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docs: update CLAUDE.md — current active files after repo reorganization

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Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
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Kisa 2026-05-12 05:10:13 -04:00
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CLAUDE.md
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# STTIL Solutions — Signal CGM | Level 1 Active Context # STTIL Solutions — Signal | Level 1 Active Context
## What This Tool Does ## What This Tool Does
Signal CGM is a B2B CGM coverage worklist tool for DMEPOS suppliers. Signal is a B2B CGM documentation readiness tracker for DMEPOS suppliers.
It ingests shipment data (CSV from Brightree/WellSky), calculates It ingests order data from any DME order management CSV export (e.g., Brightree),
coverage expiration per patient using device wear-day rules, and evaluates each patient against documentation requirements (6-month qualifying
produces a prioritized worklist so small DME teams can do proactive visit, PECOS enrollment, SWO, resupply eligibility), and produces a Signal Report
outreach BEFORE claims deny. so supplier staff can prioritize outreach and capture revenue before it leaks.
NOTE: Signal identifies gaps. It does not conduct outreach. Never write copy
implying Signal contacts prescribers or patients directly.
## Core Value Proposition ## Core Value Proposition
Shifts supplier staff time from reactive (appeals after denial) Shifts supplier staff time from reactive (appeals after denial)
@ -34,11 +36,10 @@ and stays predictable.
## Active Files ## Active Files
- python-backend/core/coverage_calculator.py - python-backend/core/coverage_calculator.py
- python-backend/core/audit_logger.py - python-backend/core/audit_logger.py
- python-backend/core/db_models.py
- python-backend/config/payer_rules.json - python-backend/config/payer_rules.json
- Projects/DMEPOS/dmepos-research-v3.md (market context) - research/dmepos-research-v3.md (market context)
- Projects/DMEPOS/compliance-roadmap-v1.md - docs/hipaa-deployment-analysis-v1.md (compliance)
- Projects/Newsletter/newsletter-strategy-v1.md - docs/sttil-brand-system-v1.md (brand)
## Current BAA Obligations (Level 1 Only) ## Current BAA Obligations (Level 1 Only)
- Hostinger VPS: Request BAA (PHI host) - Hostinger VPS: Request BAA (PHI host)
@ -48,7 +49,7 @@ and stays predictable.
## Workload Impact Model (Build This) ## Workload Impact Model (Build This)
Two-curve graph showing supplier staff time over months: Two-curve graph showing supplier staff time over months:
- Curve A: Appeals/denials workload (reactive) — starts HIGH, trends DOWN - Curve A: Appeals/denials workload (reactive) — starts HIGH, trends DOWN
- Curve B: Proactive outreach via Signal CGM — starts MANAGEABLE, stays FLAT - Curve B: Proactive outreach via Signal — starts MANAGEABLE, stays FLAT
- X-axis: Months 1–12 post-onboarding - X-axis: Months 1–12 post-onboarding
- Crossover point = ROI moment to show on discovery calls - Crossover point = ROI moment to show on discovery calls
@ -69,3 +70,4 @@ Two-curve graph showing supplier staff time over months:
- When building calculations, reference payer_rules.json for wear days - When building calculations, reference payer_rules.json for wear days
- When building audit logs, always hash patient_id before storing - When building audit logs, always hash patient_id before storing
- If asked about Phase 2/3, acknowledge and defer — do not spec or build - If asked about Phase 2/3, acknowledge and defer — do not spec or build
- Use "resupply" not "refill". CGM supply allowances are exempt from Medicare refill rules