medicafe 0.240419.2__py3-none-any.whl → 0.240613.0__py3-none-any.whl

MediLink/MediLink_Scheduler.py

@@ -1,132 +1,3 @@
 """
-MediLink Scheduler: A medical claim scheduling and management system that integrates functionalities from MediScheduler and MediLink to optimize medical claim submissions based on patient deductible status, insurance provider deadlines, and a 90-day submission window. It leverages real-time data from insurance APIs for dynamic scheduling to maximize insurance payments by aligning claim submission with deductible fulfillment.
-
-Features:
-- Deductible Optimization: Determines optimal submission times based on deductible fulfillment to maximize reimbursements.
-- Dynamic Scheduling: Updates claim submission timelines in response to changes in deductible status and insurance coverage data.
-- Secure Data Handling: Ensures the security of sensitive patient data through encryption and HIPAA-compliant practices.
-- Integration with MediLink Systems: Seamlessly formats, submits, and tracks claims across MediLink and associated systems.
-- Robust Error Handling and Notifications: Implements mechanisms for error detection and user alerts regarding scheduling and submission errors.
-
-Main Functionalities:
-1. Configuration and System Initialization:
-   - Configures and establishes secure connections to insurance APIs.
-   - Loads encrypted system settings and initializes subsystems for logging, data encryption, and notifications.
-
-2. Scheduler Integration:
-   - Enhances MediLink's main menu to include an option for "Optimize and Schedule Submissions".
-   - This option is visible only when there are new or imminent claims, activating the scheduling function for these claims.
-
-3. Scheduling Process:
-   - Identifies new or urgent claims.
-   - Fetches real-time deductible information from insurance APIs.
-   - Computes remaining deductible and determines suitable submission dates.
-   - Schedules claims with consideration for deductible status and the 90-day deadline, updating a scheduling log with details.
-
-4. User Dashboard Update:
-   - Displays scheduled submissions, including deductible statuses and scheduled dates.
-   - Allows users to manually adjust or override automated scheduling decisions.
-
-5. Pre-Submission Checks:
-   - Daily verification of claims ready for submission.
-   - Prepares 837P claim files and finalizes submission details with user confirmation.
-   - Securely transmits data to insurance providers and logs all submission activities.
-
-6. Direct Submission Handling:
-   - Uses MediLink_Up.submit_claims to manage final claim submissions.
-   - Ensures that all scheduled claims are submitted with requisite details.
-
-7. Data Security:
-   - Applies encryption to any new data storage or sensitive data involved in the scheduling process.
-   - Maintains compliance with HIPAA and relevant security standards.
-
-8. Error Management and Alerts:
-   - Extends error handling capabilities to include specific scheduling and submission issues.
-   - Enhances notifications for reminders and updates on deductible status.
-
-9. Integration with MediLink Logging and Error Handling:
-   - Integrates scheduler operations into MediLink’s existing logging and error management frameworks.
-
-10. Maintenance and Data Cleanup:
-    - Regularly refreshes insurance data mappings and updates deductible information.
-    - Manages cleanup of processed claims to maintain database integrity and performance.
-
-11. User Interface Improvements:
-    - Updates UI to ensure user-friendliness and provides clear operational feedback.
-    - Revises help documentation to reflect new functionalities and guides for scheduling tasks.
-
-Database Management:
-- Maintains a JSON-based database for patient billing data, labeled as patient_billing_db, storing information from various sources (Z.dat file, APIs, SFTP).
-- Database content includes claim statuses, deductible details, error logs, and identifiers for billing readiness.
-- Facilitates efficient tracking and processing of claims, with considerations for integrating individual patient data in batched submissions.
-- Stays on the local machine in a defined secure location per config, ensuring HIPAA compliance without the need for data encryption at rest.
-
-Note: Potential for data corruption or synchronization issues due to system limitations; backup and manual verification measures are advised.
-"""
-
-
-# JSON DB structure draft.
-{
-  "patients": {
-    "patient_id": {
-      "first_name": "John",
-      "last_name": "Doe",
-      "date_of_birth": "1985-07-12",
-      "insurance_details": {
-        "provider_id": "XYZ123",
-        "policy_number": "P123456789",
-        "coverage_start_date": "2020-01-01"
-      },
-      "contact_info": {
-        "email": "john.doe@example.com",
-        "phone": "555-1234"
-      }
-    }
-  },
-  "claims": {
-    "claim_id": {
-      "patient_id": "patient_id",
-      "date_of_service": "2023-04-01",
-      "status": "pending",
-      "scheduled_submission_date": "2023-04-15",
-      "actual_submission_date": null,
-      "billing_amount": 500.00,
-      "deductible_applied": 100.00,
-      "covered_amount": 400.00
-    }
-  },
-  "insurance_providers": {
-    "provider_id": {
-      "name": "InsuranceCorp",
-      "contact_details": {
-        "phone": "555-6789",
-        "email": "support@insurancecorp.com"
-      },
-      "endpoint": "https://api.insurancecorp.com"
-    }
-  },
-  "system_configuration": {
-    "last_update": "2023-04-18",
-    "backup_frequency": "daily",
-    "data_encryption_key": "encrypted_key_value"
-  },
-  "logs": {
-    "log_id": {
-      "timestamp": "2023-04-18T12:34:56",
-      "event_type": "error",
-      "description": "Failed to connect to insurance API",
-      "related_claim_id": "claim_id"
-    }
-  },
-   "billing_queue": {
-   "patient_id": "claim_id"
-    },
-   "submitted_837p_batches": {
-   "batch_id": {
-      "timestamp": "2023-04-20T09:00:00",
-      "patients": ["patient_id1", "patient_id2", ...],
-      "endpoint": "clearinghouse_endpoint",
-      "status": "submitted"
-   }
-  }
-}
+Implement MediLink_Scheduler
+"""

MediLink/MediLink_StatusCheck.py

@@ -1,4 +0,0 @@
-"""
-Checks and updates the status of submitted medical claims using API endpoints.
-Integrates with MediLink_Down and MediPost to retrieve and process ERAs and other relevant response data from insurance providers.
-"""

MediLink/MediLink_UI.py

@@ -1,21 +1,10 @@
-import datetime
-import sys
-
-"""
-Development Tasks for User Interface (UI) Enhancement in MediSoft Claims Submittal (MediLink) Script:
-
-Streamline user interaction for endpoint selection and patient adjustments with automated endpoint validation.
-Strengthen error handling in file conversion, transmission, and user inputs with actionable user feedback.
-Expand logging levels and develop a user notification system for process milestones and errors.
-Focus workflow on patient details for endpoint adjustments, facilitating patient-centric file submissions.
-Implement internet connectivity checks with retry options for submissions and offer pause/resume capabilities.
-Include final review and confirmation steps before submission, allowing for endpoint adjustments per patient.
-"""
+from datetime import datetime
+import os
 
 def display_welcome():
     print("\n" + "-" * 60)
-    print("\n          *~^~*:    Welcome to MediLink!    :*~^~*\n")
-    print("-" * 60 + "\n")
+    print("          *~^~*:    Welcome to MediLink!    :*~^~*")
+    print("-" * 60)
 
 def display_menu(options):
     print("Menu Options:")
@@ -35,7 +24,7 @@ def display_patient_options(detailed_patient_data):
     """
     Displays a list of patients with their current suggested endpoints, prompting for selections to adjust.
     """
-    print("\nPlease select the patients you want to adjust by entering their numbers separated by commas (e.g., 1,3,5):")
+    print("\nPlease select the patients to adjust by entering their numbers separated by commas\n(e.g., 1,3,5):")
     # Can disable this extra print for now because the px list would already be on-screen.
     #for i, data in enumerate(detailed_patient_data, start=1):
     #    patient_info = "{0} ({1}) - {2}".format(data['patient_name'], data['patient_id'], data['surgery_date'])
@@ -62,26 +51,62 @@ def get_endpoint_decision():
     """
     return input("Change endpoint? (Y/N): ").strip().lower()
 
-def display_endpoint_options(endpoint_mapping):
+def display_endpoint_options(endpoints_config):
     """
     Displays the endpoint options to the user based on the provided mapping.
 
     Args:
-        endpoint_mapping (dict): A dictionary mapping option numbers to endpoint names.
-                                  Example: {'1': 'Availity', '2': 'OptumEDI', ...}
+        endpoints_config (dict): A dictionary mapping endpoint keys to their properties, 
+                                 where each property includes a 'name' key for the user-friendly name.
+                                 Example: {'Availity': {'name': 'Availity'}, 'OptumEDI': {'name': 'OptumEDI'}, ...}
 
     Returns:
         None
     """
     print("Select the new endpoint for the patient:")
-    for option, endpoint_name in endpoint_mapping.items():
-        print("{0}. {1}".format(option, endpoint_name))
+    for index, (key, details) in enumerate(endpoints_config.items(), 1):
+        print("{0}. {1}".format(index, details['name']))
 
 def get_new_endpoint_choice():
     """
     Gets the user's choice for a new endpoint.
     """
-    return input("Select new endpoint (1, 2, or 3): ").strip()
+    return input("Select desired endpoint (e.g. 1, 2): ").strip()
+
+# Function to display full list of insurance options
+def display_insurance_options(insurance_options=None):
+
+    # Define insurance options with codes and descriptions
+    insurance_options = {
+        "11": "Other Non-Federal Programs",
+        "12": "Preferred Provider Organization (PPO)",
+        "13": "Point of Service (POS)",
+        "14": "Exclusive Provider Organization (EPO)",
+        "15": "Indemnity Insurance",
+        "16": "Health Maintenance Organization (HMO) Medicare Risk",
+        "17": "Dental Maintenance Organization",
+        "AM": "Automobile Medical",
+        "BL": "Blue Cross/Blue Shield",
+        "CH": "Champus",
+        "CI": "Commercial Insurance Co.",
+        "DS": "Disability",
+        "FI": "Federal Employees Program",
+        "HM": "Health Maintenance Organization",
+        "LM": "Liability Medical",
+        "MA": "Medicare Part A",
+        "MB": "Medicare Part B",
+        "MC": "Medicaid",
+        "OF": "Other Federal Program",
+        "TV": "Title V",
+        "VA": "Veterans Affairs Plan",
+        "WC": "Workers Compensation Health Claim",
+        "ZZ": "Mutually Defined"
+    }
+    
+    print("\nInsurance Type Options:")
+    for code, description in sorted(insurance_options.items()):
+        print("{}: {}".format(code, description))
+    print()  # Add a blank line for better readability
 
 def display_patient_summaries(detailed_patient_data):
     """
@@ -93,24 +118,59 @@ def display_patient_summaries(detailed_patient_data):
             display_file_summary(index, summary)
         except KeyError as e:
             print("Summary at index {} is missing key: {}".format(index, e))
+    print() # add blank line for improved readability.
 
 def ask_for_proceeding_with_endpoints():
     """
     Asks the user if they want to proceed with all suggested endpoints.
     """
-    proceed = input("\nDo you want to proceed with all suggested endpoints? (Y/N): ").strip().lower()
+    proceed = input("Do you want to proceed with all suggested endpoints? (Y/N): ").strip().lower()
     return proceed == 'y'
 
 def display_file_summary(index, summary):
     # Ensure surgery_date is converted to a datetime object
-    surgery_date = datetime.datetime.strptime(summary['surgery_date'], "%m-%d-%y")
+    surgery_date = datetime.strptime(summary['surgery_date'], "%m-%d-%y")
+    
+    # Add header row if it's the first index
+    if index == 1:
+        print("{:<3} {:5} {:<10} {:20} {:15} {:2} {:20}".format(
+            "No.", "Date", "ID", "Name", "Primary Ins.", "IT", "Suggested Endpoint"
+        ))
+        print("-"*80)
+
+    # Check if insurance_type is available; if not, set a default placeholder (this should already be '12' at this point)
+    insurance_type = summary.get('insurance_type', '--')
 
     # Displays the summary of a file.
-    print("{:02d}. {:5} (ID: {:<8}) {:20} {:15} Suggested Endpoint: {}".format(
+    print("{:02d}. {:5} ({:<8}) {:20} {:15} {:2} {:20}".format(
         index,
         surgery_date.strftime("%m-%d"),
         summary['patient_id'],
         summary['patient_name'][:20],
         summary['primary_insurance'][:15],
-        summary['suggested_endpoint'])
-    )
+        insurance_type[:2],
+        summary['suggested_endpoint'][:20])
+    )
+    
+def user_select_files(file_list):
+    """
+    Prompt the user to select files from a list of detected files.
+    
+    :param file_list: List of detected files.
+    :return: List of files selected by the user.
+    """
+    # Sort the files by creation time in descending order
+    file_list = sorted(file_list, key=os.path.getctime, reverse=True)
+    
+    print("Select claim files to submit from the following list:")
+    for i, file in enumerate(file_list):
+        print("{}: {}".format(i+1, os.path.basename(file)))
+    
+    selected_indices = input("\nEnter the numbers of the files to process, separated by commas\n(or press Enter to select all): ")
+    if not selected_indices:
+        return file_list
+    
+    selected_indices = [int(i.strip()) - 1 for i in selected_indices.split(',')]
+    selected_files = [file_list[i] for i in selected_indices]
+    
+    return selected_files