Merge pull request #77 from aurelianware/copilot/conduct-hipaa-audit

Author: aurelianware

docs/HIPAA-AUDIT-REPORT.md

@@ -85,6 +85,19 @@ function parseX12Response(x12Content: string): AuthResponse {
       certificationTypeCode: 'A1'
     };
   }
+  if (x12Content.includes('STC*A4')) {
+    return {
+      authorizationNumber: 'AUTH20241119001',
+      status: 'PENDED',
+      certificationTypeCode: 'A4'
+    };
+  }
+  if (x12Content.includes('STC*A3')) {
+    return {
+      status: 'DENIED',
+      certificationTypeCode: 'A3'
+    };
+  }
   return {
     status: 'ERROR',
     certificationTypeCode: 'NA'
@@ -255,7 +268,7 @@ describe('Authorization Request - Outpatient (UM01=HS)', () => {
   it('should require service date range for outpatient', () => {
     // Test outpatient-specific validation
     const hasDateRange = (request: any) => {
-      return request.serviceDateRange?.fromDate && request.serviceDateRange?.toDate;
+      return !!(request.serviceDateRange?.fromDate && request.serviceDateRange?.toDate);
     };
 
     const request = {
@@ -353,7 +366,7 @@ describe('Authorization Cancellation (UM02=3)', () => {
 describe('Eligibility Integration', () => {
 
   it('should check eligibility before submitting authorization', async () => {
-    const mockEligibilityCheck = jest.fn().mockResolvedValue({
+    const mockEligibilityCheck = jest.fn<(params: any) => Promise<{ eligible: boolean; coverageLevel: string }>>().mockResolvedValue({
       eligible: true,
       coverageLevel: 'Active Coverage'
     });
@@ -369,7 +382,7 @@ describe('Eligibility Integration', () => {
   });
 
   it('should reject authorization if member not eligible', async () => {
-    const mockEligibilityCheck = jest.fn().mockResolvedValue({
+    const mockEligibilityCheck = jest.fn<(params: any) => Promise<{ eligible: boolean; reason: string }>>().mockResolvedValue({
       eligible: false,
       reason: 'Coverage terminated'
     });
@@ -416,13 +429,13 @@ describe('Attachment Workflow Integration', () => {
 describe('Error Handling', () => {
 
   it('should handle X12 encoding errors gracefully', () => {
-    const mockEncode = jest.fn().mockRejectedValue(new Error('Integration Account not configured'));
+    const mockEncode = jest.fn<() => Promise<void>>().mockRejectedValue(new Error('Integration Account not configured'));
 
     expect(mockEncode).rejects.toThrow('Integration Account not configured');
   });
 
   it('should handle payer endpoint timeouts', async () => {
-    const mockPostToPayer = jest.fn().mockRejectedValue(new Error('Request timeout'));
+    const mockPostToPayer = jest.fn<() => Promise<void>>().mockRejectedValue(new Error('Request timeout'));
 
     await expect(mockPostToPayer()).rejects.toThrow('Request timeout');
   });

docs/SECURITY-AUDIT-SUMMARY.md

@@ -19,7 +19,7 @@ describe("AI EDI 277 Error Resolution", () => {
       const samplePayload: EDI277Payload = {
         transactionId: "TRX555",
         payer: "BestMed",
-        memberId: "123-45-6789",
+        memberId: "MBR123456789",
         errorCode: "123X",
         errorDesc: "INVALID MEMBER ID",
       };
@@ -146,7 +146,7 @@ describe("AI EDI 277 Error Resolution", () => {
       const payload: EDI277Payload = {
         transactionId: "TRX007",
         payer: "TestPayer",
-        memberId: "123-45-6789", // SSN format
+        memberId: "MBR123456789", // Test member ID (not real PHI)
         claimNumber: "CLM123456",
         providerNpi: "1234567890",
         errorCode: "TEST",
@@ -164,9 +164,9 @@ describe("AI EDI 277 Error Resolution", () => {
       const payload: EDI277Payload = {
         transactionId: "TRX008",
         payer: "TestPayer",
-        memberId: "123-45-6789",
+        memberId: "MBR123456789",
         errorCode: "TEST",
-        errorDesc: "Member 123-45-6789 not found"
+        errorDesc: "Member MBR123456789 not found"
       };
 
       const masked = maskPHIFields(payload);

docs/SECURITY-HARDENING-ROADMAP.md

@@ -341,11 +341,11 @@ Please analyze this claim rejection and provide specific resolution steps.`;
 function getMockSuggestions(scenario: ErrorScenario, payload: EDI277Payload): string[] {
   const mockSuggestions: Record<ErrorScenario, string[]> = {
     [ErrorScenario.MEMBER_ID_INVALID]: [
-      "Verify member ID format matches payer requirements (e.g., 9 digits vs alphanumeric)",
+      "Verify subscriber identifier format matches payer requirements (e.g., 9 digits vs alphanumeric)",
       "Check if using subscriber ID instead of dependent ID or vice versa",
       "Confirm member is active on service date through real-time eligibility",
-      "Validate SSN-based vs member number-based identification",
-      "Contact payer for correct member identifier format"
+      "Validate SSN-based vs subscriber number-based identification",
+      "Contact payer for correct subscriber identifier format"
     ],
     [ErrorScenario.ELIGIBILITY_ISSUE]: [
       "Verify coverage dates align with service date",