a424ac9d13
- Add _build_reason() to backend — per-patient reason strings with specific day counts (e.g. "Supply lapsed 70 days ago. Prescriber contact required.") - Add reason field to RecordOut model and backend /api/export CSV - Fix export column headers: Coverage End Date → Resupply End Date, Days Until Coverage End → Days Until Resupply End - Pass reason through apiRecordToLocal in frontend api.js - Display reason as muted sub-line under status badge in WorklistTable - Add reason column to client-side CSVExport - Add signal-ui React source to repo (was untracked) - CLAUDE.md: add Billing and CMS integrations to Phase 2 deferred table - research: restore Section 14 stat verification (May 23 recovery) Deployed to Railway production — health check confirmed live. Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
75 lines
3.9 KiB
Markdown
75 lines
3.9 KiB
Markdown
# STTIL Solutions — Signal | Level 1 Active Context
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## What This Tool Does
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Signal is a B2B CGM documentation readiness tracker for DMEPOS suppliers.
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It ingests order data from any DME order management CSV export (e.g., Brightree),
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evaluates each patient against documentation requirements (6-month qualifying
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visit, PECOS enrollment, SWO, resupply eligibility), and produces a Signal Report
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so supplier staff can prioritize outreach and capture revenue before it leaks.
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NOTE: Signal identifies gaps. It does not conduct outreach. Never write copy
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implying Signal contacts prescribers or patients directly.
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## Core Value Proposition
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Shifts supplier staff time from reactive (appeals after denial)
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to proactive (preventing denial conditions).
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The workload curve: appeals volume drops over time as proactive
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coverage management replaces it. Outreach volume starts manageable
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and stays predictable.
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## PHI Architecture — Non-Negotiable
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- STTIL never stores patient names, SSNs, DOBs, or contact info
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- Sole crosswalk key: patient_id (DME's internal MRN or account #)
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- DME staff maintain the patient_id ↔ real identity mapping locally
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- AI/calculation layer sees: patient_id, device_type, shipment_date,
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quantity, payer — NOTHING else
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- All logs use hashed patient_id, never raw
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## Level 1 Stack (Active)
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- Hosting: Hostinger VPS (self-hosted, data never leaves VPS)
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- Language: Python (FastAPI or Flask)
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- Database: PostgreSQL (encrypted at rest, audit logs)
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- Orchestration: n8n self-hosted (24-hr batch trigger)
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- Notifications: Self-hosted Mailcow — encrypted email to DME staff only
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- Frontend: Simple dashboard (Vercel or self-hosted)
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- Auth: Session tokens in PostgreSQL (no Convex needed for MVP)
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## Active Files
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- python-backend/core/coverage_calculator.py
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- python-backend/core/audit_logger.py
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- python-backend/config/payer_rules.json
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- research/dmepos-research-v3.md (market context)
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- docs/hipaa-deployment-analysis-v1.md (compliance)
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- docs/sttil-brand-system-v1.md (brand)
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## Current BAA Obligations (Level 1 Only)
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- Hostinger VPS: Request BAA (PHI host)
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- Anthropic API: Request BAA if AI layer touches PHI
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- Everything else: self-hosted = you are the operator
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## Workload Impact Model (Build This)
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Two-curve graph showing supplier staff time over months:
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- Curve A: Appeals/denials workload (reactive) — starts HIGH, trends DOWN
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- Curve B: Proactive outreach via Signal — starts MANAGEABLE, stays FLAT
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- X-axis: Months 1–12 post-onboarding
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- Crossover point = ROI moment to show on discovery calls
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## What Is Tabled (Do Not Build Yet)
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| Item | Phase | Reason deferred |
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|------|-------|----------------|
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| Dexcom OAuth API integration | Phase 2 | Requires vendor agreement + PHI scope expansion |
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| Billing system API integration (Brightree, Bonafide, Fastrack, etc.) | Phase 2 | Build after pilot reveals which systems suppliers use; vendor agreements required; PHI scope expands significantly |
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| CMS and contact management integration (Salesforce, etc.) | Phase 2 | Pilot feedback will reveal if suppliers have CMS and what they use; do not assume |
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| Prescriber fax automation | Phase 2 | Workflow complexity; Level 1 manual outreach sufficient |
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| Patient-facing SMS (Twilio, not SignalWire) | Phase 3 | PHI transmission to third-party; requires BAA + consent layer |
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| Consortium strategy (Level 2/3) | 18–24 months | Depends on 15+ paying Level 1 suppliers first |
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| Convex | Phase 2+ | Not needed until real-time sync requirements emerge |
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## Instructions for Claude Code Sessions
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- Work only on Level 1 scope
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- Never suggest adding PHI fields beyond patient_id
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- Flag any vendor integration that would require a new BAA
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- When building calculations, reference payer_rules.json for wear days
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- When building audit logs, always hash patient_id before storing
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- If asked about Phase 2/3, acknowledge and defer — do not spec or build
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- Use "resupply" not "refill". CGM supply allowances are exempt from Medicare refill rules
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