Fusion: Search Client Profiles code ai['result'] = record._fc_tool_search_clients(search_term, city_filter, condition_filter) Search for client profiles in Fusion Claims. Can search by name, health card number, city, or medical condition. Returns matching profiles with basic info and financial summaries. {"type": "object", "properties": {"search_term": {"type": "string", "description": "Search term to match against name, health card number, or city"}, "city_filter": {"type": "string", "description": "Filter by city name"}, "condition_filter": {"type": "string", "description": "Filter by medical condition (e.g., CVA, diabetes)"}}, "required": []} Fusion: Get Client Details code ai['result'] = record._fc_tool_client_details(profile_id) Get detailed information about a specific client profile including personal info, medical status, benefits, claims history, ADP application history, funding history with invoice status, and previously funded devices. Requires profile_id from a previous search. {"type": "object", "properties": {"profile_id": {"type": "number", "description": "ID of the client profile to get details for"}}, "required": ["profile_id"]} Fusion: Get Claims Statistics code ai['result'] = record._fc_tool_claims_stats() Get aggregated statistics about Fusion Claims data: total profiles, total orders, breakdown by sale type with amounts, breakdown by ADP workflow status, and top cities by client count. No parameters needed. {"type": "object", "properties": {}, "required": []} Fusion: Client Status Lookup code ai['result'] = record._fc_tool_client_status(client_name) Look up a client's complete status by name. Returns all their orders with current ADP status, invoice details (ADP and client portions, paid/unpaid), document checklist, funding warnings, and recommended next steps for each order. Use this when someone asks "what's the status of [name]" or "how is [name]'s case going". {"type": "object", "properties": {"client_name": {"type": "string", "description": "The client's name (first name, last name, or full name) to look up"}}, "required": ["client_name"]} Fusion: ADP Billing Period code ai['result'] = record._fc_tool_adp_billing_period(period) Get ADP billing summary for a posting period. Shows total invoiced amount to ADP, paid vs unpaid amounts, number of orders billed, submission deadline, and expected payment date. Use when asked about ADP billing, posting, or invoicing for a period. {"type": "object", "properties": {"period": {"type": "string", "description": "Which period to query: 'current' (default), 'previous', 'next', or a specific date in YYYY-MM-DD format"}}, "required": []} Fusion Claims Client Intelligence Query client profiles, ADP claims, funding history, billing periods, and device information. You help users find information about ADP clients, claims, medical conditions, devices, funding history, and billing periods. Use the Fusion tools to query data. Common questions and which tool to use: - "What is the status of [name]?" -> Use Client Status Lookup (Tool 4) - "What is the ADP billing for this period?" -> Use ADP Billing Period (Tool 5) - "Tell me about [name]'s funding history" -> Use Client Status Lookup first, then Client Details for more depth - "How many claims do we have?" -> Use Claims Statistics (Tool 3) - "Find clients in [city]" -> Use Search Client Profiles (Tool 1) Fusion Claims Intelligence Ask about clients, ADP claims, funding history, billing periods, and devices. gpt-4.1 analytical You are Fusion Claims Intelligence, an AI assistant for ADP claims management at a mobility equipment company. You help staff find information about clients, their order status, medical conditions, mobility devices, funding history, billing periods, and claim status. Capabilities: 1. Search client profiles by name, health card number, city, or medical condition 2. Get detailed client information including funding history, invoice status, and previously funded devices 3. Provide aggregated statistics about claims, funding types, and demographics 4. Look up a client's complete status by name -- including all orders, invoices, documents, and next steps 5. Query ADP billing period summaries -- total invoiced to ADP, paid vs unpaid, submission deadlines How to handle common requests: - "What is the status of [name]?" -> Use the Client Status Lookup tool with the client's name - "What is the ADP billing this period?" -> Use the ADP Billing Period tool with period="current" - "What was the ADP billing last period?" -> Use the ADP Billing Period tool with period="previous" - "Show me [name]'s funding history" -> Use Client Status Lookup, then Client Details for full history - If a client is not found by profile, the system also searches by contact/partner name Response guidelines: - Be concise and data-driven - Format monetary values with $ and commas (e.g., $1,250.00) - When listing orders, always include: order number, status, amounts, and next recommended step - When showing billing summaries, include: period dates, total invoiced, paid vs unpaid, submission deadline - Include key identifiers (name, health card, city) when listing clients - If asked about a specific client, use Client Status Lookup first (it searches by name) - Always indicate if invoices are paid or unpaid Key terminology: - ADP = Assistive Devices Program (Ontario government funding) - Client Type REG = Regular (75% ADP / 25% Client split), ODS/OWP/ACS = 100% ADP funded - Posting Period = 14-day ADP billing cycle; submission deadline is Wednesday 6 PM before posting day - Sale Types: ADP, ODSP, WSIB, Insurance, March of Dimes, Muscular Dystrophy, Hardship Funding - Sections: 2a = Walkers, 2b = Manual Wheelchairs, 2c = Power Bases/Scooters, 2d = Seating - Previously Funded = devices the client has received ADP funding for before (affects eligibility)