Merged in bugfix/prov-info-issues (pull request #816)

Bugfix/prov info issues * Initial commit * Passed payer name to tin npi llm call to avoid assigning tin npi to payer * Removed record that contains NO_IDENTIFIERS_FOUND from PROV_INFO_JSON * Updated unit test for test_tin_npi_funcs * Changed name check code back to original to be consistent * Updated test_tin_npi_funcs.py to pass in payer_name in functions * Add fix to unit test * Updated output in unit tests * Merged main into bugfix/prov-info-issues Approved-by: Katon Minhas
2025-12-22 19:03:09 +00:00
parent 7ffd62fd8e
commit 77c845a82e
4 changed files with 28 additions and 24 deletions
@@ -121,18 +121,17 @@ def run_one_to_one_prompts(
        relationship="one_to_one", file_path=config.FIELD_JSON_PATH
    ).combine(dynamic_one_to_one_fields)

-
-    ################## RUN PROVIDER INFO ##################
-    one_to_one_results, one_to_one_fields = tin_npi_funcs.run_provider_info_fields(
-        contract_text, one_to_one_fields, text_dict, filename
-    )
-    
    ################## RUN HYBRID SMART CHUNKED PROMPTS ##################
    # RAG function loads retrieval questions internally and matches with investment_prompts.json
    hybrid_smart_chunked_answers_dict = hybrid_smart_chunking_funcs.run_hybrid_smart_chunked_fields(
        one_to_one_fields, constants, contract_text, filename, text_dict
    )

+    ################## RUN PROVIDER INFO ##################
+    payer_name = hybrid_smart_chunked_answers_dict.get('PAYER_NAME')
+    one_to_one_results = tin_npi_funcs.run_provider_info_fields(
+        contract_text, text_dict, filename, payer_name
+    )
    
    ################## RUN FULL CONTEXT PROMPTS ##################
    full_context_answers_dict = one_to_one_funcs.run_full_context_fields(
@@ -273,6 +273,9 @@ def merge_provider_info_with_hybrid_smart_chunking(one_to_one_results, filename)
        name for name in other_names if name not in group_names and name != "UNKNOWN"
    ]  # remove any group Names from other Names

+    # Filter out records with NO_IDENTIFIERS_FOUND
+    provider_list = [p for p in provider_list if p.get('NAME') != 'NO_IDENTIFIERS_FOUND']
+
    # Reconstruct PROV_INFO_JSON and PROV_INFO_JSON_FORMATTED with IS_GROUP flags
    one_to_one_results["PROV_INFO_JSON"] = json.dumps(provider_list)
    one_to_one_results["PROV_INFO_JSON_FORMATTED"] = "\n".join(
@@ -412,7 +415,8 @@ def deduplicate_providers(
 def get_provider_info(
    text_dict: dict, 
    page_num: str, 
-    filename: str
+    filename: str,
+    payer_name:str
 ) -> list:
    """
    Extracts provider information from a specified page in a document using a language model.
@@ -436,7 +440,7 @@ def get_provider_info(
        file_path=config.FIELD_JSON_PATH, field_type="provider_info"
    )
    instruction, prompt = prompt_templates.TIN_NPI_TEMPLATE(
-        chunk, provider_fields.print_prompt_dict()
+        chunk, provider_fields.print_prompt_dict(), payer_name
    )
    claude_answer_raw = llm_utils.invoke_claude(
        prompt, "sonnet_latest", filename, max_tokens=8192, cache=True, instruction=instruction
@@ -534,10 +538,9 @@ def get_provider_info(

 def run_provider_info_fields(
    contract_text: str,
-    one_to_one_fields: FieldSet,
    text_dict: dict,
    filename: str,
-    #  payer_name: str # This is not being used right now, but it might be useful for filtering providers later
+    payer_name: str 
 ):
    """
    Extracts provider information from a contract text using regex-based identifier extraction,
@@ -632,7 +635,7 @@ def run_provider_info_fields(
        # Process each page separately and combine results
        combined_provider_info = []
        for page_num in relevant_pages:
-            page_provider_info = get_provider_info(text_dict, page_num, filename)
+            page_provider_info = get_provider_info(text_dict, page_num, filename, payer_name)
            combined_provider_info.extend(page_provider_info)

        # Clean and standardize results
@@ -657,4 +660,4 @@ def run_provider_info_fields(
    filename_tin = get_all_matches(filename, regex_patterns.FILE_NAME_TIN_PATTERN)
    one_to_one_results["FILENAME_TIN"] = filename_tin[0] if filename_tin else "N/A"

-    return one_to_one_results, one_to_one_fields
+    return one_to_one_results
@@ -1,6 +1,7 @@

 import src.config as config
 from src.prompts.fieldset import FieldSet
+from src.utils import string_utils

 PIPE_FORMAT_INSTRUCTIONS = "Briefly explain your answer, then enclose your final answer in |pipes|. If the requested information doesn't apply to this context, return |N/A|. If the information should exist but cannot be clearly identified, return |UNKNOWN|."

@@ -862,13 +863,17 @@ def ONE_TO_ONE_SINGLE_FIELD_INSTRUCTION() -> str:
    )


-def TIN_NPI_TEMPLATE(context, questions):
+def TIN_NPI_TEMPLATE(context, questions, payer_name):
+    payer_instruction = ""
+    if not string_utils.is_empty(payer_name):
+        payer_instruction = f'\n\nIMPORTANT: "{payer_name}" is the PAYER (insurance company) in this contract. Do NOT extract TIN or NPI information for "{payer_name}" - only extract information for healthcare providers who deliver services.'
+    
    instruction = f"""
 Analyze the following healthcare payer-provider contract text and extract provider entities - these are healthcare providers who deliver services, NOT payers/insurance companies who reimburse for services.

 IMPORTANT DISTINCTION:
 - Providers: Physicians, physician groups, hospitals, clinics who DELIVER healthcare
- Payers: Insurance companies, health plans who PAY for healthcare services
+- Payers: Insurance companies, health plans who PAY for healthcare services{payer_instruction}

 CRITICAL: If a provider has multiple TINs or NPIs, include ALL of them separated by pipes (|) in the same provider record. Do NOT create separate records for the same provider entity.

@@ -118,7 +118,7 @@ class TestTinNpiFuncs:
            ]
        )

-        result = tin_npi_funcs.get_provider_info(sample_text_dict, "1", "test.pdf")
+        result = tin_npi_funcs.get_provider_info(sample_text_dict, "1", "test.pdf", payer_name="Test Payer")
        assert len(result) == 1

    @patch("src.utils.llm_utils.invoke_claude")
@@ -134,11 +134,10 @@ class TestTinNpiFuncs:
            ]
        )

-        one_to_one_fields = FieldSet(relationship="one_to_one")
        contract_text = "Contract with TIN 12-3456789"

-        results, fields = tin_npi_funcs.run_provider_info_fields(
-            contract_text, one_to_one_fields, sample_text_dict, "test.pdf"
+        results = tin_npi_funcs.run_provider_info_fields(
+            contract_text, sample_text_dict, "test.pdf", "Test Payer"
        )

        assert "PROV_INFO_JSON" in results
@@ -274,12 +273,11 @@ class TestTinNpiFuncs:
            ]
        )

-        one_to_one_fields = FieldSet(relationship="one_to_one")
        # Include both exact and OCR-correctable TINs
        contract_text = "Contract with TIN 12-3456789 and corrupted TIN 98765432O"

-        results, fields = tin_npi_funcs.run_provider_info_fields(
-            contract_text, one_to_one_fields, sample_text_dict, "test.pdf"
+        results = tin_npi_funcs.run_provider_info_fields(
+            contract_text, sample_text_dict, "test.pdf", "Test Pyer"
        )

        # Check that quality tracking fields are present
@@ -333,12 +331,11 @@ class TestTinNpiFuncs:
            ]
        )

-        one_to_one_fields = FieldSet(relationship="one_to_one")
        # Only OCR-corrupted identifiers, no clean ones
        contract_text = "Contract with corrupted TIN 12345678O and NPI 123456789O"

-        results, fields = tin_npi_funcs.run_provider_info_fields(
-            contract_text, one_to_one_fields, sample_text_dict, "test.pdf"
+        results = tin_npi_funcs.run_provider_info_fields(
+            contract_text,  sample_text_dict, "test.pdf", "Test Payer"
        )

        # Should find OCR-corrected values