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Merged in bugfix/reimb_method (pull request #571)

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reimb_method as flat rate instead of per diem fixed

* reimb_method as flat rate instead of per diem fixed


Approved-by: Katon Minhas
This commit is contained in:
Mayank Aamseek
2025-06-11 14:07:44 +00:00
committed by Katon Minhas
parent f556e352b8
commit 45f1584f38
1 changed files with 1 additions and 1 deletions
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fieldExtraction/src/prompts/investment_prompts.json
+1 -1
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@@ -33,7 +33,7 @@
"field_name": "AARETE_DERIVED_REIMB_METHOD",
"relationship": "one_to_n",
"field_type": "methodology_breakout",
"prompt": "What is the method of reimbursement? Choose only from the following valid values: {valid_values}.\nFollow these mapping rules:\n- If any of Medicare, Medicaid, Average Sales Price (ASP), AWP (Average Wholesale Price), WAC (Wholesale Acquisition Cost), RBRVS (Resource-Based Relative Value Scale) or RVU (Relative Value Unit) or any type of Fee Schedule is mentioned, return 'Fee Schedule'\n- In case of MS-DRG, AP-DRG, APR-DRG, APG, EAPG, APC/ OPPS or ASC, return 'Grouper'.\n- In case of Percent of Charge or Percentage of Billed, return 'Billed Charges'.\n- For mixed methodologies (e.g., 'cost plus 5% based on AWP'), prioritize the base method (AWP)\n- answer 'DOFR' only when this exact term i.e. 'DOFR' is present.\n- answer 'Medicare Member Cost Share' only when this exact phrase appears.\n\nImportant exceptions and additional rules:\n- Reimbursements with specific dollar values cannot be 'Fee Schedule'\n- Provider interest rates are not considered 'Flat Rate'. \n- ASA is not a reimbursement method and not a fee schedule. \n If no specific rule is matched, map to the most appropriate value from the given valid values.",
"prompt": "What is the method of reimbursement? Choose only from the following valid values: {valid_values}.\nFollow these mapping rules:\n- If any of Medicare, Medicaid, Average Sales Price (ASP), AWP (Average Wholesale Price), WAC (Wholesale Acquisition Cost), RBRVS (Resource-Based Relative Value Scale) or RVU (Relative Value Unit) or any type of Fee Schedule is mentioned, return 'Fee Schedule'\n- In case of MS-DRG, AP-DRG, APR-DRG, APG, EAPG, APC/ OPPS or ASC, return 'Grouper'.\n- In case of Percent of Charge or Percentage of Billed, return 'Billed Charges'.\n- When reimbursement is defined on a per-day basis, the applicable method is Per Diem.\n- For mixed methodologies (e.g., 'cost plus 5% based on AWP'), prioritize the base method (AWP)\n- answer 'DOFR' only when this exact term i.e. 'DOFR' is present.\n- answer 'Medicare Member Cost Share' only when this exact phrase appears.\n\nImportant exceptions and additional rules:\n- Reimbursements with specific dollar values cannot be 'Fee Schedule'\n- Provider interest rates are not considered 'Flat Rate'. \n- ASA is not a reimbursement method and not a fee schedule. \n If no specific rule is matched, map to the most appropriate value from the given valid values.",
"valid_values": "VALID_REIMB_TERM_FULL"
},
{