BCBOT — Eligibility Verification SOP

1. How it works (daily flow summary)

At 6:00pm Task Scheduler launches the robot, which does everything itself:

2. Per-client requirements

• Windows machine at the office with Dentrix installed and running (ideally the front-desk one). Remote access (RustDesk / AnyDesk / RDP) to administer it.
• "Microsoft Print to PDF" available (comes with Windows 10/11).
• Stedi account (BC ClearingHouse) with eligibility API key.
• Gmail with 16-char App Password (to send emails).
• Provider data: NPI, TIN, legal name.

3. Installation (once per client)

3.1 Software

pip install pdfplumber reportlab pypdf

3.2 Folder and files

1. Create C:\BCBOT.
2. Copy all system files (see §10) to C:\BCBOT.
3. In run_robot.bat and run_daily.bat, set the python.exe path for this client.

3.3 Credentials (text files, NEVER in code)

Create in C:\BCBOT (Notepad → Save As, type "All Files"):

3.4 Provider config

In fase0_build_270.py, edit the PROVIDER block:

PROVIDER = {
    "organizationName": "LEGAL NAME OF THE OFFICE",
    "npi": "PROVIDER_NPI",
    "taxId": "TIN_WITHOUT_DASH",
}

And CLINIC in fase0_run.py (short name that appears in emails).

4. Per-client data (roster + payer crosswalk)

This is what makes the robot verify MOST patients, not just some.

4.1 Roster (member IDs) — "Insurance Carrier List" report

In Dentrix → Office Manager → Reports → Reference → Insurance Carrier List:

• Report Type: Dental
• Select Insurance Carrier: From <ALL> To <ALL> ← critical, to include ALL carriers
• List Types: Standard List + Include Subscribers
• Leave unchecked: Include All Insured Patients, Provider IDs, Mailing Labels
• OK → goes to Batch Processor → open that item → Print to PDF → save as roster_full.pdf

Parse to cache:

python fase0_parse_roster.py roster_full.pdf roster_cache.json

Generates roster_cache.json (Chart# → member ID + payer ID + carrier). Refresh every 1–3 months or when many new patients come in (new ones don't appear until regenerating the roster).

4.2 Payer crosswalk (carrier name → Stedi payer ID)

The payer ID from Dentrix's roster is garbage ("SOURCE") in ~2/3 of cases, so the real payer ID is resolved by carrier name:

• payer_map.csv — MASTER list (carrier → Stedi payer ID). Primary source; keep updated.
• carrier_to_payer_REVIEW.csv — crosswalk of the client's roster carriers, auto-mapped + manually reviewed (FINAL_PAYER_ID column).

Payer resolution priority (implemented in fase0_build_270.py):

1. Patient's REAL roster payer (if valid, not "SOURCE") — wins.
2. Reviewed crosswalk by name (exact or spaceless: "Met life" = "MetLife").
3. Match against master payer_map.csv (token subset, safe).
4. Local manual crosswalk.

4.3 Payers NOT supported by Stedi

In carrier_map.py, maintain the list of carriers/payers Stedi doesn't support (e.g. Solstice / 76578). Those escalate directly without querying (verified in the payer's own portal). Add ones the client uses that Stedi rejects.

4.4 Self-pay / Medicaid

Detected by carrier name and listed separately (not escalated as "missing data") — no insurance to verify.

5. The "-BC" note convention

The team marks already-verified appointments with "BC" standalone in the note (any variant: -BC, - BC, /BC, INS ACTIVE BC). The robot skips those and only processes the ones WITHOUT mark. Training the front-desk on this convention is part of onboarding.

6. Automation

6.1 Windows auto-login (recommended, for reboots)

If the machine reboots by itself, Windows must stay logged in so the robot can handle windows. Configure auto-login (netplwiz → uncheck "Users must enter a user name and password", or AutoAdminLogon in registry).

6.2 Scheduled task at 6pm

In cmd (as admin):

schtasks /Create /TN "BCBOT Diario" /TR "C:\BCBOT\run_daily.bat" /SC DAILY /ST 18:00 /F

run_daily.bat launches the robot in AUTO mode (no dialogs) that runs everything and closes. The task is permanent: survives reboots and runs daily by itself.

7. The 2 emails (daily output)

[ESCALATION] {CLINIC} — {date}

Patients to resolve manually, grouped by reason (couldn't verify / inactive / unsupported payer / retry). The team verifies manually and marks them with "-BC".

[PDF TO UPLOAD {CLINIC} {date}]

Verified OK, with coverage PDFs attached (Stedi logo covered) to upload to the patient's file in Dentrix.

If SMTP fails, emails are saved to C:\BCBOT\out\ (email_1_escalacion.txt, email_2_pdfs_para_subir.txt) and PDFs in out/ to send manually.

8. Alerts

• If the robot can't open/log in to Dentrix → [BCBOT ALERTA] email to hello@brandacare.com (check the machine remotely).
• If the PDF comes out empty (0 KB) → alert email (day with no patients, or something got stuck).

9. Maintenance and troubleshooting

10. File inventory (C:\BCBOT)

Robot / automation

Python pipeline

Data

Credentials (§3.3) — 5 .txt files.
Output — C:\BCBOT\out\ (logs, emails as .txt, coverage PDFs).

11. New client onboarding checklist