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Status: 📋 Stub — Schemas to be completed during implementation
Spec: PM-34
Last Updated: 2026-03-02
Integration Pattern: Event (appointment status trigger) + Data (pm_eligibility_checks, pm_checkin_discrepancies) + Platform Layer (PF-10 notifications)

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Integration Overview

PM-34 adds a real-time eligibility check-in layer that:
  1. Listens for PM-03 appointment checked_in status transitions.
  2. Invokes PM-02 eligibility verification; stores result with trigger_context = 'checkin'.
  3. Detects discrepancies against last-known eligibility; creates pm_checkin_discrepancies records.
  4. Optionally sends PF-10 notifications to front desk.
  5. Feeds copay/coinsurance to PM-07 charge defaults.

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Integration Points

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PM-03 (Appointment Scheduling) → PM-34

Pattern: Event subscription or direct call from check-in UI
Trigger: Appointment status transitions to checked_in
Data exchanged:
FieldSourceDestinationNotes
appointment_idpm_appointmentspm_eligibility_checksFK for trigger context
patient_idpm_appointmentsPM-02 call paramsPatient for eligibility
organization_idpm_appointmentspm_eligibility_checks, pm_checkin_discrepanciesTenant isolation
Contract: TODO — define event payload or API call when PM-03 appointment-status trigger is implemented.
Status: 📋 Planned

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PM-34 → PM-02 (Insurance & Eligibility Verification)

Pattern: Data / API call
Description: PM-34 invokes PM-02 eligibility check with trigger_context = 'checkin'; stores appointment_id on result row.
Request parameters:
ParameterTypeSourceNotes
patient_idUUIDpm_appointmentsPatient
policy_idUUIDpm_insurance_policies (primary)Primary insurance policy
trigger_contextTEXTPM-34'checkin'
appointment_idUUIDpm_appointmentsOptional FK
Response: pm_eligibility_checks row (existing PM-02 schema + new trigger_context, appointment_id, is_stale columns).
Timeout: Org-configurable; default 10s (PM-28 checkin_eligibility_timeout_seconds). On timeout: is_stale = true, discrepancy created.
Status: 📋 Planned

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PM-34 → PF-10 (Notifications)

Pattern: Platform Layer
Trigger: Discrepancy record created
Condition: pm_module_settings.checkin_eligibility_notification_enabled = true
Notification target: Users with pm.checkin.eligibility.manage in the same organization Payload schema: 
{
  "type": "pm_checkin_discrepancy",
  "organization_id": "uuid",
  "appointment_id": "uuid",
  "patient_id": "uuid",
  "discrepancy_type": "new_plan | copay_change | ...",
  "discrepancy_id": "uuid"
}
Status: 📋 Planned

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PM-34 → PM-07 (Charge Management)

Pattern: Data
Description: When a charge is created for the appointment, PM-07 reads the latest eligibility check (trigger_context = ‘checkin’) and auto-populates copay/deductible remaining in charge defaults.
Fields consumed:
Eligibility FieldPM-07 TargetNotes
copay_amountcharge defaults copay fieldAuto-populated; overridable by front desk
deductible_remainingcharge defaults deductible displayInformational
Status: 📋 Planned

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PM-12 (Patient Portal / Kiosk) → PM-34 → PM-02

Pattern: Event or API call
Description: When patient confirms or updates insurance in PM-12 portal/kiosk flow, PM-12 triggers PM-02 verification via PM-34 logic with trigger_context = 'portal' or 'kiosk'.
Status: 📋 Planned — PM-12 owns the UI trigger; PM-34 defines the trigger_context values and discrepancy handling.

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PM-34 → PM-30 (Coordination of Benefits)

Pattern: Data (soft dependency)
Description: COB order (primary/secondary payer sequence) is read from pm_insurance_policies. PM-30 integration is additive when available; no hard dependency.
Status: 📋 Planned (soft dependency; no blocking)

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Platform Layers Used

LayerPurpose
@/platform/schedulingAppointment and encounter context
@/platform/notifications (PF-10)Front desk discrepancy alert
@/platform/permissionspm.checkin.eligibility.view, .manage permission checks

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Security & Tenant Isolation

  • pm_checkin_discrepancies: RLS enabled; organization_id on all rows; SECURITY DEFINER helper pm_has_org_access.
  • pm_eligibility_checks new columns: covered by existing PM-02 RLS.
  • No PHI in event payloads beyond IDs; detail fetched via RLS-protected query.

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Contract Validation Checklist

  • Event payload schemas completed for PM-03 → PM-34 trigger
  • PM-02 API call parameters documented with types
  • PF-10 notification payload schema validated
  • PM-07 field mapping documented with column names from types.ts (post-Phase 1)
  • Security: organization_id present in all payloads; no PHI in notification body
  • Timeout and error handling documented for PM-02 call