Merged in bugfix/special_case_fixes (pull request #633)

Bugfix/special case fixes

* notebook with fix added

* fixed additions case


Approved-by: Alex Galarce
This commit is contained in:
Mayank Aamseek
2025-07-25 14:15:41 +00:00
committed by Alex Galarce
parent b9fce2077e
commit 6693c388c1
@@ -610,6 +610,7 @@ For any fields that don't apply to a particular methodology, use "N/A" as the va
- These are often found in follow-on sentences or clauses and may not be part of a comparative limit but are still enforceable and reimbursable.
- If the methodology includes two reimbursement methodologies that are comparative or equal, such as "70% of Billed Charges equal to Provider's Acquisition Cost plus five percent (5%)", each should be represented as a separate dictionary in the output list.
- For each dictionary, only one of the following fields should be present: REIMB_FEE_RATE, REIMB_PCT_RATE, or REIMB_CONVERSION_FACTOR. The others should be "N/A".
- Do not repeat the same reimbursement information in different output entries. For example, if 'cost of vaccines plus a $5 administration fee' is present and $5 is already captured as an addition, do not create a separate dictionary with $5 as a flat fee. Only include it once as an addition.
In the case of 'RBRVS', 'RVU', or American Society of Anesthesiology ('ASA'), any dollar amount mentioned refers to a conversion factor (even if it is not explicitly labeled as such), and not to a flat fee rate. In such cases, the output should have 'REIMB_CONVERSION_FACTOR' field populated with the dollar amount, and 'REIMB_FEE_RATE' field should be blank.