claude_commands/msh-check-claims.md

MSH Insurance Reimbursement Check

Automate checking reimbursement status for submitted MSH insurance claims using Playwright browser automation.

Read

~/.claude/msh-insurance/claims-submission-guide.md

Instructions

CRITICAL REQUIREMENTS - READ CAREFULLY:

⚠️ AUTOMATION MODE - NO USER INTERACTION ALLOWED ⚠️

1. NEVER PROMPT THE USER: Do not ask questions, do not wait for input, do not output "Ready to proceed?" or similar
2. NEVER PROVIDE MANUAL INSTRUCTIONS: Do not say "Please follow these steps" or "Let me know when..."
3. AUTOMATE EVERYTHING: Use Playwright MCP browser tools to perform ALL actions automatically
4. OUTPUT PROGRESS IMMEDIATELY: Print status messages as you go (use print() or echo to force output)
5. RUN TO COMPLETION: Execute all steps from start to finish without stopping

YOU ARE RUNNING IN AUTOMATED MODE - CHECK ALL PENDING CLAIMS

Input: No arguments needed - the command will automatically read claims from ~/.claude/msh-insurance/claims-tracker.json

Workflow - AUTOMATE ALL STEPS:

FIRST: Load pending claims

1. Read ~/.claude/msh-insurance/claims-tracker.json
2. Filter for claims where reimbursement.status is "pending"
3. Output: "Found X pending claims to check"

Automate browser navigation using Playwright MCP tools:

1. Navigate to MSH portal:

   • Use browser_navigate to https://www.msh-services.com/index_assure_previnter.php?lang=en
   • Output: "Browser opened"

2. Dismiss cookie/GDPR overlay (if present):

   • Use browser_snapshot to check for cookie banner
   • If present, use browser_click to accept cookies (look for "Accept", "Accepter", "OK" buttons)
   • Output: "Cookie banner dismissed" or "No cookie banner found"

3. Login:

   • Load credentials from ~/.bash_secret (MSH_INTL_LOGIN, MSH_INTL_PASS)
   • Use browser_type to fill username field
   • Use browser_type to fill password field
   • Use browser_click to click login button
   • Output: "Logged in successfully"

4. Navigate to "Your claims" page:

   • Click "Your reimbursements" menu to expand it
   • Click "Your claims" link
   • Or navigate directly to: https://www.msh-services.com/index.php?module=demandes&controller=index&action=index
   • Output: "On claims page"

5. For each pending claim:

   a. Use browser_snapshot to see the claims table

   b. Find the claim number (from claims-tracker.json) in the table

   • Table has columns: "Date of claim", "Claim No.", "Claim status"
   • Look for the claim number in the "Claim No." column

   c. Check the "Claim status" column for this claim:

   CASE 1: Status shows "In progress"

   • This means claim is still being processed, not yet reimbursed
   • Keep tracker: reimbursement.status = "pending"
   • Output: "⏳ Claim [CLAIM_NUMBER]: Still in progress"
   • Continue to next claim

   CASE 2: Status shows "Processed on [date] ([reimbursement_number])"

   • This means claim has been processed and reimbursed!
   • The reimbursement_number is a clickable link (e.g., "CH260000429")
   • Click the reimbursement number link
   • Output: "Checking claim [CLAIM_NUMBER]..."

   d. If claim was processed (CASE 2), read the reimbursement details page:

   • Use browser_snapshot to capture the page content
   • The page shows:
     • Processing date (in first table)
     • Claim number
     • Total reimbursement amount (e.g., "45.32 CHF")
     • Payment method ("Wire transfer")
     • Payment recipient
   • Below that, a "Details of the reimbursement notice" section shows:
     • Beneficiary name as heading
     • Table with: Date of service, Service, Expenses incurred, Accepted amount, Other insurance, Our payment
     • "Our payment" column contains the actual reimbursed amount
   • IMPORTANT: Look for any explanation text or deductible information on the page:
     • Check for "Deductible", "Franchise", "Co-payment" mentions
     • Check for any notes explaining why reimbursement differs from expected
     • This info often appears near the "Accepted amount" or in footnotes

   e. Extract information from details page:

   • Processing date (from "Processing date" cell)
   • Total reimbursement amount (from "Total reimbursement" cell)
   • Reimbursed amount per service (from "Our payment" column in details table)
   • Deductible/explanation info (if present) - capture any text explaining discrepancies

   f. Calculate expected reimbursement and flag discrepancies:

   • Get original amount from tracker (e.g., 47.70 CHF)
   • If claim.emergency = true: expected = 100% of amount
   • If claim.emergency = false: expected = 95% of amount
   • Calculate: expected_amount = amount * (1.00 if emergency else 0.95)
   • If abs(reimbursed_amount - expected_amount) > 0.50 CHF:
     • Flag to user: "⚠ Claim [CLAIM_NUMBER]: Reimbursed [amount] CHF but expected [expected] CHF (original: [original] CHF)"

   g. Update tracker for processed claim:

   • Update: reimbursement.status = "paid"
   • Update: reimbursement.amount_reimbursed = [total reimbursement amount]
   • Update: reimbursement.reimbursement_date = [processing date in YYYY-MM-DD format]
   • Update: reimbursement.reimbursement_number = [reimbursement number, e.g., "CH260000429"]
   • If partial reimbursement (discrepancy detected):
     • Update: reimbursement.accepted_amount = [accepted amount from details table]
     • Update: reimbursement.deductible_applied = [deductible amount if mentioned]
     • Update: reimbursement.explanation = [any explanation text found]
     • Update: reimbursement.notes = "⚠ [explanation of discrepancy]"
   • Output: "✓ Claim [CLAIM_NUMBER]: REIMBURSED - [amount] CHF on [date]"

   h. Navigate back to claims list:

   • Use browser_click on "Go back to the list" link if available
   • Or use browser_navigate to https://www.msh-services.com/index.php?module=demandes&controller=index&action=index
   • Output: "Back to claims list"

   i. Handle pagination if needed:

   • The claims table shows 20 claims per page
   • If there are more pages (check for "Page suivante" / "Next page" link), navigate to next page
   • Continue checking pending claims on subsequent pages

   j. Repeat for next pending claim

6. After checking all claims:

   • Update ~/.claude/msh-insurance/claims-tracker.json with all changes
   • Update metadata:
     • last_updated = current timestamp in ISO format
     • pending_claims = count of claims where reimbursement.status is "pending"
     • reimbursed_claims = count of claims where reimbursement.status is "paid"
     • rejected_claims = count of claims where reimbursement.status is "rejected"
     • outstanding_amount = sum of amounts for all pending claims
     • total_reimbursed = sum of amount_reimbursed for all paid claims
   • Output summary of findings

7. Commit changes to git:

   cd ~/.claude/msh-insurance
   git add claims-tracker.json
   git commit -m "Update claims tracker: reimbursement check on [date]"
   git push
   

8. Final summary output:

   === REIMBURSEMENT CHECK SUMMARY ===
   Total claims checked: X
   Newly reimbursed: Y (total: CHF Z.ZZ)
   Still pending: N
   
   [List newly reimbursed claims with amounts and dates]
   [List any claims with unexpected reimbursement amounts]
   

9. Critical requirements:

   • AUTOMATION ONLY: Use Playwright MCP browser automation tools. Never output manual instructions or ask user to do anything
   • FULL AUTOMATION: Complete the entire workflow from browser open to updating tracker without any user interaction
   • PROGRESS OUTPUT: Print progress messages as you go (e.g., "Browser opened", "Logged in", "Checking claim...")
   • EXPECTED REIMBURSEMENT RATES:
     • Medical expenses: 95% of amount
     • Emergency expenses: 100% of amount
     • Flag any discrepancies > 0.50 CHF to user
   • PAGE NAVIGATION: Use "Your claims" page (/index.php?module=demandes&controller=index&action=index), NOT "Your reimbursement notices"
   • STATUS DETECTION: Look for "Processed on [date] ([reimbursement_number])" in the status column
   • MUST dismiss cookie/GDPR banner before logging in (if present)
   • MUST navigate back to claims list after checking each processed claim
   • MUST update claims-tracker.json with all status changes
   • Exit with code 0 if completed successfully, code 1 if failed

WRONG APPROACH - DO NOT DO THIS:

Ready to proceed? Once you've logged in...
Please follow these steps...
Let me know when you're done...

CORRECT APPROACH - DO THIS:

=== Starting MSH reimbursement check ===
Reading claims tracker...
Found 19 pending claims to check

Opening browser...
Browser opened
Logging in...
Logged in successfully
On claims page

Checking claim CFW7954479...
⏳ Claim CFW7954479: Still in progress

Checking claim CFW7954704...
⏳ Claim CFW7954704: Still in progress

Checking claim CFW7955311...
✓ Claim CFW7955311: REIMBURSED - 45.32 CHF on 2026-01-05
Back to claims list

Checking claim CFW7961812...
✓ Claim CFW7961812: REIMBURSED - 104.88 CHF on 2026-01-06
Back to claims list

... (checking remaining claims)

=== REIMBURSEMENT CHECK SUMMARY ===
Total claims checked: 19
Newly reimbursed: 2 (total: CHF 150.20)
Still pending: 17

NEWLY REIMBURSED:
✓ CFW7955311 - 45.32 CHF on 2026-01-05 (Sylvia Hannah AVERBACH - Lab tests)
✓ CFW7961812 - 104.88 CHF on 2026-01-06 (Sylvia Hannah AVERBACH - Dental Check-up)

Updated claims tracker and committed changes to git.
Done

IMPORTANT: Output these progress messages immediately as each step completes to provide real-time feedback.

Run

cd ~/.claude/msh-insurance && git pull