"""Signal API — FastAPI backend for CSV ingestion, scoring, and export.""" import csv import hashlib import io import os import sys from datetime import date, date as date_type from functools import lru_cache from pathlib import Path from typing import Optional import jwt from jwt import PyJWKClient, ExpiredSignatureError, InvalidTokenError from fastapi import Depends, FastAPI, File, Header, HTTPException, UploadFile from fastapi.middleware.cors import CORSMiddleware from fastapi.responses import StreamingResponse from pydantic import BaseModel # Ensure python-backend root is on path (works both locally and in Docker) _backend_root = Path(__file__).parent.parent if str(_backend_root) not in sys.path: sys.path.insert(0, str(_backend_root)) from core.coverage_calculator import ShipmentRecord, calculate_batch from core.audit_logger import AuditAction, log_event from core.doc_state_machine import compute_doc_state, DocState from core.persistence import ( persist_export, persist_upload, upsert_confirmed_visit, load_confirmed_visits_for_org, get_or_create_org, ) from api.normalizer import normalize_csv app = FastAPI(title="Signal API", version="1.0.0", docs_url="/docs") # CORS — locked to Vercel frontend and localhost for dev. # Set ALLOWED_ORIGINS in Railway as a comma-separated list for production. _origins_env = os.getenv("ALLOWED_ORIGINS", "") _allowed_origins: list[str] = ( [o.strip() for o in _origins_env.split(",") if o.strip()] if _origins_env else [ "http://localhost:5173", "http://localhost:5174", "http://127.0.0.1:5173", ] ) app.add_middleware( CORSMiddleware, allow_origins=_allowed_origins, allow_credentials=True, allow_methods=["*"], allow_headers=["*"], ) # API key auth — enforced when SIGNAL_API_KEY env var is set. # In dev (no env var), all requests pass. In production, X-API-Key header is required. _api_key = os.getenv("SIGNAL_API_KEY", "") _clerk_jwks_url = os.getenv("CLERK_JWKS_URL", "") @lru_cache(maxsize=1) def _get_jwks_client() -> PyJWKClient: if not _clerk_jwks_url: raise RuntimeError("CLERK_JWKS_URL is not set") return PyJWKClient(_clerk_jwks_url, cache_keys=True, cache_jwk_set=True, lifespan=300) def verify_clerk_token(authorization: str) -> dict: """Verify a Clerk Bearer JWT. Returns decoded claims or raises HTTP 401.""" if not authorization.startswith("Bearer "): raise HTTPException(status_code=401, detail="Missing or malformed Authorization header") token = authorization.removeprefix("Bearer ").strip() try: client = _get_jwks_client() signing_key = client.get_signing_key_from_jwt(token) return jwt.decode(token, signing_key.key, algorithms=["RS256"], options={"verify_exp": True, "verify_nbf": True}) except ExpiredSignatureError: raise HTTPException(status_code=401, detail="Token has expired") except InvalidTokenError as exc: raise HTTPException(status_code=401, detail=f"Invalid token: {exc}") except RuntimeError: raise HTTPException(status_code=503, detail="Auth service not configured") except Exception: raise HTTPException(status_code=401, detail="Token verification failed") def require_auth( authorization: str = Header(default=""), x_api_key: str = Header(default=""), ) -> dict: """ Accept either a Clerk JWT (Authorization: Bearer) or a direct API key (X-Api-Key). Returns a claims dict. API-key path returns a synthetic service-account dict. """ # Fast path: API key (for direct access / testing) if _api_key and x_api_key == _api_key: return {"sub": "service-account", "via": "api_key"} # Clerk JWT path (frontend / production) if authorization.startswith("Bearer "): return verify_clerk_token(authorization) # Dev mode: no keys set — allow all if not _api_key and not _clerk_jwks_url: return {"sub": "dev", "via": "open"} raise HTTPException(status_code=401, detail="Authentication required") DEVICE_DISPLAY = { "dexcom_g7": "Dexcom G7", "dexcom_g6": "Dexcom G6", "freestyle_libre_2": "FreeStyle Libre 2", "freestyle_libre_3": "FreeStyle Libre 3", "omnipod_5": "Omnipod 5", } FLAG_LABELS = { "SUPPLY_LAPSED": "Docs Required", "VISIT_REQUIRED": "Escalate", "TRANSFER_PENDING": "New Patient", "RENEWAL_CRITICAL": "Escalate", "RENEWAL_ELEVATED": "Confirm Appointment", "RENEWAL_SOON": "Begin Outreach", "RESUPPLY_READY": "Clear to Ship", "ACTIVE": "On Track", "NO_RECENT_SHIPMENT": "No Recent Shipment", } FLAG_ACTIONS = { "SUPPLY_LAPSED": "Pull patient file — verify documentation is current before initiating any new order", "VISIT_REQUIRED": "Contact prescriber's office and patient directly — ask: 'Was there a visit in the past 6 months to evaluate this patient's CGM dosing needs?' No shipment until visit is confirmed and documented", "TRANSFER_PENDING": "Obtain full documentation set (SWO, PECOS, PA, diagnosis) — Signal cannot assess status until records are on file", "RENEWAL_CRITICAL": "Contact prescriber's office and patient directly — ask: 'Was there a visit in the past 6 months to evaluate CGM dosing needs?' Appointment must be on calendar within 45 days", "RENEWAL_ELEVATED": "Follow up with prescriber's office — ask: 'Was there a visit in the past 6 months to evaluate CGM dosing needs?' Confirm appointment is scheduled", "RENEWAL_SOON": "Contact prescriber's office — ask: 'Was there a visit in the past 6 months to evaluate this patient's CGM dosing needs?' Schedule evaluation now if not yet completed", "RESUPPLY_READY": "Initiate resupply order — patient is within the 30-day resupply window", "ACTIVE": "No action needed — documentation current, visit more than 90 days out", "NO_RECENT_SHIPMENT": "Verify status with prescriber office — confirm patient is still active", } class DocStateOut(BaseModel): swo: str visit: str pecos: str pa: str diagnosis: str class RecordOut(BaseModel): patient_id: str device_type: str device_display: str payer: str component: str days_until_coverage_end: int days_until_visit_due: Optional[int] = None flag: str priority_score: int coverage_end_date: str next_visit_due_date: Optional[str] = None action: str status_label: str reason: str rule_version: str visit_date_confidence: str = "estimated" is_transfer: bool = False doc_state: Optional[DocStateOut] = None cascade: list[str] = [] order_number: Optional[str] = None hcpcs: Optional[str] = None recommended_next_step_code: str = "NO_ACTION_NEEDED" # Real values the frontend must echo back on /api/confirm-visit so the # recompute uses actual data instead of fabricated defaults. last_shipment_date: Optional[str] = None quantity: int = 1 csv_visit_date: Optional[str] = None csv_swo_status: Optional[str] = None csv_pecos_verified: Optional[str] = None csv_pa_status: Optional[str] = None csv_diagnosis_on_file: Optional[str] = None csv_transfer_from: Optional[str] = None class UploadResponse(BaseModel): records: list[RecordOut] total: int skipped: int skipped_reasons: list[str] stats: dict mapping_summary: dict batch_id: Optional[str] = None def _build_reason(flag_val: str, days_until_end: int, days_until_visit: Optional[int]) -> str: if flag_val == "SUPPLY_LAPSED": ago = abs(days_until_end) unit = "day" if ago == 1 else "days" return f"Supply lapsed {ago} {unit} ago. Prescriber contact required before next shipment." if flag_val == "VISIT_REQUIRED": if days_until_visit is not None and days_until_visit <= 0: overdue = abs(days_until_visit) unit = "day" if overdue == 1 else "days" return f"Qualifying visit overdue by {overdue} {unit}. Confirm documentation immediately." return "Qualifying visit renewal required. Confirm documentation before resupply." if flag_val == "RENEWAL_CRITICAL": if days_until_visit is not None: unit = "day" if days_until_visit == 1 else "days" return f"Qualifying visit due in {days_until_visit} {unit}. Contact prescriber immediately." return "Qualifying visit renewal critical. Confirm visit documentation before resupply." if flag_val == "RENEWAL_ELEVATED": if days_until_visit is not None: unit = "day" if days_until_visit == 1 else "days" return f"Qualifying visit due in {days_until_visit} {unit}. Schedule prescriber appointment soon." return "Qualifying visit renewal elevated. Schedule prescriber appointment." if flag_val == "RENEWAL_SOON": if days_until_visit is not None: unit = "day" if days_until_visit == 1 else "days" return f"Qualifying visit due in {days_until_visit} {unit}. Monitor and plan ahead." return "Qualifying visit renewal approaching. Monitor status." if flag_val == "RESUPPLY_READY": unit = "day" if days_until_end == 1 else "days" return f"Coverage ends in {days_until_end} {unit}. Patient is within resupply window — initiate shipment now." if flag_val == "TRANSFER_PENDING": return "Patient transferred from prior supplier. Verify all documentation before proceeding." if flag_val == "NO_RECENT_SHIPMENT": return "No shipment on file in 12+ months. Contact the prescriber office to confirm the patient is still active and has not transferred care." unit = "day" if days_until_end == 1 else "days" return f"Coverage on track. Resupply window opens in approximately {days_until_end} {unit}." def _normalize_payer_type(payer: str) -> str: """Map raw payer string to doc_state_machine payer_type.""" from core.coverage_calculator import _normalize_payer normalized = _normalize_payer(payer) # Ensure medicare_advantage is not collapsed to medicare if "medicare advantage" in payer.lower() or "medicare_advantage" in payer.lower(): return "medicare_advantage" return normalized def _recommended_next_step_code( flag_val: str, doc: Optional[DocStateOut], cascade: Optional[list] = None ) -> str: if doc and doc.pa == "Denied": return "PA_APPEAL" if doc and doc.pa == "Required — Not Started": return "INITIATE_PA" if doc and "Not Confirmed" in (doc.visit or ""): return "AWAITING_VISIT_CONFIRMATION" if doc and doc.swo in ("Pending", "Expired"): return "REQUEST_SWO_UPDATE" if doc and doc.diagnosis == "Missing": return "OBTAIN_DIAGNOSIS" if doc and doc.pecos == "Not Verified": return "VERIFY_PRESCRIBER_PECOS" if doc and doc.pa == "Pending": return "PA_FOLLOW_UP" if flag_val in ("RESUPPLY_READY", "ACTIVE") and not cascade: return "READY_TO_BILL" return "NO_ACTION_NEEDED" def _to_record_out(r, record=None, confirmed_visit_date=None) -> RecordOut: flag_val = r.flag.value if hasattr(r.flag, "value") else str(r.flag) # Compute doc state if we have the original record doc_state_out = None cascade = [] if record is not None: normalized_payer = _normalize_payer_type(r.payer) doc = compute_doc_state( payer_type=normalized_payer, csv_swo_status=record.csv_swo_status, csv_visit_date=record.csv_visit_date, confirmed_visit_date=confirmed_visit_date, csv_pecos_verified=record.csv_pecos_verified, csv_pa_status=record.csv_pa_status, csv_diagnosis_on_file=record.csv_diagnosis_on_file, is_transfer=bool(record.csv_transfer_from), ) doc_state_out = DocStateOut( swo=doc.swo, visit=doc.visit, pecos=doc.pecos, pa=doc.pa, diagnosis=doc.diagnosis ) cascade = doc.cascade return RecordOut( patient_id=r.patient_id, device_type=r.device_type, device_display=DEVICE_DISPLAY.get(r.device_type, r.device_type), payer=r.payer, component=r.component, days_until_coverage_end=r.days_until_coverage_end, days_until_visit_due=r.days_until_visit_due, flag=flag_val, priority_score=r.priority_score, coverage_end_date=r.coverage_end_date.isoformat(), next_visit_due_date=r.next_visit_due_date.isoformat() if r.next_visit_due_date else None, action=FLAG_ACTIONS.get(flag_val, "Review"), status_label=FLAG_LABELS.get(flag_val, flag_val), reason=_build_reason(flag_val, r.days_until_coverage_end, r.days_until_visit_due), rule_version=r.rule_version, visit_date_confidence=getattr(r, "visit_date_confidence", "estimated"), is_transfer=getattr(r, "is_transfer", False), doc_state=doc_state_out, cascade=cascade, order_number=getattr(record, "order_number", None) if record else None, hcpcs=getattr(record, "hcpcs", None) if record else None, recommended_next_step_code=_recommended_next_step_code(flag_val, doc_state_out, cascade), last_shipment_date=r.last_shipment_date.isoformat() if r.last_shipment_date else None, quantity=getattr(record, "quantity", 1) if record else 1, csv_visit_date=record.csv_visit_date.isoformat() if record and record.csv_visit_date else None, csv_swo_status=getattr(record, "csv_swo_status", None) if record else None, csv_pecos_verified=getattr(record, "csv_pecos_verified", None) if record else None, csv_pa_status=getattr(record, "csv_pa_status", None) if record else None, csv_diagnosis_on_file=getattr(record, "csv_diagnosis_on_file", None) if record else None, csv_transfer_from=getattr(record, "csv_transfer_from", None) if record else None, ) def _compute_stats(records: list[RecordOut]) -> dict: flags = [r.flag for r in records] return { "total": len(records), "supply_lapsed": flags.count("SUPPLY_LAPSED"), "visit_required": flags.count("VISIT_REQUIRED"), "transfer_pending": flags.count("TRANSFER_PENDING"), "renewal_critical": flags.count("RENEWAL_CRITICAL"), "renewal_elevated": flags.count("RENEWAL_ELEVATED"), "renewal_soon": flags.count("RENEWAL_SOON"), "resupply_ready": flags.count("RESUPPLY_READY"), "active": flags.count("ACTIVE"), "no_recent_shipment": flags.count("NO_RECENT_SHIPMENT"), "prescriber_action": ( flags.count("SUPPLY_LAPSED") + flags.count("VISIT_REQUIRED") + flags.count("RENEWAL_CRITICAL") + flags.count("RENEWAL_ELEVATED") ), } @app.get("/health") def health(): return {"status": "ok", "service": "signal-api", "version": "1.0.0"} @app.get("/health/db") def health_db(): from core.supabase_client import get_client import os client = get_client() if not client: return { "status": "unavailable", "supabase_url_set": bool(os.getenv("SUPABASE_URL")), "service_key_set": bool(os.getenv("SUPABASE_SERVICE_KEY")), } try: result = client.table("organizations").select("id").limit(1).execute() return {"status": "ok", "org_count": len(result.data)} except Exception as e: return {"status": "error", "detail": str(e)} @app.post("/api/upload", response_model=UploadResponse) async def upload_csv( file: UploadFile = File(...), claims: dict = Depends(require_auth), ): if not (file.filename or "").endswith(".csv"): raise HTTPException(status_code=400, detail="File must be a .csv") content = await file.read() try: text = content.decode("utf-8") except UnicodeDecodeError: text = content.decode("latin-1") records, skipped_reasons, mapping_summary = normalize_csv(text) if not records: log_event(AuditAction.CSV_INGEST, file.filename or "unknown", "demo_user", "failure", "0.0.0.0", detail="No processable rows") raise HTTPException( status_code=422, detail={ "message": "No processable rows found in the uploaded file.", "skipped": skipped_reasons[:10], "mapping_summary": mapping_summary, }, ) # Load confirmed visit dates from Supabase for this org clerk_org_id = claims.get("o", {}).get("id") if isinstance(claims.get("o"), dict) else None org_id = get_or_create_org(clerk_org_id=clerk_org_id) confirmed_visits = load_confirmed_visits_for_org(org_id) if org_id else {} results = calculate_batch(records, as_of=date.today(), confirmed_visits=confirmed_visits) # Build a lookup from patient_id to original record for doc state computation record_lookup = {r.patient_id: r for r in records} out = [ _to_record_out( r, record=record_lookup.get(r.patient_id), confirmed_visit_date=confirmed_visits.get( hashlib.sha256(r.patient_id.encode()).hexdigest() ), ) for r in results ] log_event(AuditAction.CSV_INGEST, file.filename or "unknown", "demo_user", "success", "0.0.0.0", detail=f"{len(out)} records scored") batch_id = persist_upload( filename=file.filename or "unknown", content_bytes=content, shipment_records=records, coverage_results=results, skipped_count=len(skipped_reasons), mapping_summary=mapping_summary, clerk_org_id=clerk_org_id, ) return UploadResponse( records=out, total=len(out), skipped=len(skipped_reasons), skipped_reasons=skipped_reasons[:20], stats=_compute_stats(out), mapping_summary=mapping_summary, batch_id=batch_id, ) class ExportRequest(BaseModel): records: list[RecordOut] batch_id: Optional[str] = None @app.post("/api/export") async def export_work_queue( body: ExportRequest, claims: dict = Depends(require_auth), ): """Generate a downloadable work-queue CSV from a list of scored records.""" records = body.records output = io.StringIO() writer = csv.writer(output) writer.writerow([ "Order Number", "HCPCS", "Patient ID", "Device", "Payer", "Status", "Recommended Next Step", "Priority Score", "Days Until Resupply End", "Next Visit Due", "Recommended Action", "Resupply End Date", "Reason", "Visit Confidence", "SWO Status", "Visit Status", "PA Status", "Diagnosis Status", "PECOS Status", ]) for r in records: doc = r.doc_state writer.writerow([ r.order_number or "", r.hcpcs or "", r.patient_id, r.device_display, r.payer, r.status_label, r.recommended_next_step_code, r.priority_score, r.days_until_coverage_end, r.next_visit_due_date or "", r.action, r.coverage_end_date, r.reason, r.visit_date_confidence, doc.swo if doc else "", doc.visit if doc else "", doc.pa if doc else "", doc.diagnosis if doc else "", doc.pecos if doc else "", ]) output.seek(0) today = date.today().isoformat() export_filename = f"signal-work-queue-{today}.csv" log_event(AuditAction.WORKLIST_EXPORT, export_filename, "demo_user", "success", "0.0.0.0", detail=f"{len(records)} records exported") persist_export(batch_id=body.batch_id, filename=export_filename, row_count=len(records)) return StreamingResponse( io.BytesIO(output.getvalue().encode("utf-8")), media_type="text/csv", headers={ "Content-Disposition": f"attachment; filename=signal-work-queue-{today}.csv" }, ) class ConfirmVisitRequest(BaseModel): patient_id: str confirmed_date: str # ISO date string YYYY-MM-DD # Fields needed to recompute coverage after confirmation shipment_date: str payer: str device_type: str quantity: int = 1 component: str = "sensor" # Doc status fields echoed from the original upload so the recompute # preserves checklist state instead of regressing it to defaults csv_visit_date: Optional[str] = None csv_swo_status: Optional[str] = None csv_pecos_verified: Optional[str] = None csv_pa_status: Optional[str] = None csv_diagnosis_on_file: Optional[str] = None csv_transfer_from: Optional[str] = None order_number: Optional[str] = None hcpcs: Optional[str] = None @app.post("/api/confirm-visit") async def confirm_visit( body: ConfirmVisitRequest, claims: dict = Depends(require_auth), ): """ Store a staff-confirmed qualifying visit date and return the updated coverage record. The confirmed date persists across all future CSV imports for this patient_id. """ from core.coverage_calculator import ShipmentRecord, calculate_coverage # Validate dates try: confirmed = date_type.fromisoformat(body.confirmed_date) shipment = date_type.fromisoformat(body.shipment_date) except ValueError as e: raise HTTPException(status_code=400, detail=f"Invalid date: {e}. Use YYYY-MM-DD.") if confirmed > date_type.today(): raise HTTPException(status_code=400, detail="Confirmed date cannot be in the future.") # Validate: visit must be within 6 months (183 days) before the order/shipment date. # 183 days = ~6 months, consistent with CMS CGM qualifying visit window. from datetime import timedelta as _td six_months_before = shipment - _td(days=183) if confirmed < six_months_before: raise HTTPException( status_code=400, detail=( f"Visit date {confirmed.isoformat()} is more than 6 months before " f"the order date {shipment.isoformat()}. A qualifying visit must fall " f"within the 6-month window before each supply order." ), ) # Get org clerk_org_id = claims.get("o", {}).get("id") if isinstance(claims.get("o"), dict) else None org_id = get_or_create_org(clerk_org_id=clerk_org_id) if not org_id: raise HTTPException(status_code=503, detail="Organization not found.") # Hash and store patient_hash = hashlib.sha256(body.patient_id.encode()).hexdigest() success = upsert_confirmed_visit(org_id, patient_hash, confirmed, confirmed_by="staff") if not success: raise HTTPException(status_code=503, detail="Failed to save confirmed visit.") # Recompute coverage with confirmed visit date, preserving the doc status # fields echoed from the original upload csv_visit = None if body.csv_visit_date: try: csv_visit = date_type.fromisoformat(body.csv_visit_date) except ValueError: csv_visit = None record = ShipmentRecord( patient_id=body.patient_id, device_type=body.device_type, shipment_date=shipment, quantity=body.quantity, payer=body.payer, component=body.component, csv_visit_date=csv_visit, csv_swo_status=body.csv_swo_status, csv_pecos_verified=body.csv_pecos_verified, csv_pa_status=body.csv_pa_status, csv_diagnosis_on_file=body.csv_diagnosis_on_file, csv_transfer_from=body.csv_transfer_from, order_number=body.order_number, hcpcs=body.hcpcs, ) result = calculate_coverage(record, confirmed_visit_date=confirmed) log_event( AuditAction.CSV_INGEST, f"confirm-visit:{body.patient_id[:8]}", "staff", "success", "0.0.0.0", detail=f"Visit confirmed {confirmed.isoformat()}", ) return _to_record_out(result, record=record, confirmed_visit_date=confirmed)