medicafe 0.240517.0__py3-none-any.whl → 0.240613.0__py3-none-any.whl

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@@ -1,173 +1,3 @@
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  """
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- 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.
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-
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- Features:
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- - Deductible Optimization: Determines optimal submission times based on deductible fulfillment to maximize reimbursements.
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- - Dynamic Scheduling: Updates claim submission timelines in response to changes in deductible status and insurance coverage data.
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- - Secure Data Handling: Ensures the security of sensitive patient data through encryption and HIPAA-compliant practices.
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- - Integration with MediLink Systems: Seamlessly formats, submits, and tracks claims across MediLink and associated systems.
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- - Robust Error Handling and Notifications: Implements mechanisms for error detection and user alerts regarding scheduling and submission errors.
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-
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- Main Functionalities:
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- 1. Configuration and System Initialization:
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- - Configures and establishes secure connections to insurance APIs.
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- - Loads encrypted system settings and initializes subsystems for logging, data encryption, and notifications.
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-
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- 2. Scheduler Integration:
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- - Enhances MediLink's main menu to include an option for "Optimize and Schedule Submissions".
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- - This option is visible only when there are new or imminent claims, activating the scheduling function for these claims.
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-
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- 3. Scheduling Process:
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- - Identifies new or urgent claims.
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- - Fetches real-time deductible information from insurance APIs.
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- - Computes remaining deductible and determines suitable submission dates.
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- - Schedules claims with consideration for deductible status and the 90-day deadline, updating a scheduling log with details.
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-
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- 4. User Dashboard Update:
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- - Displays scheduled submissions, including deductible statuses and scheduled dates.
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- - Allows users to manually adjust or override automated scheduling decisions.
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-
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- 5. Pre-Submission Checks:
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- - Daily verification of claims ready for submission.
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- - Prepares 837P claim files and finalizes submission details with user confirmation.
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- - Securely transmits data to insurance providers and logs all submission activities.
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-
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- 6. Direct Submission Handling:
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- - Uses MediLink_Up.submit_claims to manage final claim submissions.
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- - Ensures that all scheduled claims are submitted with requisite details.
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-
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- 7. Data Security:
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- - Applies encryption to any new data storage or sensitive data involved in the scheduling process.
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- - Maintains compliance with HIPAA and relevant security standards.
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-
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- 8. Error Management and Alerts:
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- - Extends error handling capabilities to include specific scheduling and submission issues.
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- - Enhances notifications for reminders and updates on deductible status.
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-
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- 9. Integration with MediLink Logging and Error Handling:
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- - Integrates scheduler operations into MediLink’s existing logging and error management frameworks.
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-
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- 10. Maintenance and Data Cleanup:
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- - Regularly refreshes insurance data mappings and updates deductible information.
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- - Manages cleanup of processed claims to maintain database integrity and performance.
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-
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- 11. User Interface Improvements:
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- - Updates UI to ensure user-friendliness and provides clear operational feedback.
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- - Revises help documentation to reflect new functionalities and guides for scheduling tasks.
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-
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- Database Management:
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- - Maintains a JSON-based database for patient billing data, labeled as patient_billing_db, storing information from various sources (Z.dat file, APIs, SFTP).
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- - Database content includes claim statuses, deductible details, error logs, and identifiers for billing readiness.
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- - Facilitates efficient tracking and processing of claims, with considerations for integrating individual patient data in batched submissions.
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- - Stays on the local machine in a defined secure location per config, ensuring HIPAA compliance without the need for data encryption at rest.
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-
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- Note: Potential for data corruption or synchronization issues due to system limitations; backup and manual verification measures are advised.
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-
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- Crosswalk Example:
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- "payer_id": {
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- "87726": {
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- "medisoft_medicare_id": [],
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- "medisoft_id": [
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- "320"
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- ],
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- "endpoint": "OPTUMEDI"
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- },
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- "60054": {
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- "medisoft_medicare_id": [],
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- "medisoft_id": [
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- "369"
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- ],
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- "endpoint": "OPTUMEDI"
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- },
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- "00590": {
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- "medisoft_medicare_id": [],
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- "medisoft_id": [
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- "317"
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- ],
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- "endpoint": "OPTUMEDI"
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- },
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-
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-
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- Crosswalk add:
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- - submit_buffer_maria per payer_id
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- - submit_limit_days per payer_id
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- - deductible_max = $2500.
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- - submit limit buffer = 15 days before final.
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-
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- MediLink_Scheduler logic to produce dates of submission:
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- deductible slows it until a max limit ($2500), then send anyway.
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- after maria buffer, before submit (-15?) limit day.
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- Maria collects pre-payment, this is a factor, needs to be somehow accounted for in the process where a quantity gets pre-assigned to a patient so we know when to submit the claim.
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-
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- Date last reviewed, Insurance Type, In network, Annual Deductable Remaining, Recieved pre-payment amount, Check# or 'Cash'.
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-
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- In the future those pre-payments should be either eCheck, Zelle or by CC + 5% surcharge.
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-
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- """
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-
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-
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- # JSON DB structure draft.
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- {
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- "patients": {
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- "patient_id": {
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- "first_name": "John",
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- "last_name": "Doe",
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- "date_of_birth": "1985-07-12",
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- "insurance_details": {
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- "provider_id": "XYZ123",
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- "policy_number": "P123456789",
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- "coverage_start_date": "2020-01-01"
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- },
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- "contact_info": {
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- "email": "john.doe@example.com",
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- "phone": "555-1234"
124
- }
125
- }
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- },
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- "claims": {
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- "claim_id": {
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- "patient_id": "patient_id",
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- "date_of_service": "2023-04-01",
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- "status": "pending",
132
- "scheduled_submission_date": "2023-04-15",
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- "actual_submission_date": null,
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- "billing_amount": 500.00,
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- "deductible_applied": 100.00,
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- "covered_amount": 400.00
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- }
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- },
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- "insurance_providers": {
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- "provider_id": {
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- "name": "InsuranceCorp",
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- "contact_details": {
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- "phone": "555-6789",
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- "email": "support@insurancecorp.com"
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- },
146
- "endpoint": "https://api.insurancecorp.com"
147
- }
148
- },
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- "system_configuration": {
150
- "last_update": "2023-04-18",
151
- "backup_frequency": "daily",
152
- "data_encryption_key": "encrypted_key_value"
153
- },
154
- "logs": {
155
- "log_id": {
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- "timestamp": "2023-04-18T12:34:56",
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- "event_type": "error",
158
- "description": "Failed to connect to insurance API",
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- "related_claim_id": "claim_id"
160
- }
161
- },
162
- "billing_queue": {
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- "patient_id": "claim_id"
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- },
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- "submitted_837p_batches": {
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- "batch_id": {
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- "timestamp": "2023-04-20T09:00:00",
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- "patients": ["patient_id1", "patient_id2", ...],
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- "endpoint": "clearinghouse_endpoint",
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- "status": "submitted"
171
- }
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- }
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- }
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+ Implement MediLink_Scheduler
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+ """
@@ -1,4 +0,0 @@
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- """
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- Checks and updates the status of submitted medical claims using API endpoints.
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- Integrates with MediLink_Down and MediPost to retrieve and process ERAs and other relevant response data from insurance providers.
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- """
MediLink/MediLink_UI.py CHANGED
@@ -1,22 +1,10 @@
1
1
  from datetime import datetime
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-
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- """
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- Development Tasks for User Interface (UI) Enhancement in MediSoft Claims Submittal (MediLink) Script:
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-
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- - [ ] Streamline user interaction for endpoint selection and patient adjustments with automated endpoint validation.
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- - [ ] Strengthen error handling in file conversion, transmission, and user inputs with actionable user feedback.
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- - [ ] Expand logging levels and develop a user notification system for process milestones and errors.
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- - [ ] Focus workflow on patient details for endpoint adjustments, facilitating patient-centric file submissions.
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- - [ ] Implement internet connectivity checks with retry options for submissions and offer pause/resume capabilities.
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- - [ ] Include final review and confirmation steps before submission, allowing for endpoint adjustments per patient.
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- - [ ] TODO Need to resolve suggested endpoint issues/refresh/quasi-persist (this is partially implemented, careful)
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- - [ ] TODO Augment the menu for displaying the insurance type information before submittal.
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- """
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+ import os
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3
 
16
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  def display_welcome():
17
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  print("\n" + "-" * 60)
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  print(" *~^~*: Welcome to MediLink! :*~^~*")
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- print("-" * 60 + "\n")
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+ print("-" * 60)
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21
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  def display_menu(options):
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  print("Menu Options:")
@@ -85,6 +73,41 @@ def get_new_endpoint_choice():
85
73
  """
86
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  return input("Select desired endpoint (e.g. 1, 2): ").strip()
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75
 
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+ # Function to display full list of insurance options
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+ def display_insurance_options(insurance_options=None):
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+
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+ # Define insurance options with codes and descriptions
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+ insurance_options = {
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+ "11": "Other Non-Federal Programs",
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+ "12": "Preferred Provider Organization (PPO)",
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+ "13": "Point of Service (POS)",
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+ "14": "Exclusive Provider Organization (EPO)",
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+ "15": "Indemnity Insurance",
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+ "16": "Health Maintenance Organization (HMO) Medicare Risk",
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+ "17": "Dental Maintenance Organization",
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+ "AM": "Automobile Medical",
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+ "BL": "Blue Cross/Blue Shield",
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+ "CH": "Champus",
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+ "CI": "Commercial Insurance Co.",
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+ "DS": "Disability",
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+ "FI": "Federal Employees Program",
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+ "HM": "Health Maintenance Organization",
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+ "LM": "Liability Medical",
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+ "MA": "Medicare Part A",
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+ "MB": "Medicare Part B",
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+ "MC": "Medicaid",
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+ "OF": "Other Federal Program",
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+ "TV": "Title V",
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+ "VA": "Veterans Affairs Plan",
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+ "WC": "Workers Compensation Health Claim",
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+ "ZZ": "Mutually Defined"
104
+ }
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+
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+ print("\nInsurance Type Options:")
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+ for code, description in sorted(insurance_options.items()):
108
+ print("{}: {}".format(code, description))
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+ print() # Add a blank line for better readability
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+
88
111
  def display_patient_summaries(detailed_patient_data):
89
112
  """
90
113
  Displays summaries of all patients and their suggested endpoints.
@@ -95,24 +118,59 @@ def display_patient_summaries(detailed_patient_data):
95
118
  display_file_summary(index, summary)
96
119
  except KeyError as e:
97
120
  print("Summary at index {} is missing key: {}".format(index, e))
121
+ print() # add blank line for improved readability.
98
122
 
99
123
  def ask_for_proceeding_with_endpoints():
100
124
  """
101
125
  Asks the user if they want to proceed with all suggested endpoints.
102
126
  """
103
- proceed = input("\nDo you want to proceed with all suggested endpoints? (Y/N): ").strip().lower()
127
+ proceed = input("Do you want to proceed with all suggested endpoints? (Y/N): ").strip().lower()
104
128
  return proceed == 'y'
105
129
 
106
130
  def display_file_summary(index, summary):
107
131
  # Ensure surgery_date is converted to a datetime object
108
132
  surgery_date = datetime.strptime(summary['surgery_date'], "%m-%d-%y")
133
+
134
+ # Add header row if it's the first index
135
+ if index == 1:
136
+ print("{:<3} {:5} {:<10} {:20} {:15} {:2} {:20}".format(
137
+ "No.", "Date", "ID", "Name", "Primary Ins.", "IT", "Suggested Endpoint"
138
+ ))
139
+ print("-"*80)
140
+
141
+ # Check if insurance_type is available; if not, set a default placeholder (this should already be '12' at this point)
142
+ insurance_type = summary.get('insurance_type', '--')
109
143
 
110
144
  # Displays the summary of a file.
111
- print("{:02d}. {:5} (ID: {:<8}) {:20} {:15} Suggested Endpoint: {}".format(
145
+ print("{:02d}. {:5} ({:<8}) {:20} {:15} {:2} {:20}".format(
112
146
  index,
113
147
  surgery_date.strftime("%m-%d"),
114
148
  summary['patient_id'],
115
149
  summary['patient_name'][:20],
116
150
  summary['primary_insurance'][:15],
117
- summary['suggested_endpoint'])
118
- )
151
+ insurance_type[:2],
152
+ summary['suggested_endpoint'][:20])
153
+ )
154
+
155
+ def user_select_files(file_list):
156
+ """
157
+ Prompt the user to select files from a list of detected files.
158
+
159
+ :param file_list: List of detected files.
160
+ :return: List of files selected by the user.
161
+ """
162
+ # Sort the files by creation time in descending order
163
+ file_list = sorted(file_list, key=os.path.getctime, reverse=True)
164
+
165
+ print("Select claim files to submit from the following list:")
166
+ for i, file in enumerate(file_list):
167
+ print("{}: {}".format(i+1, os.path.basename(file)))
168
+
169
+ selected_indices = input("\nEnter the numbers of the files to process, separated by commas\n(or press Enter to select all): ")
170
+ if not selected_indices:
171
+ return file_list
172
+
173
+ selected_indices = [int(i.strip()) - 1 for i in selected_indices.split(',')]
174
+ selected_files = [file_list[i] for i in selected_indices]
175
+
176
+ return selected_files
MediLink/MediLink_Up.py CHANGED
@@ -7,19 +7,6 @@ import MediLink_837p_encoder
7
7
  from MediLink_ConfigLoader import log
8
8
  from MediLink_DataMgmt import operate_winscp
9
9
 
10
- """
11
- Handles the transmission of files to endpoints and related tasks for the MediLink script.
12
-
13
- Functions:
14
- - check_internet_connection(): Checks for an active internet connection.
15
- - UPDATE THIS: transmit_files_to_endpoint(converted_files, endpoint_config, local_storage_path): Transmits files to a specified endpoint using WinSCP.
16
- - handle_transmission_result(transmission_result): Handles the result of the file transmission process.
17
- - submit_claims(detailed_patient_data_grouped_by_endpoint, config): Submits claims to respective endpoints based on patient data and configuration.
18
- - confirm_transmission(detailed_patient_data_grouped_by_endpoint): Displays patient data ready for transmission and asks for confirmation.
19
-
20
- This module provides functionality for transmitting files, confirming transmissions, and ensuring connectivity for the MediLink script.
21
- """
22
-
23
10
  # Internet Connectivity Check
24
11
  def check_internet_connection():
25
12
  """
@@ -367,12 +354,15 @@ def confirm_transmission(detailed_patient_data_grouped_by_endpoint):
367
354
  lists of detailed patient data as values.
368
355
  :param config: Configuration settings loaded from a JSON file.
369
356
  """
357
+ # Clear terminal for clarity
358
+ os.system('cls')
359
+
370
360
  print("\nReview of patient data ready for transmission:")
371
361
  for endpoint, patient_data_list in detailed_patient_data_grouped_by_endpoint.items():
372
362
  print("\nEndpoint: {0}".format(endpoint))
373
363
  for patient_data in patient_data_list:
374
364
  patient_info = "({1}) {0}".format(patient_data['patient_name'], patient_data['patient_id'])
375
- print("- {:<35} | {:<5}, ${:<6}, Primary: {}".format(
365
+ print("- {:<33} | {:<5}, ${:<6}, {}".format(
376
366
  patient_info, patient_data['surgery_date'][:5], patient_data['amount'], patient_data['primary_insurance']))
377
367
 
378
368
  confirmation = input("\nProceed with transmission to all endpoints? (Y/N): ").strip().lower()
@@ -1,6 +1,6 @@
1
1
  Metadata-Version: 2.1
2
2
  Name: medicafe
3
- Version: 0.240517.0
3
+ Version: 0.240613.0
4
4
  Summary: MediCafe
5
5
  Home-page: https://github.com/katanada2
6
6
  Author: Daniel Vidaud
@@ -14,6 +14,8 @@ Requires-Dist: argparse
14
14
  Requires-Dist: numpy ==1.11.3
15
15
  Requires-Dist: pandas ==0.20.0
16
16
  Requires-Dist: tqdm ==4.14.0
17
+ Requires-Dist: lxml ==4.2.0
18
+ Requires-Dist: python-docx
17
19
 
18
20
 
19
21
  # Project Overview: MediCafe
@@ -0,0 +1,43 @@
1
+ MediBot/MediBot.bat,sha256=9RK-ID3T2xPz3cDEeTlv7nhMy_GhbGYtbD4vutGOSeE,6153
2
+ MediBot/MediBot.py,sha256=X7ZU-xYsnw7xL7nBZTDudhSXdsnEavcHORE4hPM4L58,16704
3
+ MediBot/MediBot_Charges.py,sha256=47DEQpj8HBSa-_TImW-5JCeuQeRkm5NMpJWZG3hSuFU,0
4
+ MediBot/MediBot_Crosswalk_Library.py,sha256=PRsPtoGOwpHvqYnLl_ABTMNkKJlFHtqjgldWxnXQmQI,14669
5
+ MediBot/MediBot_Post.py,sha256=47DEQpj8HBSa-_TImW-5JCeuQeRkm5NMpJWZG3hSuFU,0
6
+ MediBot/MediBot_Preprocessor.py,sha256=OI9rfDF01OLuLFZoSzIceO3r5fkKEFN7tynXPIceoo4,11941
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+ MediBot/MediBot_Preprocessor_lib.py,sha256=aU5VWwLqDxka8DGLkrji6C9rYMzoqjxLScZ64Ya-0ok,24170
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+ MediBot/MediBot_UI.py,sha256=_CS9BV3882mNp-UmMUPKZOsDI3ZGxft5mcr36-Nq1FQ,10318
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+ MediBot/MediBot_dataformat_library.py,sha256=AVRAl4oDHR6nq2bBiJf2YABrdtnfiQYdYzV0BMvL7U0,8346
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+ MediBot/MediBot_docx_decoder.py,sha256=y2OOjRPWKYn5LnCX3lngNQtGkOOEE6VDaeqvkkIc5ec,13341
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+ MediBot/MediPost.py,sha256=C1hZJFr65rN6F_dckjdBxFC0vL2CoqY9W3YFqU5HXtE,336
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+ MediBot/PDF_to_CSV_Cleaner.py,sha256=ZZphmq-5K04DkrZNlcwNAIoZPOD_ROWvS3PMkKFxeiM,8799
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+ MediBot/__init__.py,sha256=47DEQpj8HBSa-_TImW-5JCeuQeRkm5NMpJWZG3hSuFU,0
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+ MediBot/update_json.py,sha256=eAu3BPYtlGlwVGZdTUmrqq4qLTVcplt-6EnzcGCheG0,1557
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+ MediBot/update_medicafe.py,sha256=CYxRHNXb-ZwGELWSXJA90foMwac_GBdXhD9hwClUjpA,2249
16
+ MediLink/MediLink.py,sha256=X95f6h3s5zgfPrmVO7jCIU8OHmxbiqiUB_XVQI5oVf8,19616
17
+ MediLink/MediLink_277_decoder.py,sha256=Z3hQK2j-YzdXjov6aDlDRc7M_auFBnl3se4OF5q6_04,4358
18
+ MediLink/MediLink_837p_encoder.py,sha256=onrbzk-6QG97oHRn-AvDtcsYyQ-OpqZJE4KWjgPTwxQ,23550
19
+ MediLink/MediLink_837p_encoder_library.py,sha256=RdXsG-k_plNE4vMgFel7L00nwq3pG67iWCpJGXlUtjs,42676
20
+ MediLink/MediLink_API_v2.py,sha256=P--ud2ENGsqnB8JLQQ_eiEJw8KGSlIO2eQKz0DfXeNo,7670
21
+ MediLink/MediLink_APIs.py,sha256=_EFNjBFwtZsEJM771xa6g-zQCCRrebIHj73ElVVZ8Fs,6229
22
+ MediLink/MediLink_ConfigLoader.py,sha256=rrZmy1_d8-2qx_G7pCph-zhlQq_6c6jorYl47J0DxYo,3914
23
+ MediLink/MediLink_DataMgmt.py,sha256=y8nNe25mj2ajUmPo7508q_T1vxkYiKzwdRit0oX8V9s,20344
24
+ MediLink/MediLink_Decoder.py,sha256=F_cCYhLwhQj72YgFpSuo1FNcxRrHWbaY2iVpD_fypxc,2418
25
+ MediLink/MediLink_Down.py,sha256=ND0_QPhKXTqN8JYqbzwZbfxvn3X-iqFHn4SCm4EXkug,5916
26
+ MediLink/MediLink_ERA_decoder.py,sha256=MiOtDcXnmevPfHAahIlTLlUc14VcQWAor9Xa7clA2Ts,8710
27
+ MediLink/MediLink_Gmail.py,sha256=FV13-umZIouhetnwkGOBgFQYl5FTyOs__SpjaycUxKk,21195
28
+ MediLink/MediLink_Mailer.py,sha256=47DEQpj8HBSa-_TImW-5JCeuQeRkm5NMpJWZG3hSuFU,0
29
+ MediLink/MediLink_Parser.py,sha256=U1hMkhTObNHk_4AXNnCAonnnPYaCiz9L0epP6a0KH2k,4271
30
+ MediLink/MediLink_Scan.py,sha256=47DEQpj8HBSa-_TImW-5JCeuQeRkm5NMpJWZG3hSuFU,0
31
+ MediLink/MediLink_Scheduler.py,sha256=UJvxhDvHraqra2_TlQVlGeh5jRFrrfK6nCVUHnKOEMY,38
32
+ MediLink/MediLink_StatusCheck.py,sha256=47DEQpj8HBSa-_TImW-5JCeuQeRkm5NMpJWZG3hSuFU,0
33
+ MediLink/MediLink_UI.py,sha256=k_Kz5tB2NC2CIZLd3JRWCu5IJfGUAr14Iw4kY6sECZo,6979
34
+ MediLink/MediLink_Up.py,sha256=02KS_pRZxFd-dZek-YzYfph409BBRfNKCouAWph9op8,18460
35
+ MediLink/MediLink_batch.bat,sha256=nqL5QwCLyRQFSPdv6kgtcV_cpky7FXSOWVl6OxjRXb4,118
36
+ MediLink/Soumit_api.py,sha256=5JfOecK98ZC6NpZklZW2AkOzkjvrbYxpJpZNH3rFxDw,497
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