Files
DentalManagementMH06/apps/Frontend/src/utils/procedureCombosMapping.ts
Gitead 1e581c193c feat: United/DentalHub claim submission automation and patient list sync
- Add full Selenium automation for United/DentalHub claim submission
  (steps 1-8: login, OTP, patient search, practitioner page, code entry,
  other coverage No, attachments, submit, Status & History PDF)
- Consolidate UnitedDH siteKey to UNITED_SCO throughout app
- Fix procedure date overwrite with Ctrl+A+Delete before typing service date
- Fix OTP popup reliability: emit every poll (no throttle)
- Fix Chrome session persistence: only clear cookies on startup
- Add touchPatient() to storage: claim submission now pushes patient to
  top of list across eligibility, claims, and documents pages

Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
2026-05-25 00:29:04 -04:00

411 lines
12 KiB
TypeScript
Executable File

import { InputServiceLine } from "@repo/db/types";
import Decimal from "decimal.js";
import rawCodeTable from "@/assets/data/procedureCodesMH.json";
import rawCCACodeTable from "@/assets/data/procedureCodesCCA.json";
import rawDDMACodeTable from "@/assets/data/procedureCodesDDMA.json";
import rawUnitedDHCodeTable from "@/assets/data/procedureCodesUnitedDH.json";
import rawTuftsSCOCodeTable from "@/assets/data/procedureCodesTuftsSCO.json";
import { PROCEDURE_COMBOS } from "./procedureCombos";
/* ----------------------------- Types ----------------------------- */
export type CodeRow = {
"Procedure Code": string;
Description?: string;
Price?: string | number | null;
PriceLTEQ21?: string | number | null;
PriceGT21?: string | number | null;
[k: string]: unknown;
};
const CODE_TABLE = rawCodeTable as CodeRow[];
const CCA_CODE_TABLE = rawCCACodeTable as CodeRow[];
const DDMA_CODE_TABLE = rawDDMACodeTable as CodeRow[];
const UNITEDDH_CODE_TABLE = rawUnitedDHCodeTable as CodeRow[];
const TUFTSSCO_CODE_TABLE = rawTuftsSCOCodeTable as CodeRow[];
export type ClaimFormLike = {
serviceDate: string; // form-level service date
serviceLines: InputServiceLine[];
};
export type ApplyOptions = {
append?: boolean;
startIndex?: number;
lineDate?: string;
clearTrailing?: boolean;
replaceAll?: boolean;
};
/* ----------------------------- Helpers ----------------------------- */
export const COMBO_BUTTONS = Object.values(PROCEDURE_COMBOS).map((c) => ({
id: c.id,
label: c.label,
}));
// Build a fast lookup map keyed by normalized code
const normalizeCode = (code: string) => code.replace(/\s+/g, "").toUpperCase();
const CODE_MAP: Map<string, CodeRow> = (() => {
const m = new Map<string, CodeRow>();
for (const r of CODE_TABLE) {
const k = normalizeCode(String(r["Procedure Code"] || ""));
if (k && !m.has(k)) m.set(k, r);
}
return m;
})();
const CCA_CODE_MAP: Map<string, CodeRow> = (() => {
const m = new Map<string, CodeRow>();
for (const r of CCA_CODE_TABLE) {
const k = normalizeCode(String(r["Procedure Code"] || ""));
if (k && !m.has(k)) m.set(k, r);
}
return m;
})();
const DDMA_CODE_MAP: Map<string, CodeRow> = (() => {
const m = new Map<string, CodeRow>();
for (const r of DDMA_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) {
const k = normalizeCode(String(r["Procedure Code"] || ""));
if (k && !m.has(k)) m.set(k, r);
}
return m;
})();
const TUFTSSCO_CODE_MAP: Map<string, CodeRow> = (() => {
const m = new Map<string, CodeRow>();
for (const r of TUFTSSCO_CODE_TABLE) {
const k = normalizeCode(String(r["Procedure Code"] || ""));
if (k && !m.has(k)) m.set(k, r);
}
return m;
})();
/** Return the correct fee-schedule map for the given insurance type. */
function getCodeMap(insuranceSiteKey?: string): Map<string, CodeRow> {
if (insuranceSiteKey === "CCA") return CCA_CODE_MAP;
if (insuranceSiteKey === "DDMA") return DDMA_CODE_MAP;
if (insuranceSiteKey === "UNITED_SCO") return UNITEDDH_CODE_MAP;
if (insuranceSiteKey === "TuftsSCO") return TUFTSSCO_CODE_MAP;
return CODE_MAP; // default: MassHealth
}
// this function is solely for abbrevations feature in claim-form
export function getDescriptionForCode(
code: string | undefined
): string | undefined {
if (!code) return undefined;
const row = CODE_MAP.get(normalizeCode(code));
return row?.Description;
}
const isBlankPrice = (v: unknown) => {
if (v == null) return true;
const s = String(v).trim().toUpperCase();
return s === "" || s === "IC" || s === "NC";
};
const toDecimalOrZero = (v: unknown): Decimal => {
if (isBlankPrice(v)) return new Decimal(0);
const n = typeof v === "string" ? parseFloat(v) : (v as number);
return new Decimal(Number.isFinite(n) ? n : 0);
};
// Accepts string or Date, supports MM/DD/YYYY and YYYY-MM-DD
type DateInput = string | Date;
const parseDate = (d: DateInput): Date => {
if (d instanceof Date)
return new Date(d.getFullYear(), d.getMonth(), d.getDate());
const s = String(d).trim();
// MM/DD/YYYY
const mdy = /^(\d{2})\/(\d{2})\/(\d{4})$/;
const m1 = mdy.exec(s);
if (m1) {
const mm = Number(m1[1]);
const dd = Number(m1[2]);
const yyyy = Number(m1[3]);
return new Date(yyyy, mm - 1, dd);
}
// YYYY-MM-DD
const ymd = /^(\d{4})-(\d{2})-(\d{2})$/;
const m2 = ymd.exec(s);
if (m2) {
const yyyy = Number(m2[1]);
const mm = Number(m2[2]);
const dd = Number(m2[3]);
return new Date(yyyy, mm - 1, dd);
}
// Fallback
return new Date(s);
};
const ageOnDate = (dob: DateInput, on: DateInput): number => {
const birth = parseDate(dob);
const ref = parseDate(on);
let age = ref.getFullYear() - birth.getFullYear();
const hadBirthday =
ref.getMonth() > birth.getMonth() ||
(ref.getMonth() === birth.getMonth() && ref.getDate() >= birth.getDate());
if (!hadBirthday) age -= 1;
return age;
};
/**
* we can implement per-code age buckets without changing the JSON.
*
* Behavior:
* - Default: same as before: age <= 21 -> PriceLTEQ21, else PriceGT21
* - Fallback to Price if tiered field is blank/IC/NC
* - Special-cases D1110 and D1120 according to MH rules
*/
export function pickPriceForRowByAge(
row: CodeRow,
age: number,
normalizedCode?: string
): Decimal {
// Special-case rules (add more codes here if needed)
if (normalizedCode) {
// D1110: only valid for age >=14 (14..21 => PriceLTEQ21, >21 => PriceGT21)
if (normalizedCode === "D1110") {
if (age < 14) {
// D1110 not applicable to children <14 (those belong to D1120)
return new Decimal(0);
}
if (age >= 14 && age <= 21) {
// use PriceLTEQ21 only if present
if (!isBlankPrice(row.PriceLTEQ21))
return toDecimalOrZero(row.PriceLTEQ21);
return new Decimal(0);
}
// age > 21
if (!isBlankPrice(row.PriceGT21)) return toDecimalOrZero(row.PriceGT21);
return new Decimal(0);
}
// D1120: child 0-13 => PriceLTEQ21, otherwise no price (NC)
if (normalizedCode === "D1120") {
if (age < 14) {
if (!isBlankPrice(row.PriceLTEQ21))
return toDecimalOrZero(row.PriceLTEQ21);
return new Decimal(0);
}
// age >= 14 => NC / no price
return new Decimal(0);
}
}
// Generic/default behavior (unchanged)
if (age <= 21) {
if (!isBlankPrice(row.PriceLTEQ21)) return toDecimalOrZero(row.PriceLTEQ21);
} else {
if (!isBlankPrice(row.PriceGT21)) return toDecimalOrZero(row.PriceGT21);
}
// Fallback to Price if tiered not available/blank
if (!isBlankPrice(row.Price)) return toDecimalOrZero(row.Price);
return new Decimal(0);
}
/**
* Gets price for a code using age & code table.
*/
function getPriceForCodeWithAgeFromMap(
map: Map<string, CodeRow>,
code: string,
age: number
): Decimal {
const norm = normalizeCode(code);
const row = map.get(norm);
return row ? pickPriceForRowByAge(row, age, norm) : new Decimal(0);
}
// helper keeping lines empty,
export const makeEmptyLine = (lineDate: string): InputServiceLine => ({
procedureCode: "",
procedureDate: lineDate,
quad: "",
arch: "",
toothNumber: "",
toothSurface: "",
totalBilled: new Decimal(0),
totalAdjusted: new Decimal(0),
totalPaid: new Decimal(0),
});
// Ensure the array has at least `min` lines; append blank ones if needed.
const ensureCapacity = (
lines: (InputServiceLine | undefined)[],
min: number,
lineDate: string
) => {
while (lines.length < min) {
lines.push(makeEmptyLine(lineDate));
}
};
/* ------------------------- Main entry points ------------------------- */
/**
* Map prices for ALL existing lines in a form (your "Map Price" button),
* using patient's DOB and the form's serviceDate (or per-line procedureDate).
* Returns a NEW form object (immutable).
*/
export function mapPricesForForm<T extends ClaimFormLike>(params: {
form: T;
patientDOB: DateInput;
insuranceSiteKey?: string;
}): T {
const { form, patientDOB, insuranceSiteKey } = params;
const map = getCodeMap(insuranceSiteKey);
return {
...form,
serviceLines: form.serviceLines.map((ln) => {
const age = ageOnDate(patientDOB, form.serviceDate);
const code = normalizeCode(ln.procedureCode || "");
if (!code) return { ...ln };
const price = getPriceForCodeWithAgeFromMap(map, code, age);
return { ...ln, procedureCode: code, totalBilled: price };
}),
};
}
/**
* Apply a preset combo (fills codes & prices) using patientDOB and serviceDate.
* Returns a NEW form object (immutable).
*/
export function applyComboToForm<T extends ClaimFormLike>(
form: T,
comboId: keyof typeof PROCEDURE_COMBOS,
patientDOB: DateInput,
options: ApplyOptions = {},
insuranceSiteKey?: string
): T {
const preset = PROCEDURE_COMBOS[String(comboId)];
if (!preset) return form;
const {
append = true,
startIndex,
lineDate = form.serviceDate,
clearTrailing = false,
replaceAll = false, // NEW
} = options;
const next: T = { ...form, serviceLines: [...form.serviceLines] };
// Replace-all: blank all existing and start from 0
if (replaceAll) {
for (let i = 0; i < next.serviceLines.length; i++) {
next.serviceLines[i] = makeEmptyLine(lineDate);
}
}
// determine insertion index
let insertAt = 0;
if (!replaceAll) {
if (append) {
let last = -1;
next.serviceLines.forEach((ln, i) => {
if (ln.procedureCode?.trim()) last = i;
});
insertAt = Math.max(0, last + 1);
} else if (typeof startIndex === "number") {
insertAt = Math.max(
0,
Math.min(startIndex, next.serviceLines.length - 1)
);
}
} // if replaceAll, insertAt stays 0
// Make sure we have enough rows for the whole combo
ensureCapacity(next.serviceLines, insertAt + preset.codes.length, lineDate);
// Age on the specific line date we will set
const age = ageOnDate(patientDOB, lineDate);
const map = getCodeMap(insuranceSiteKey);
for (let j = 0; j < preset.codes.length; j++) {
const i = insertAt + j;
if (i >= next.serviceLines.length) break;
const codeRaw = preset.codes[j];
if (!codeRaw) continue;
const code = normalizeCode(codeRaw);
const price = getPriceForCodeWithAgeFromMap(map, code, age);
const original = next.serviceLines[i];
next.serviceLines[i] = {
...original,
procedureCode: code,
procedureDate: lineDate,
quad: (original as any)?.quad ?? "",
arch: (original as any)?.arch ?? "",
toothNumber: preset.toothNumbers?.[j] ?? (original as any)?.toothNumber ?? "",
toothSurface: (original as any)?.toothSurface ?? "",
totalBilled: price,
totalAdjusted: new Decimal(0),
totalPaid: new Decimal(0),
} as InputServiceLine;
}
if (replaceAll || clearTrailing) {
const after = insertAt + preset.codes.length;
for (let i = after; i < next.serviceLines.length; i++) {
next.serviceLines[i] = makeEmptyLine(lineDate);
}
}
return next;
}
export { CODE_MAP, CCA_CODE_MAP, DDMA_CODE_MAP, UNITEDDH_CODE_MAP, TUFTSSCO_CODE_MAP, getCodeMap, getPriceForCodeWithAgeFromMap };
export type PriceMismatch = {
procedureCode: string;
enteredPrice: number;
schedulePrice: number;
};
/** Compare each service line's totalBilled against the fee schedule.
* Returns lines where the entered price differs from the schedule price.
* Returns empty array if the siteKey has no schedule (United, Tufts, etc.). */
export function findPriceMismatches(
serviceLines: InputServiceLine[],
insuranceSiteKey: string | undefined,
patientDOB: string,
serviceDate: string,
): PriceMismatch[] {
const supported = ["MH", "MASSHEALTH", "CCA", "DDMA", "UNITEDDH", "TUFTSSCO"];
if (!insuranceSiteKey || !supported.includes(insuranceSiteKey.toUpperCase())) return [];
const map = getCodeMap(insuranceSiteKey);
const mismatches: PriceMismatch[] = [];
for (const line of serviceLines) {
const code = normalizeCode(line.procedureCode || "");
if (!code) continue;
const enteredPrice = new Decimal(Number(line.totalBilled) || 0);
if (enteredPrice.isZero()) continue;
const age = ageOnDate(patientDOB, serviceDate);
const schedulePrice = getPriceForCodeWithAgeFromMap(map, code, age);
if (!schedulePrice.isZero() && !enteredPrice.equals(schedulePrice)) {
mismatches.push({
procedureCode: code,
enteredPrice: enteredPrice.toNumber(),
schedulePrice: schedulePrice.toNumber(),
});
}
}
return mismatches;
}