Initial import: eCW Charge Validation bot and results Portal

Snapshot of the working project as of 2026-10-23 (local 2d4d4fc), one
commit with no earlier history: the tracked files were de-identified
first (synthetic claim ids and patient data only; see Context.md
section 7). Credentials, run logs, screenshots, claim reports and client
workbooks are gitignored and not included.

Co-Authored-By: Claude Opus 5.5 <noreply@anthropic.com>

tests/test_payer_groups.py

@@ -0,0 +1,154 @@
+"""
+Payer -> Group Name lookup.
+
+    python tests\\test_payer_groups.py
+
+Exact-string match only, on purpose: eCW's own PAYER values already differ by
+case and spacing for what is really the same carrier (`United Healthcare` /
+`United Health Care` / `United healthcare` all appear in one real export), so
+"close enough" matching would have to guess which of several real, distinct
+strings a new one is closest to. Billing data does not get a guess — an
+unrecognized string must come back None and get a human's attention.
+"""
+
+import sys
+import json
+import pathlib
+import tempfile
+
+sys.path.insert(0, str(pathlib.Path(__file__).resolve().parent.parent / "src"))
+
+from ecw_bot.core import payer_groups                # noqa: E402
+
+TMP = pathlib.Path(tempfile.mkdtemp())
+
+MAPPING = {
+    "Medicaid": "Medicaid",
+    "DentaQuest": "Dentaquest",
+    "Anthem Blue Cross Blue Shield": "Commercial",
+}
+
+
+def case_exact_match_returns_group():
+    assert payer_groups.classify("Medicaid", MAPPING) == "Medicaid"
+    assert payer_groups.classify("DentaQuest", MAPPING) == "Dentaquest"
+
+
+def case_unmapped_payer_returns_none():
+    assert payer_groups.classify("Some New Payer LLC", MAPPING) is None
+
+
+def case_case_sensitive_no_fuzzy_matching():
+    """Different case is a different string, on purpose — see module docstring."""
+    assert payer_groups.classify("medicaid", MAPPING) is None
+    assert payer_groups.classify("MEDICAID", MAPPING) is None
+
+
+def case_blank_or_none_payer_is_unmapped():
+    assert payer_groups.classify("", MAPPING) is None
+    assert payer_groups.classify(None, MAPPING) is None
+
+
+def case_load_mapping_reads_json_file():
+    path = TMP / "mapping.json"
+    path.write_text(json.dumps({"Medicaid": "Medicaid"}), encoding="utf-8")
+    loaded = payer_groups.load_mapping(path)
+    assert loaded == {"Medicaid": "Medicaid"}, loaded
+
+
+def case_load_mapping_missing_file_raises():
+    try:
+        payer_groups.load_mapping(TMP / "does_not_exist.json")
+    except FileNotFoundError as exc:
+        assert "does_not_exist.json" in str(exc), exc
+        return
+    raise AssertionError("expected FileNotFoundError")
+
+
+def case_seed_config_loads_and_covers_medicaid_and_dentaquest():
+    """
+    The real config file this ships with, not a fixture. Since 2026-10-06 it
+    is the team's Claim Status Dashboard pairs (tools/import_payer_groups.py),
+    so its group names are the dashboard's own.
+    """
+    mapping = payer_groups.load_mapping()
+    assert mapping.get("Medicaid") == "Medicaid", mapping.get("Medicaid")
+    assert mapping.get("DentaQuest") == "Dental - CHP+/DentaQuest",         mapping.get("DentaQuest")
+    assert mapping.get("Child Health Plan Plus") == "CHP+"
+
+
+RAE_PAYERS = [
+    "BH COLORADO ACCESS",
+    "BH ROCKY MOUNTAIN HEALTH",
+    "BH ROCKY MTN HEALTH 2022",
+    "BH ROCK MTN UB",
+    "Carelon Behavioral Health, Inc",
+    "CCH CO COMMUNITY HEALTH ALLIANCE",
+    "HEALTH COLORADO INC",
+    "Northeast Colorado Health Department",
+    "Northeast Health Partners",
+]
+
+
+def case_seed_config_groups_the_nine_rae_payers_as_rae_payer():
+    """
+    The client's own RAE list (document condition #11) — all Medicaid
+    plans, grouped "RAE (Behavioral Health)" on the dashboard (the five the
+    dashboard spells differently are kept by the import), and "RAE payer"
+    for the conditions' rules. Plain "Medicaid" stays "Medicaid".
+    """
+    mapping = payer_groups.load_mapping()
+    for payer in RAE_PAYERS:
+        assert payer_groups.classify(payer, mapping) ==             "RAE (Behavioral Health)", (payer, mapping.get(payer))
+        assert payer_groups.rule_group(payer, mapping) == "RAE payer", payer
+    assert payer_groups.classify("Medicaid", mapping) == "Medicaid"
+    assert payer_groups.rule_group("Medicaid", mapping) == "Medicaid"
+
+
+DASH = {"Anthem": "Commercial Ins", "Rocky Mountain Health Prime":
+        "Regional Accountable Entity-RAE (Reporting Group)",
+        "Outreach": "Self Pay", "Kip": "Payer Not In Group",
+        "CHP": "CHP+", "Old": "Commercial",
+        "AARP Medicare Advantage": "Commercial Ins"}
+
+
+def case_rule_group_translates_dashboard_names_for_the_conditions():
+    assert payer_groups.rule_group("Anthem", DASH) == "Commercial"
+    assert payer_groups.rule_group("Rocky Mountain Health Prime", DASH) ==         "RAE payer"
+    assert payer_groups.rule_group("Outreach", DASH) == "Program"
+    assert payer_groups.rule_group("Kip", DASH) is None
+    assert payer_groups.rule_group("CHP", DASH) == "CHP+"      # passes through
+    assert payer_groups.rule_group("Old", DASH) == "Commercial"
+    assert payer_groups.rule_group("Unknown", DASH) is None
+
+
+def case_medicare_advantage_follows_the_dashboard():
+    """Operator ruling 2026-10-21: the dashboard's Commercial Ins, for every
+    condition — no override keeps it on Medicare any more."""
+    assert payer_groups.classify("AARP Medicare Advantage", DASH) ==         "Commercial Ins"
+    assert payer_groups.rule_group("AARP Medicare Advantage", DASH) ==         "Commercial"
+    assert payer_groups.RULE_OVERRIDES == {}
+
+
+CASES = [v for k, v in sorted(globals().items()) if k.startswith("case_")]
+
+
+def main() -> int:
+    failures = 0
+    for fn in CASES:
+        name = fn.__name__[5:].replace("_", " ")
+        try:
+            fn()
+            print(f"  ok    {name}")
+        except AssertionError as exc:
+            print(f"  FAIL  {name}: {exc}")
+            failures += 1
+        except Exception as exc:
+            print(f"  ERROR {name}: {type(exc).__name__}: {exc}")
+            failures += 1
+    print(f"\n{len(CASES) - failures}/{len(CASES)} passed")
+    return 1 if failures else 0
+
+
+if __name__ == "__main__":
+    sys.exit(main())