort}/downloads/${filename}`;
const resp = await axios.get(localUrl, { responseType: "arraybuffer", timeout: 30000 });
let group = await storage.findPdfGroupByPatientTitleKey(patientId, "INSURANCE_CLAIM");
if (!group) group = await storage.createPdfGroup(patientId, "Claims", "INSURANCE_CLAIM");
await storage.createPdfFile(group.id!, filename, resp.data);
log("ddma-claim-processor", "PDF saved", { patientId, filename });
} catch (err: any) {
log("ddma-claim-processor", "failed to save PDF (non-fatal)", { error: err?.message ?? err });
}
}
export interface DDMAClaimProcessorInput {
enrichedPayload: any;
userId: number;
@@ -139,6 +156,13 @@ export async function runDDMAClaimProcessor(
}
}
// Auto-save PDF for batch-column calls (no socketId = no frontend listener)
if (pdf_url && !socketId) {
const claim = claimId ? await storage.getClaim(claimId).catch(() => null) : null;
const patientId = claim?.patientId ?? enrichedPayload?.claim?.patientId ?? enrichedPayload?.patientId;
if (patientId) await savePdfFromSelenium(pdf_url, Number(patientId));
}
emitToSocket(socketId, "selenium:ddma_claim_completed", {
jobId,
claimId,

24
apps/Backend/src/queue/processors/tuftsSCOClaimProcessor.ts
View File

@@ -14,6 +14,8 @@ import {
} from "../../services/seleniumTuftsSCOClaimClient";
import { io } from "../../socket";
import { storage } from "../../storage";
import axios from "axios";
import path from "path";
function log(tag: string, msg: string, ctx?: any) {
console.log(`${new Date().toISOString()} [${tag}] ${msg}`, ctx ?? "");
@@ -85,6 +87,21 @@ async function pollUntilDone(
throw new Error(`Tufts SCO claim polling exhausted all attempts for session ${sessionId}`);
}
async function savePdfFromSelenium(pdf_url: string, patientId: number) {
try {
const filename = path.basename(new URL(pdf_url).pathname);
const seleniumPort = process.env.SELENIUM_PORT || "5002";
const localUrl = `http://localhost:${seleniumPort}/downloads/${filename}`;
const resp = await axios.get(localUrl, { responseType: "arraybuffer", timeout: 30000 });
let group = await storage.findPdfGroupByPatientTitleKey(patientId, "INSURANCE_CLAIM");
if (!group) group = await storage.createPdfGroup(patientId, "Claims", "INSURANCE_CLAIM");
await storage.createPdfFile(group.id!, filename, resp.data);
log("tuftssco-claim-processor", "PDF saved", { patientId, filename });
} catch (err: any) {
log("tuftssco-claim-processor", "failed to save PDF (non-fatal)", { error: err?.message ?? err });
}
}
export interface TuftsSCOClaimProcessorInput {
enrichedPayload: any;
userId: number;
@@ -130,6 +147,13 @@ export async function runTuftsSCOClaimProcessor(
}
}
// Auto-save PDF for batch-column calls (no socketId = no frontend listener)
if (pdf_url && !socketId) {
const claim = claimId ? await storage.getClaim(claimId).catch(() => null) : null;
const patientId = claim?.patientId ?? enrichedPayload?.claim?.patientId ?? enrichedPayload?.patientId;
if (patientId) await savePdfFromSelenium(pdf_url, Number(patientId));
}
emitToSocket(socketId, "selenium:tuftssco_claim_completed", {
jobId,
claimId,

27
apps/Backend/src/queue/processors/unitedDHClaimProcessor.ts
View File

@@ -14,6 +14,8 @@ import {
} from "../../services/seleniumUnitedDHClaimClient";
import { io } from "../../socket";
import { storage } from "../../storage";
import axios from "axios";
import path from "path";
function log(tag: string, msg: string, ctx?: any) {
console.log(`${new Date().toISOString()} [${tag}] ${msg}`, ctx ?? "");
@@ -97,6 +99,24 @@ async function pollUntilDone(
throw new Error(`UnitedDH claim polling exhausted all attempts for session ${sessionId}`);
}
async function savePdfFromSelenium(pdf_url: string, patientId: number) {
try {
const filename = path.basename(new URL(pdf_url).pathname);
const seleniumPort = process.env.SELENIUM_PORT || "5002";
const localUrl = `http://localhost:${seleniumPort}/downloads/${filename}`;
const resp = await axios.get(localUrl, { responseType: "arraybuffer", timeout: 30000 });
let group = await storage.findPdfGroupByPatientTitleKey(patientId, "INSURANCE_CLAIM");
if (!group) {
group = await storage.createPdfGroup(patientId, "Claims", "INSURANCE_CLAIM");
}
await storage.createPdfFile(group.id!, filename, resp.data);
log("uniteddh-claim-processor", "PDF saved", { patientId, filename });
} catch (err: any) {
log("uniteddh-claim-processor", "failed to save PDF (non-fatal)", { error: err?.message ?? err });
}
}
export interface UnitedDHClaimProcessorInput {
enrichedPayload: any;
userId: number;
@@ -149,6 +169,13 @@ export async function runUnitedDHClaimProcessor(
}
}
// Auto-save PDF for batch-column calls (no socketId = no frontend listener)
if (pdf_url && !socketId) {
const claim = claimId ? await storage.getClaim(claimId).catch(() => null) : null;
const patientId = claim?.patientId ?? enrichedPayload?.claim?.patientId ?? enrichedPayload?.patientId;
if (patientId) await savePdfFromSelenium(pdf_url, Number(patientId));
}
emitToSocket(socketId, "selenium:uniteddh_claim_completed", {
jobId,
claimId,

20
apps/Backend/src/queue/processors/unitedSCOEligibilityProcessor.ts
View File

@@ -104,13 +104,21 @@ async function processUnitedSCOResult(
// 4) Determine eligibility status
const eligStatus = (seleniumResult?.eligibility ?? "").toLowerCase();
const newStatus = eligStatus === "active" || eligStatus === "y" ? "ACTIVE" : "INACTIVE";
const newStatus =
eligStatus === "active" || eligStatus === "y" ? "ACTIVE" :
eligStatus === "inactive" ? "INACTIVE" : null;
await storage.updatePatient(patient.id, {
status: newStatus,
insuranceProvider: "United Healthcare SCO",
});
output.patientUpdateStatus = `Patient status updated to ${newStatus}`;
if (newStatus) {
await storage.updatePatient(patient.id, {
status: newStatus,
insuranceProvider: "United Healthcare SCO",
});
output.patientUpdateStatus = `Patient status updated to ${newStatus}`;
} else {
// Unknown eligibility — still update insuranceProvider but leave status unchanged
await storage.updatePatient(patient.id, { insuranceProvider: "United Healthcare SCO" });
output.patientUpdateStatus = `Eligibility unknown — status not changed`;
}
// 5) Resolve PDF buffer from file path (same as DDMA)
let pdfBuffer: Buffer | null = null;

2
apps/Backend/src/queue/queues.ts
View File

@@ -14,6 +14,8 @@ export type SeleniumJobType =
| "cca-claim-submit"
| "cca-preauth-submit"
| "ddma-claim-submit"
| "tuftssco-claim-submit"
| "uniteddh-claim-submit"
| "tuftssco-eligibility-check"
| "mh-eligibility-history-check"
| "cmsp-eligibility-history-remaining-check";

184
apps/Backend/src/routes/claims.ts
View File

@@ -9,6 +9,7 @@ import fs from "fs";
import axios from "axios";
import archiver from "archiver";
import { seleniumQueue } from "../queue/queues";
import { enqueueSeleniumJob } from "../queue/jobRunner";
import { Prisma } from "@repo/db/generated/prisma";
import { Decimal } from "decimal.js";
import {
@@ -415,6 +416,28 @@ router.post(
}
);
// Maps patient.insuranceProvider free-text → the siteKey stored in InsuranceCredential
function batchColumnDeriveSiteKey(provider: string): string {
const p = provider.toLowerCase().trim();
if (!p || p.includes("masshealth") || p === "mh" || p === "mass health") return "MH";
if (p.includes("commonwealth care alliance") || p === "cca") return "CCA";
if (p.includes("ddma") || p.includes("delta dental ma")) return "DDMA";
if (p.includes("tufts") || p.includes("dentaquest") || p === "tuftssco") return "TUFTS_SCO";
if ((p.includes("united") && p.includes("sco")) || p.includes("dentalhub") || p === "united_sco") return "UNITED_SCO";
return "MH"; // default fallback
}
// Returns the canonical insuranceProvider name stored in the Claim record
function batchColumnCanonicalName(siteKey: string): string {
switch (siteKey) {
case "CCA": return "CCA";
case "DDMA": return "Delta Dental MA";
case "TUFTS_SCO": return "Tufts SCO";
case "UNITED_SCO": return "United/DentalHub";
default: return "MassHealth";
}
}
// POST /api/claims/batch-column
// Query params: date=YYYY-MM-DD (required), staffIds=1,2 (required)
// For each appointment in the selected staff columns:
@@ -555,10 +578,15 @@ router.post(
continue;
}
// MassHealth credentials
const credentials = await storage.getInsuranceCredentialByUserAndSiteKey(req.user.id, "MH");
// Always derive siteKey from the patient record — claim.insuranceProvider
// may be stale (e.g. previously set to "MassHealth" by the old hardcoded path)
const rawInsuranceProvider = (patient.insuranceProvider ?? "").trim();
const siteKey = batchColumnDeriveSiteKey(rawInsuranceProvider);
const canonicalInsuranceProvider = batchColumnCanonicalName(siteKey);
const credentials = await storage.getInsuranceCredentialByUserAndSiteKey(req.user.id, siteKey);
if (!credentials) {
resultItem.error = "No MassHealth credentials found — check Settings";
resultItem.error = `No ${canonicalInsuranceProvider} credentials found — check Settings`;
results.push(resultItem);
continue;
}
@@ -573,7 +601,7 @@ router.post(
// Priority: Select Procedures choice > existing claim > first provider
const claimNpiProviderId = procNpiProviderId ?? activeClaim?.npiProviderId ?? npiProvider?.id ?? null;
console.log(`[batch-column] apt=${apt.id} procNpiId=${procNpiProviderId} claimNpiId=${activeClaim?.npiProviderId} resolved=${claimNpiProviderId}`);
console.log(`[batch-column] apt=${apt.id} siteKey=${siteKey} procNpiId=${procNpiProviderId} claimNpiId=${activeClaim?.npiProviderId} resolved=${claimNpiProviderId}`);
const patientName = `${patient.firstName ?? ""} ${patient.lastName ?? ""}`.trim();
@@ -597,7 +625,7 @@ router.post(
? Number(claimNpiProviderId)
: null;
console.log(`[batch-column] creating claim: patientId=${patient.id} aptId=${apt.id} staffId=${safeStaffId} npiProviderId=${safeNpiId} serviceDate=${serviceDate} dobStr=${dobStr} lines=${serviceLines.length}`);
console.log(`[batch-column] creating claim: patientId=${patient.id} aptId=${apt.id} staffId=${safeStaffId} npiProviderId=${safeNpiId} serviceDate=${serviceDate} dobStr=${dobStr} lines=${serviceLines.length} insurance=${canonicalInsuranceProvider}`);
const newClaim = await storage.createClaim({
patientId: Number(patient.id),
@@ -608,7 +636,7 @@ router.post(
memberId,
dateOfBirth: new Date(dobStr),
serviceDate: new Date(serviceDate),
insuranceProvider: "MassHealth",
insuranceProvider: canonicalInsuranceProvider,
remarks: "",
missingTeethStatus: "No_missing",
missingTeeth: {},
@@ -643,33 +671,6 @@ router.post(
if (saved) resolvedNpiProvider = saved;
}
// Build enriched payload for selenium
const enrichedPayload: any = {
patientId: Number(patient.id),
appointmentId: Number(apt.id),
userId: req.user.id,
staffId: Number(apt.staffId),
patientName,
memberId,
dateOfBirth: dobStr,
serviceDate,
insuranceProvider: "MassHealth",
insuranceSiteKey: "MH",
missingTeethStatus: activeClaim?.missingTeethStatus ?? "No_missing",
missingTeeth: activeClaim?.missingTeeth ?? {},
remarks: activeClaim?.remarks ?? "",
serviceLines,
claimId,
massdhpUsername: credentials.username,
massdhpPassword: credentials.password,
};
if (resolvedNpiProvider) {
enrichedPayload.npiProvider = {
npiNumber: resolvedNpiProvider.npiNumber,
providerName: resolvedNpiProvider.providerName,
};
}
// Collect attachments: appointment-level files + claim-level files
const apptFiles = await storage.getAppointmentFiles(Number(apt.id));
const claimFiles = (activeClaim as any)?.claimFiles ?? [];
@@ -689,17 +690,120 @@ router.post(
return [{ originalname: f.filename, bufferBase64, mimetype: f.mimeType ?? "application/octet-stream" }];
});
// Enqueue selenium claim-submit job
const job = await seleniumQueue.add("claim-submit", {
jobType: "claim-submit",
// Base claim data shared across all insurance pathways
const baseClaimPayload: any = {
patientId: Number(patient.id),
appointmentId: Number(apt.id),
userId: req.user.id,
enrichedPayload,
files: filesForQueue,
staffId: Number(apt.staffId),
patientName,
memberId,
dateOfBirth: dobStr,
serviceDate,
missingTeethStatus: activeClaim?.missingTeethStatus ?? "No_missing",
missingTeeth: activeClaim?.missingTeeth ?? {},
remarks: activeClaim?.remarks ?? "",
serviceLines,
claimId,
});
...(resolvedNpiProvider ? {
npiProvider: {
npiNumber: resolvedNpiProvider.npiNumber,
providerName: resolvedNpiProvider.providerName,
},
} : {}),
};
// Enqueue to the correct insurance pathway
let jobId: string;
if (siteKey === "MH") {
const enrichedPayload = {
...baseClaimPayload,
insuranceProvider: "MassHealth",
insuranceSiteKey: "MH",
massdhpUsername: credentials.username,
massdhpPassword: credentials.password,
};
const job = await seleniumQueue.add("claim-submit", {
jobType: "claim-submit",
userId: req.user.id,
enrichedPayload,
files: filesForQueue,
claimId,
});
jobId = String(job.id);
} else if (siteKey === "CCA") {
const enrichedPayload = {
claim: {
...baseClaimPayload,
insuranceProvider: "CCA",
insuranceSiteKey: "CCA",
cca_username: credentials.username,
cca_password: credentials.password,
},
files: filesForQueue,
};
jobId = enqueueSeleniumJob({
jobType: "cca-claim-submit",
userId: req.user.id,
enrichedPayload,
claimId,
});
} else if (siteKey === "DDMA") {
const enrichedPayload = {
claim: {
...baseClaimPayload,
insuranceProvider: "Delta Dental MA",
insuranceSiteKey: "DDMA",
massddmaUsername: credentials.username,
massddmaPassword: credentials.password,
},
};
jobId = enqueueSeleniumJob({
jobType: "ddma-claim-submit",
userId: req.user.id,
enrichedPayload,
claimId,
});
} else if (siteKey === "TUFTS_SCO") {
const enrichedPayload = {
claim: {
...baseClaimPayload,
insuranceProvider: "Tufts SCO",
insuranceSiteKey: "TuftsSCO",
dentaquestUsername: credentials.username,
dentaquestPassword: credentials.password,
},
};
jobId = enqueueSeleniumJob({
jobType: "tuftssco-claim-submit",
userId: req.user.id,
enrichedPayload,
claimId,
});
} else if (siteKey === "UNITED_SCO") {
const enrichedPayload = {
claim: {
...baseClaimPayload,
insuranceProvider: "United/DentalHub",
insuranceSiteKey: "UNITED_SCO",
uniteddhUsername: credentials.username,
uniteddhPassword: credentials.password,
},
};
jobId = enqueueSeleniumJob({
jobType: "uniteddh-claim-submit",
userId: req.user.id,
enrichedPayload,
claimId,
});
} else {
resultItem.error = `Unsupported insurance type: ${siteKey}`;
results.push(resultItem);
continue;
}
resultItem.processed = true;
resultItem.jobId = String(job.id);
resultItem.jobId = jobId;
} catch (aptErr: any) {
console.error("[batch-column] apt error:", aptErr);