From 45f1584f381561a636360033313dd0c6ca5c3115 Mon Sep 17 00:00:00 2001 From: Mayank Aamseek Date: Wed, 11 Jun 2025 14:07:44 +0000 Subject: [PATCH] Merged in bugfix/reimb_method (pull request #571) reimb_method as flat rate instead of per diem fixed * reimb_method as flat rate instead of per diem fixed Approved-by: Katon Minhas --- fieldExtraction/src/prompts/investment_prompts.json | 2 +- 1 file changed, 1 insertion(+), 1 deletion(-) diff --git a/fieldExtraction/src/prompts/investment_prompts.json b/fieldExtraction/src/prompts/investment_prompts.json index 310e82b..27e26c4 100644 --- a/fieldExtraction/src/prompts/investment_prompts.json +++ b/fieldExtraction/src/prompts/investment_prompts.json @@ -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" }, {