Gitead
b7e06adf2f
- PDF import now marks payments as PAID when MassHealth patient's mhPaidAmount >= totalBilled (no patient balance) - Newly created patients from MH vouchers get insuranceProvider = 'MassHealth' - Existing patients with blank insuranceProvider get it filled on import - Fix: update patient name from PDF if existing record has empty name - Various frontend/selenium/route updates Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
321 lines
12 KiB
JavaScript
321 lines
12 KiB
JavaScript
import Decimal from "decimal.js";
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import rawCodeTable from "@/assets/data/procedureCodesMH.json";
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import rawCCACodeTable from "@/assets/data/procedureCodesCCA.json";
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import rawDDMACodeTable from "@/assets/data/procedureCodesDDMA.json";
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import rawUnitedDHCodeTable from "@/assets/data/procedureCodesUnitedDH.json";
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import rawTuftsSCOCodeTable from "@/assets/data/procedureCodesTuftsSCO.json";
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import { PROCEDURE_COMBOS } from "./procedureCombos";
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const CODE_TABLE = rawCodeTable;
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const CCA_CODE_TABLE = rawCCACodeTable;
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const DDMA_CODE_TABLE = rawDDMACodeTable;
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const UNITEDDH_CODE_TABLE = rawUnitedDHCodeTable;
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const TUFTSSCO_CODE_TABLE = rawTuftsSCOCodeTable;
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/* ----------------------------- Helpers ----------------------------- */
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export const COMBO_BUTTONS = Object.values(PROCEDURE_COMBOS).map((c) => ({
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id: c.id,
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label: c.label,
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}));
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// Build a fast lookup map keyed by normalized code
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const normalizeCode = (code) => code.replace(/\s+/g, "").toUpperCase();
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const CODE_MAP = (() => {
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const m = new Map();
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for (const r of CODE_TABLE) {
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const k = normalizeCode(String(r["Procedure Code"] || ""));
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if (k && !m.has(k))
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m.set(k, r);
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}
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return m;
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})();
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const CCA_CODE_MAP = (() => {
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const m = new Map();
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for (const r of CCA_CODE_TABLE) {
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const k = normalizeCode(String(r["Procedure Code"] || ""));
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if (k && !m.has(k))
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m.set(k, r);
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}
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return m;
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})();
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const DDMA_CODE_MAP = (() => {
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const m = new Map();
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for (const r of DDMA_CODE_TABLE) {
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const k = normalizeCode(String(r["Procedure Code"] || ""));
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if (k && !m.has(k))
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m.set(k, r);
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}
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return m;
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})();
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const UNITEDDH_CODE_MAP = (() => {
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const m = new Map();
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for (const r of UNITEDDH_CODE_TABLE) {
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const k = normalizeCode(String(r["Procedure Code"] || ""));
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if (k && !m.has(k))
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m.set(k, r);
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}
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return m;
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})();
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const TUFTSSCO_CODE_MAP = (() => {
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const m = new Map();
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for (const r of TUFTSSCO_CODE_TABLE) {
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const k = normalizeCode(String(r["Procedure Code"] || ""));
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if (k && !m.has(k))
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m.set(k, r);
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}
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return m;
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})();
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/** Return the correct fee-schedule map for the given insurance type. */
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function getCodeMap(insuranceSiteKey) {
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const k = (insuranceSiteKey ?? "").replace(/_/g, "").toLowerCase();
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if (k === "cca")
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return CCA_CODE_MAP;
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if (k === "ddma")
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return DDMA_CODE_MAP;
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if (k === "unitedsco" || k === "uniteddh" || k === "dentalhub")
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return UNITEDDH_CODE_MAP;
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if (k === "tuftssco" || k === "tufts")
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return TUFTSSCO_CODE_MAP;
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return CODE_MAP; // default: MassHealth
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}
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// this function is solely for abbrevations feature in claim-form
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export function getDescriptionForCode(code) {
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if (!code)
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return undefined;
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const row = CODE_MAP.get(normalizeCode(code));
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return row?.Description;
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}
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const isBlankPrice = (v) => {
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if (v == null)
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return true;
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const s = String(v).trim().toUpperCase();
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return s === "" || s === "IC" || s === "NC";
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};
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const toDecimalOrZero = (v) => {
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if (isBlankPrice(v))
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return new Decimal(0);
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const n = typeof v === "string" ? parseFloat(v) : v;
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return new Decimal(Number.isFinite(n) ? n : 0);
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};
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const parseDate = (d) => {
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if (d instanceof Date)
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return new Date(d.getFullYear(), d.getMonth(), d.getDate());
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const s = String(d).trim();
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// MM/DD/YYYY
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const mdy = /^(\d{2})\/(\d{2})\/(\d{4})$/;
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const m1 = mdy.exec(s);
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if (m1) {
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const mm = Number(m1[1]);
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const dd = Number(m1[2]);
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const yyyy = Number(m1[3]);
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return new Date(yyyy, mm - 1, dd);
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}
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// YYYY-MM-DD
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const ymd = /^(\d{4})-(\d{2})-(\d{2})$/;
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const m2 = ymd.exec(s);
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if (m2) {
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const yyyy = Number(m2[1]);
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const mm = Number(m2[2]);
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const dd = Number(m2[3]);
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return new Date(yyyy, mm - 1, dd);
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}
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// Fallback
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return new Date(s);
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};
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const ageOnDate = (dob, on) => {
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const birth = parseDate(dob);
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const ref = parseDate(on);
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let age = ref.getFullYear() - birth.getFullYear();
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const hadBirthday = ref.getMonth() > birth.getMonth() ||
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(ref.getMonth() === birth.getMonth() && ref.getDate() >= birth.getDate());
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if (!hadBirthday)
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age -= 1;
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return age;
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};
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/**
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* we can implement per-code age buckets without changing the JSON.
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*
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* Behavior:
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* - Default: same as before: age <= 21 -> PriceLTEQ21, else PriceGT21
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* - Fallback to Price if tiered field is blank/IC/NC
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* - Special-cases D1110 and D1120 according to MH rules
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*/
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export function pickPriceForRowByAge(row, age, normalizedCode) {
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// Special-case rules (add more codes here if needed)
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if (normalizedCode) {
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// D1110: only valid for age >=14
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if (normalizedCode === "D1110") {
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if (age < 14)
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return new Decimal(0); // D1110 not for children <14
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// age >= 14: use age-split if present, then flat Price
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if (age <= 21 && !isBlankPrice(row.PriceLTEQ21))
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return toDecimalOrZero(row.PriceLTEQ21);
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if (age > 21 && !isBlankPrice(row.PriceGT21))
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return toDecimalOrZero(row.PriceGT21);
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if (!isBlankPrice(row.Price))
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return toDecimalOrZero(row.Price);
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return new Decimal(0);
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}
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// D1120: valid for child 0-13 only
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if (normalizedCode === "D1120") {
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if (age >= 14)
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return new Decimal(0); // NC for adults
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if (!isBlankPrice(row.PriceLTEQ21))
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return toDecimalOrZero(row.PriceLTEQ21);
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if (!isBlankPrice(row.Price))
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return toDecimalOrZero(row.Price);
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return new Decimal(0);
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}
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}
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// Generic/default: age-split first, flat Price as fallback
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if (age <= 21 && !isBlankPrice(row.PriceLTEQ21))
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return toDecimalOrZero(row.PriceLTEQ21);
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if (age > 21 && !isBlankPrice(row.PriceGT21))
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return toDecimalOrZero(row.PriceGT21);
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if (!isBlankPrice(row.Price))
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return toDecimalOrZero(row.Price);
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return new Decimal(0);
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}
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/**
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* Gets price for a code using age & code table.
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*/
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function getPriceForCodeWithAgeFromMap(map, code, age) {
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const norm = normalizeCode(code);
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const row = map.get(norm);
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return row ? pickPriceForRowByAge(row, age, norm) : new Decimal(0);
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}
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// helper keeping lines empty,
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export const makeEmptyLine = (lineDate) => ({
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procedureCode: "",
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procedureDate: lineDate,
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quad: "",
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arch: "",
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toothNumber: "",
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toothSurface: "",
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totalBilled: new Decimal(0),
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totalAdjusted: new Decimal(0),
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totalPaid: new Decimal(0),
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});
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// Ensure the array has at least `min` lines; append blank ones if needed.
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const ensureCapacity = (lines, min, lineDate) => {
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while (lines.length < min) {
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lines.push(makeEmptyLine(lineDate));
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}
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};
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/* ------------------------- Main entry points ------------------------- */
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/**
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* Map prices for ALL existing lines in a form (your "Map Price" button),
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* using patient's DOB and the form's serviceDate (or per-line procedureDate).
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* Returns a NEW form object (immutable).
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*/
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export function mapPricesForForm(params) {
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const { form, patientDOB, insuranceSiteKey } = params;
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const map = getCodeMap(insuranceSiteKey);
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return {
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...form,
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serviceLines: form.serviceLines.map((ln) => {
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const age = ageOnDate(patientDOB, form.serviceDate);
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const code = normalizeCode(ln.procedureCode || "");
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if (!code)
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return { ...ln };
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const price = getPriceForCodeWithAgeFromMap(map, code, age);
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return { ...ln, procedureCode: code, totalBilled: price };
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}),
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};
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}
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/**
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* Apply a preset combo (fills codes & prices) using patientDOB and serviceDate.
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* Returns a NEW form object (immutable).
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*/
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export function applyComboToForm(form, comboId, patientDOB, options = {}, insuranceSiteKey) {
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const preset = PROCEDURE_COMBOS[String(comboId)];
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if (!preset)
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return form;
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const { append = true, startIndex, lineDate = form.serviceDate, clearTrailing = false, replaceAll = false, // NEW
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} = options;
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const next = { ...form, serviceLines: [...form.serviceLines] };
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// Replace-all: blank all existing and start from 0
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if (replaceAll) {
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for (let i = 0; i < next.serviceLines.length; i++) {
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next.serviceLines[i] = makeEmptyLine(lineDate);
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}
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}
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// determine insertion index
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let insertAt = 0;
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if (!replaceAll) {
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if (append) {
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let last = -1;
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next.serviceLines.forEach((ln, i) => {
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if (ln.procedureCode?.trim())
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last = i;
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});
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insertAt = Math.max(0, last + 1);
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}
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else if (typeof startIndex === "number") {
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insertAt = Math.max(0, Math.min(startIndex, next.serviceLines.length - 1));
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}
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} // if replaceAll, insertAt stays 0
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// Make sure we have enough rows for the whole combo
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ensureCapacity(next.serviceLines, insertAt + preset.codes.length, lineDate);
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const age = options.skipPrice ? 0 : ageOnDate(patientDOB, lineDate);
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const map = options.skipPrice ? CODE_MAP : getCodeMap(insuranceSiteKey);
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for (let j = 0; j < preset.codes.length; j++) {
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const i = insertAt + j;
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if (i >= next.serviceLines.length)
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break;
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const codeRaw = preset.codes[j];
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if (!codeRaw)
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continue;
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const code = normalizeCode(codeRaw);
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const price = options.skipPrice
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? new Decimal(0)
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: getPriceForCodeWithAgeFromMap(map, code, age);
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const original = next.serviceLines[i];
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next.serviceLines[i] = {
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...original,
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procedureCode: code,
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procedureDate: lineDate,
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quad: original?.quad ?? "",
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arch: original?.arch ?? "",
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toothNumber: preset.toothNumbers?.[j] ?? original?.toothNumber ?? "",
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toothSurface: original?.toothSurface ?? "",
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totalBilled: price,
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totalAdjusted: new Decimal(0),
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totalPaid: new Decimal(0),
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};
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}
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if (replaceAll || clearTrailing) {
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const after = insertAt + preset.codes.length;
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for (let i = after; i < next.serviceLines.length; i++) {
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next.serviceLines[i] = makeEmptyLine(lineDate);
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}
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}
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return next;
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}
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export { CODE_MAP, CCA_CODE_MAP, DDMA_CODE_MAP, UNITEDDH_CODE_MAP, TUFTSSCO_CODE_MAP, getCodeMap, getPriceForCodeWithAgeFromMap };
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/** Compare each service line's totalBilled against the fee schedule.
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* Returns lines where the entered price differs from the schedule price.
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* Returns empty array if the siteKey has no schedule (United, Tufts, etc.). */
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export function findPriceMismatches(serviceLines, insuranceSiteKey, patientDOB, serviceDate) {
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const supported = ["MH", "MASSHEALTH", "CCA", "DDMA", "UNITEDDH", "UNITEDSCO", "TUFTSSCO"];
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if (!insuranceSiteKey || !supported.includes(insuranceSiteKey.toUpperCase()))
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return [];
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const map = getCodeMap(insuranceSiteKey);
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const mismatches = [];
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for (const line of serviceLines) {
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const code = normalizeCode(line.procedureCode || "");
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if (!code)
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continue;
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const enteredPrice = new Decimal(Number(line.totalBilled) || 0);
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if (enteredPrice.isZero())
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continue;
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const age = ageOnDate(patientDOB, serviceDate);
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const schedulePrice = getPriceForCodeWithAgeFromMap(map, code, age);
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if (!schedulePrice.isZero() && !enteredPrice.equals(schedulePrice)) {
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mismatches.push({
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procedureCode: code,
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enteredPrice: enteredPrice.toNumber(),
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schedulePrice: schedulePrice.toNumber(),
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});
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}
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}
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return mismatches;
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}
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