feat: AI claim queue auto-return + D1120 age warning

- claims-page: after auto-submit closes the form, automatically navigate
  back to /appointments when an AI claim queue is pending resume, eliminating
  the manual navigation delay between appointments
- internal-chat-workflow: warn and block claim when D1120 (child prophy) is
  requested for a patient aged 14+ — recommend D1110 (adult prophy) instead,
  and advise manual claim if user insists on D1120

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

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

@@ -65,6 +65,13 @@ export function deriveSiteKey(provider: string): string {
   return "MH";
 }
 
+// Returns true when the user said "united" without a specific qualifier
+// (e.g. "united sco", "united healthcare") — needs clarification.
+function isAmbiguousUnited(hint: string | null | undefined): boolean {
+  const h = (hint ?? "").toLowerCase().trim();
+  return h === "united";
+}
+
 // siteKey → autoCheck value used by the insurance-status page prefill.
 // For MH, pass the patient's DOB so under-21 patients route to CMSP.
 export function siteKeyToAutoCheck(siteKey: string, dob?: string | Date | null): string {
@@ -109,6 +116,32 @@ interface StorageLike {
 
 // ─── Shared helpers ───────────────────────────────────────────────────────────
 
+function calcAge(dob: string | null | undefined, on?: string | null): number | null {
+  if (!dob) return null;
+  try {
+    const birth = new Date(dob);
+    const ref = on ? new Date(on) : new Date();
+    let age = ref.getFullYear() - birth.getFullYear();
+    const m = ref.getMonth() - birth.getMonth();
+    if (m < 0 || (m === 0 && ref.getDate() < birth.getDate())) age--;
+    return age;
+  } catch { return null; }
+}
+
+function checkD1120Age(
+  matched: CdtResult[],
+  patientName: string,
+  dob: string | null | undefined,
+  serviceDate?: string | null
+): ChatResponse | null {
+  if (!matched.some((r) => r.code === "D1120")) return null;
+  const age = calcAge(dob, serviceDate);
+  if (age === null || age < 14) return null;
+  return {
+    reply: `${patientName} is ${age} years old. D1120 (child prophy) is only for patients under 14 — I recommend using D1110 (adult prophy) instead. If you still need D1120, please claim manually for this patient.`,
+  };
+}
+
 function patientToResult(p: any): ResolvedPatient {
   return {
     id: p.id,
@@ -317,6 +350,13 @@ async function handleEligibilityById(
     };
   }
 
+  // User explicitly chose "Other United" — it's not in the app
+  if ((c.insuranceHint ?? "").toLowerCase().includes("other united")) {
+    return {
+      reply: "That United plan is not currently supported in the app. Please check it manually.",
+    };
+  }
+
   // Try to resolve existing patient for name display + insurance (use DOB to pick the right family member)
   const existingPatient = await findPatientByMemberId(memberId, dob, storage);
   const patient: ResolvedPatient | null = existingPatient
@@ -331,6 +371,24 @@ async function handleEligibilityById(
     };
   }
 
+  // "united" alone is ambiguous — there's United SCO (Dental Hub) in the app
+  // and other United plans that are not supported.
+  if (isAmbiguousUnited(c.insuranceHint) && !patient?.insuranceProvider) {
+    const label = patient
+      ? `${patient.firstName ?? ""} ${patient.lastName ?? ""}`.trim()
+      : `Member ID ${memberId}`;
+    return {
+      reply: `Which United plan is ${label}?`,
+      action: "need_insurance_clarification",
+      actionData: {
+        memberId,
+        dob: resolvedDob,
+        patient,
+        options: ["United SCO / Dental Hub", "Other United (not in app)"],
+      },
+    };
+  }
+
   // Determine siteKey
   const siteKey = resolveSiteKey(
     patient?.insuranceProvider ?? null,
@@ -348,7 +406,7 @@ async function handleEligibilityById(
         memberId,
         dob: resolvedDob,
         patient,
-        options: ["MassHealth", "BCBS MA", "CCA", "Tufts SCO", "Delta Dental MA", "United/DentalHub"],
+        options: ["MassHealth", "BCBS MA", "CCA", "Tufts SCO", "Delta Dental MA", "United SCO / Dental Hub"],
       },
     };
   }
@@ -378,6 +436,13 @@ async function handleCheckAndClaim(
   storage: StorageLike,
   customAliases: { phrase: string; cdtCode: string }[] = []
 ): Promise<ChatResponse> {
+  // User explicitly chose "Other United" — it's not in the app
+  if ((c.insuranceHint ?? "").toLowerCase().includes("other united")) {
+    return {
+      reply: "That United plan is not currently supported in the app. Please check it manually.",
+    };
+  }
+
   // 1. Resolve patient
   let patient: ResolvedPatient | null = null;
   let memberId = c.memberId?.trim() ?? null;
@@ -408,6 +473,24 @@ async function handleCheckAndClaim(
     };
   }
 
+  // "united" alone is ambiguous — clarify before proceeding
+  if (isAmbiguousUnited(c.insuranceHint) && !patient?.insuranceProvider) {
+    const label = patient
+      ? `${patient.firstName ?? ""} ${patient.lastName ?? ""}`.trim()
+      : `Member ID ${memberId}`;
+    return {
+      reply: `Which United plan is ${label}?`,
+      action: "need_insurance_clarification",
+      actionData: {
+        memberId,
+        dob: resolvedDob,
+        patient,
+        procedureNames: c.procedureNames ?? [],
+        options: ["United SCO / Dental Hub", "Other United (not in app)"],
+      },
+    };
+  }
+
   // 2. Determine siteKey
   const siteKey = resolveSiteKey(
     patient?.insuranceProvider ?? null,
@@ -426,7 +509,7 @@ async function handleCheckAndClaim(
         dob,
         patient,
         procedureNames: c.procedureNames ?? [],
-        options: ["MassHealth", "BCBS MA", "CCA", "Tufts SCO", "Delta Dental MA", "United/DentalHub"],
+        options: ["MassHealth", "BCBS MA", "CCA", "Tufts SCO", "Delta Dental MA", "United SCO / Dental Hub"],
       },
     };
   }
@@ -454,6 +537,10 @@ async function handleCheckAndClaim(
     ? `${patient.firstName ?? ""} ${patient.lastName ?? ""}`.trim()
     : `Member ID ${memberId}`;
 
+  // D1120 age check — recommend D1110 for patients 14+
+  const d1120Warning = checkD1120Age(matched, label, patient?.dateOfBirth ?? resolvedDob, c.appointmentDate);
+  if (d1120Warning) return d1120Warning;
+
   const reply = `Ready to check eligibility for ${label} and claim: ${
     matched.map((r) => `${r.code} (${r.description})`).join(", ") || "no procedures mapped"
   }.`;
@@ -521,6 +608,10 @@ async function handleClaimOnly(
     };
   }
 
+  // D1120 age check — recommend D1110 for patients 14+
+  const d1120Warning = checkD1120Age(matched, fullName, patient.dateOfBirth, c.appointmentDate);
+  if (d1120Warning) return d1120Warning;
+
   // Resolve service date: use explicit date from message, then latest appointment, then ask
   let serviceDate: string | null = c.appointmentDate ?? null;
   let appointmentId: number | null = null;

apps/Backend/src/data/insuranceAliases.json

@@ -23,8 +23,10 @@
   { "keyword": "united healthone sco",        "siteKey": "UNITED_SCO" },
   { "keyword": "united healthcare sco",       "siteKey": "UNITED_SCO" },
   { "keyword": "united healthcare",           "siteKey": "UNITED_SCO" },
+  { "keyword": "united sco / dental hub",    "siteKey": "UNITED_SCO" },
   { "keyword": "united sco",                  "siteKey": "UNITED_SCO" },
   { "keyword": "dentalhub",                   "siteKey": "UNITED_SCO" },
+  { "keyword": "dental hub",                  "siteKey": "UNITED_SCO" },
   { "keyword": "united_sco",                  "siteKey": "UNITED_SCO" },
 
   { "keyword": "blue cross blue shield",      "siteKey": "BCBS_MA" },

apps/Frontend/src/pages/claims-page.tsx

@@ -813,6 +813,18 @@ export default function ClaimsPage() {
     setIsClaimFormOpen(false);
 
     clearUrlParams(["newPatient", "appointmentId"]);
+
+    // If an AI claim queue is pending resume, go straight back to appointments
+    try {
+      const raw = sessionStorage.getItem("ai_claim_queue");
+      if (raw) {
+        const parsed = JSON.parse(raw);
+        if (parsed?.pendingResume && Array.isArray(parsed.appointments) && parsed.appointments.length > 0) {
+          setWouterLocation("/appointments");
+          return;
+        }
+      }
+    } catch {}
   };
 
   // Pre Auth section

apps/Frontend/src/pages/insurance-status-page.tsx

@@ -170,6 +170,7 @@ export default function InsuranceStatusPage() {
   const pendingAutoCheck = useRef<"mh" | "mh-history" | "cmsp" | "ddma" | "delta-ins" | "united-sco" | "tufts-sco" | "cca" | null>(null);
   const [triggerTarget, setTriggerTarget] = useState<string | null>(null);
   const pendingScrollTo = useRef<string | null>(null);
+  const [prefillTick, setPrefillTick] = useState(0);
 
   // Prefill from chatbot
   useEffect(() => {
@@ -188,6 +189,9 @@ export default function InsuranceStatusPage() {
         }
         if (ac) pendingAutoCheck.current = ac;
         sessionStorage.removeItem("chatbot_eligibility");
+        // Increment tick so the auto-trigger effect re-fires even when
+        // memberId/dob are unchanged (same patient submitted a second time).
+        setPrefillTick((n) => n + 1);
       } catch {}
     };
     apply();
@@ -658,7 +662,7 @@ export default function InsuranceStatusPage() {
       setTriggerTarget(check);
     }
     // eslint-disable-next-line react-hooks/exhaustive-deps
-  }, [memberId, dateOfBirth]);
+  }, [memberId, dateOfBirth, prefillTick]);
 
   // small helper: remove given query params from the current URL (silent, no reload)
   const clearUrlParams = (params: string[]) => {