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Merged in bugfix/outlier_maximum_fix (pull request #678)

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outlier maximum fix to main

* outlier maximum prompt updated


Approved-by: Katon Minhas
This commit is contained in:
VenkataKrishna Reddy Avula
2025-08-22 13:54:36 +00:00
committed by Katon Minhas
parent 04aa447831
commit 3b2f3a7789
1 changed files with 1 additions and 1 deletions
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fieldExtraction/src/prompts/investment_prompts.json
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@@ -598,7 +598,7 @@
"field_name": "OUTLIER_MAXIMUM",
"relationship": "one_to_n",
"field_type": "outlier",
"prompt": "Extract the maximum dollar amount that can be reimbursed for an outlier claim, regardless of actual costs incurred, from the service description and reimbursement methodology. Focus on identifying:\n\n**What to Look For:**\n1. **Maximum Payment Amounts**: Specific dollar values that cap outlier reimbursement (e.g., 'maximum $500,000', 'not to exceed $1,000,000', 'capped at $750,000')\n2. **Cap Application Scope**: Whether the cap applies per claim, per day, per admission, or per episode (e.g., 'maximum per claim', 'daily cap of', 'per admission limit')\n3. **Reimbursement Limits**: Language that establishes upper bounds on outlier payments (e.g., 'outlier payment shall not exceed', 'total reimbursement limited to', 'maximum allowable amount')\n4. **Multiple Cap Levels**: Different maximum amounts for different scenarios or service types\n\n**Common Indicator Phrases**: Look for 'maximum outlier payment', 'outlier payment shall not exceed', 'outlier cap', 'maximum reimbursement', 'payment capped at', 'not to exceed', 'maximum allowable', 'upper limit', 'reimbursement ceiling', 'total payment limited to', and similar cap-related terminology.\n\n**Contract Language**: Include the exact contract language that specifies the reimbursement cap or maximum limit for qualifying outlier claims.\n\n**Instructions**: Extract the specific maximum dollar amount and include the exact contract language that establishes this cap. If multiple maximums exist for different scenarios, return all values with their associated contexts. If there is no cap on outlier payments, return 'N/A'.\n\n**Format**: Include both the dollar amount and the exact contract language (e.g., '$500000 - maximum outlier payment shall not exceed $500,000 per admission')"
"prompt": "What is the maximum dollar amount that can be reimbursed for an outlier claim, regardless of actual costs incurred? Extract any outlier terms or reimbursement methodology language that sets a reimbursement cap or maximum limit specifically for qualifying outlier claims. Look for 'maximum outlier payment', 'outlier payment shall not exceed', 'outlier cap', 'outlier reimbursement limited to', 'outlier payment capped at'. IMPORTANT: Do NOT include general payment caps like 'shall not exceed billed charges' or overall reimbursement limits - only extract maximums that specifically apply to the outlier payment portion. Return dollar amount only (e.g. '$500000') or 'N/A'."
},
{
"field_name": "OUTLIER_MAXIMUM_FREQUENCY",