From 884c6530c4480fa756ddcd06acbcfcb2610bfae4 Mon Sep 17 00:00:00 2001 From: VenkataKrishna Reddy Avula Date: Thu, 19 Feb 2026 21:53:07 +0000 Subject: [PATCH] Merged in bugfix/DAIP2-1701-issue-tracker-fixes-methodology-breakout (pull request #885) Bugfix/DAIP2-1701 issue tracker fixes methodology breakout * testing fee schedules issues * logging debug added for lesser of * Merged DEV into bugfix/DAIP2-1701-issue-tracker-fixes-methodology-breakout * special case term fix * updated lesser of distribution prompt * Merged DEV into bugfix/DAIP2-1701-issue-tracker-fixes-methodology-breakout * refactor: use f-string for special case term concatenation Approved-by: Siddhant Medar --- src/pipelines/shared/extraction/one_to_n_funcs.py | 2 +- src/prompts/prompt_templates.py | 9 +++++++++ 2 files changed, 10 insertions(+), 1 deletion(-) diff --git a/src/pipelines/shared/extraction/one_to_n_funcs.py b/src/pipelines/shared/extraction/one_to_n_funcs.py index a692f69..3b6180f 100644 --- a/src/pipelines/shared/extraction/one_to_n_funcs.py +++ b/src/pipelines/shared/extraction/one_to_n_funcs.py @@ -239,7 +239,7 @@ def process_single_carveout( return ("reimbursement", answer_dict) elif reimbursement_categorization in special_case_definitions.keys(): - answer_dict[reimbursement_categorization] = reimb_term + answer_dict[reimbursement_categorization] = f"{service_term} - {reimb_term}" answer_dict.pop("REIMB_TERM", None) answer_dict.pop("SERVICE_TERM", None) return ("special_case", answer_dict) diff --git a/src/prompts/prompt_templates.py b/src/prompts/prompt_templates.py index 3a0d5ca..1caaf89 100644 --- a/src/prompts/prompt_templates.py +++ b/src/prompts/prompt_templates.py @@ -678,6 +678,15 @@ DECISION LOGIC: If nothing applies → return N/A + CONDITIONAL METHODOLOGY RULE: + -If a “lesser of” or “not to exceed” statement: + →Applies only under a specific condition (e.g., “where there is no rate,” “if not listed,” “when no fee schedule exists”), and + →Defines an alternative reimbursement method rather than limiting the base METHODOLOGY, + -Treat it as a separate reimbursement methodology. + -Do NOT apply it as a constraint to the primary METHODOLOGY. + -Do NOT merge it into the output. + -Only include “lesser of” or “not to exceed” language when it operates as an overarching ceiling that applies to the base METHODOLOGY itself. + 3. COMBINE & FORMAT Substitution: