Payer calls

import express from "express";
import { verifyDaybookWebhook } from "./verify.js";
import { crm } from "./crm.js"; // your denial queue, CRM or PM system

const API = "https://api.daybookhealthcare.com/v1";
const auth = { Authorization: "Bearer " + process.env.DAYBOOK_API_KEY, "Content-Type": "application/json" };
const MAX_ATTEMPTS = 3;

// 1. The queue rule: denials for a missing authorization, five days old, no appeal filed, no call yet.
export async function sweepDenialQueue() {
  const tickets = await crm.tickets.find({
    queue: "denials", carc: ["CO-197", "CO-16"], olderThanDays: 5, appealFiled: false, daybookCallId: null,
  });
  for (const t of tickets) await startCall(t);
}

// 2. One ticket, one call. The ticket and attempt are the idempotency key, so a crashed sweep never dials twice.
async function startCall(t) {
  const res = await fetch(API + "/calls", {
    method: "POST",
    headers: { ...auth, "Idempotency-Key": "ticket-" + t.id + "-call-" + (t.callAttempts + 1) },
    body: JSON.stringify({
      payer: t.payerId,
      call_type: "claim_status",
      claim: { patient_control_number: t.claimId, payer_claim_number: t.icn, date_of_service: t.dateOfService },
      patient: t.patient, // first_name, last_name, date_of_birth, member_id: PHI goes here, never in metadata
      provider: { npi: t.renderingNpi },
      questions: ["Was the retro authorization request received?"],
      metadata: { ticket: t.id, account: t.accountId, queue: "denials" },
    }),
  });
  if (!res.ok) {
    await crm.tickets.note(t.id, "Daybook refused the call: " + (await res.json()).error.message);
    return;
  }
  const call = await res.json(); // status "queued"
  await crm.tickets.update(t.id, { daybookCallId: call.id, callAttempts: t.callAttempts + 1, status: "calling payer" });
}

// 3. The answer comes back on the same ticket, signed. Verify, acknowledge, then write.
const app = express();
app.post("/daybook/webhooks", express.raw({ type: "application/json" }), async (req, res) => {
  const event = verifyDaybookWebhook(req.body, req.headers, process.env.DAYBOOK_WEBHOOK_SECRET);
  res.sendStatus(200);
  if (await crm.events.seen(event.id)) return; // a retried delivery carries the same id
  const call = event.data;
  const ticketId = call.metadata?.ticket;
  if (!ticketId) return;

  if (event.type === "call.completed") {
    const a = call.answer;
    await crm.tickets.update(ticketId, {
      payerSaid: a.status, reference: a.reference_number, rep: a.rep_name, nextStep: a.next_step,
      payerClaimNumber: call.claim?.payer_claim_number, transcriptUrl: call.transcript_url,
    });
    // 4. Move the ticket by what the payer said.
    if (a.status === "paid") {
      await crm.tickets.close(ticketId, { matchDeposit: a.details?.check_number, paidCents: a.details?.paid_amount_cents });
    } else if (a.status === "denied") {
      await crm.tickets.openStep(ticketId, "file_appeal", { reason: a.details?.denial_reason });
    } else if (a.status === "not_on_file") {
      await crm.tickets.openStep(ticketId, "resubmit");
    } else {
      await crm.tickets.followUp(ticketId, { inDays: 7 }); // pending or in_process
    }
  } else if (event.type === "call.failed" || event.type === "call.canceled") {
    // 5. The exception path: try again tomorrow, then hand the ticket to a person with the reason.
    const t = await crm.tickets.get(ticketId);
    if (event.type === "call.failed" && t.callAttempts < MAX_ATTEMPTS) {
      await crm.tickets.update(ticketId, { status: "retry call", retryAfter: tomorrow() });
    } else {
      await crm.tickets.assign(ticketId, {
        to: "ar-follow-up",
        note: "Daybook could not reach " + t.payerName + " after " + t.callAttempts + " calls: " + call.ended_reason,
      });
    }
  }
  await crm.events.mark(event.id);
});

const tomorrow = () => new Date(Date.now() + 86_400_000).toISOString();

import os, requests
from flask import Flask, request
from verify import verify_daybook_webhook
from desk import desk  # your dashboard: tickets, billers, screen pops

API = "https://api.daybookhealthcare.com/v1"
AUTH = {"Authorization": "Bearer " + os.environ["DAYBOOK_API_KEY"]}

# 1. Hold the line for a biller: the agent does the phone tree and the hold, then rings them.
def hold_the_line_for(ticket, biller):
    res = requests.post(
        API + "/calls",
        headers={**AUTH, "Idempotency-Key": f"ticket-{ticket.id}-handoff-{ticket.call_attempts + 1}"},
        json={
            "payer": ticket.payer_id,  # "meridian"
            "call_type": "appeal_status",
            "mode": "handoff",
            "handoff": {"phone": biller.phone_e164, "name": biller.name},
            "questions": [
                "Was the appeal received, and which reviewer has it?",
                "What is the decision deadline?",
            ],
            "claim": {"patient_control_number": ticket.claim_id, "payer_claim_number": ticket.icn,
                      "date_of_service": ticket.date_of_service},
            "patient": ticket.patient,  # PHI goes here, never in metadata
            "provider": {"npi": ticket.npi},
            "metadata": {"ticket": ticket.id, "biller": biller.id},
        },
    )
    call = res.json()
    desk.tickets.update(ticket.id, daybook_call_id=call["id"], status="Daybook is calling the payer")

app = Flask(__name__)

@app.post("/daybook/webhooks")
def daybook_webhook():
    event = verify_daybook_webhook(request.get_data(), request.headers, os.environ["DAYBOOK_WEBHOOK_SECRET"])
    if desk.events.seen(event["id"]):
        return "", 200
    call = event["data"]
    ticket_id = call["metadata"]["ticket"]
    biller_id = call["metadata"]["biller"]

    if event["type"] == "call.on_hold":
        # 2. The biller keeps working; the ticket shows the hold ticking.
        desk.tickets.banner(ticket_id, f"Daybook is on hold with the payer, {call['hold_seconds'] // 60} min so far")
    elif event["type"] == "call.handoff_ready":
        # 3. A rep is on the line and the biller's phone is ringing: pop the ticket with the questions.
        desk.screen_pop(biller_id, ticket_id, questions=call["handoff"]["questions"], rep=call["handoff"].get("rep_name"))
    elif event["type"] == "call.completed":
        # 4. What the agent captured before the handoff; the biller records the rest on the ticket.
        a = call["answer"] or {}
        desk.tickets.update(ticket_id, status="worked by biller", reference=a.get("reference_number"),
                            rep=a.get("rep_name"), transcript_url=call["transcript_url"])
        desk.tickets.ask(biller_id, ticket_id, "Record what the payer said on the call")
    elif event["type"] in ("call.failed", "call.canceled"):
        # 5. Nobody picked up the ring, or the payer hung up: back to the queue with the reason.
        desk.tickets.update(ticket_id, status="needs a call", note=f"Handoff did not complete: {call.get('ended_reason')}")
    desk.events.mark(event["id"])
    return "", 200

# Start a claim status call that repeats every 5 days until the status changes
curl https://api.daybookhealthcare.com/v1/calls \
  -H "Authorization: Bearer $DAYBOOK_API_KEY" \
  -H "Content-Type: application/json" \
  -H "Idempotency-Key: $(uuidgen)" \
  -d '{
    "payer": "keystone",
    "call_type": "claim_status",
    "claim": { "patient_control_number": "A-20817-1", "date_of_service": "2026-09-30" },
    "patient": { "first_name": "Jordan", "last_name": "Sample",
                 "date_of_birth": "1980-01-01", "member_id": "W000000001" },
    "provider": { "npi": "1999999984" },
    "schedule": { "repeat_every_days": 5, "until": "status_changes" },
    "metadata": { "ticket": "TCK-61007", "queue": "silent-claims" }
  }'
# -> "next_run_at": "2026-11-14T14:02:11Z". Every later run is a new call with
#    "repeat_of": "call_01JBX8M4Q2T7" and the same metadata, so your handler needs no special case.

# Your 835 says it paid: stop the series before the next run
curl -X POST https://api.daybookhealthcare.com/v1/calls/call_01JBX8M4Q2T7/cancel \
  -H "Authorization: Bearer $DAYBOOK_API_KEY" \
  -H "Content-Type: application/json" \
  -H "Idempotency-Key: $(uuidgen)" \
  -d '{ "reason": "Paid on the 835 of 2026-11-12" }'