jacob-mathison/doczyai-pipelines
1
0
Fork 0
Code Issues Pull Requests Actions Packages Projects Releases Activity

Merged in field/prod_prog_lob (pull request #386)

Browse Source 
Updated crosswalks

* Updated crosswalks

* Merged main into field/prod_prog_lob

* Update CONTRACT_PRODUCT prompt


Approved-by: Alex Galarce
This commit is contained in:
Katon Minhas
2025-02-07 21:58:02 +00:00
parent 8533d3cf78
commit 91a71643dc
6 changed files with 121 additions and 46 deletions
Download Patch File Download Diff File Expand all files Collapse all files
fieldExtraction/crosswalk/mappings/crosswalk_lob.json
+20
View File
@@ -0,0 +1,20 @@
{
"metadata": {
"from_col": "CONTRACT_LINE_OF_BUSINESS",
"to_col": "AARETE_DERIVED_LINE_OF_BUSINESS"
},
"mapping": {
"MEDICAID" : "Medicaid",
"MEDICARE-MEDICAID" : "Medicare-Medicaid",
"MEDICARE" : "Medicare",
"MEDICARE-ADVANTAGE" : "Medicare",
"COMMERCIAL" : "Commercial-Group",
"COMMERCIAL-EXCHANGE" : "Commercial-Group",
"GROUP" : "Commercial-Group",
"MARKETPLACE" : "Marketplace-Exchange-Individual & Family",
"CORRECTIONS" : "Corrections",
"VETERANS AFFAIRS" : "Veterans Affairs (VA)",
"CIVILIAN HEALTH AND MEDICAL PROGRAM" : "Civilian Health and Medical Program (CHAMPVA)",
"TRICARE" : "TRICARE"
}
}
fieldExtraction/crosswalk/mappings/crosswalk_product.json
+10
View File
@@ -0,0 +1,10 @@
{
"metadata": {
"from_col": "CONTRACT_PRODUCT",
"to_col": "AARETE_DERIVED_PRODUCT"
},
"mapping": {
"EXAMPLE_PRODUCT" : "EXAMPLE_PRODUCT"
}
}
fieldExtraction/crosswalk/mappings/crosswalk_program.json
+32
View File
@@ -0,0 +1,32 @@
{
"metadata": {
"from_col": "CONTRACT_PROGRAM",
"to_col": "AARETE_DERIVED_PROGRAM"
},
"mapping": {
"Aged, Blind, Disabled (ABD)": "Aged, Blind, Disabled (ABD)",
"Children’s Health Insurance Program (CHIP)": "Children’s Health Insurance Program (CHIP)",
"CHIP" : "Children’s Health Insurance Program (CHIP)",
"Children’s Health Insurance Program Perinate (CHIP-Perinate)": "Children’s Health Insurance Program Perinate (CHIP-Perinate)",
"CHIP-P" : "Children’s Health Insurance Program Perinate (CHIP-Perinate)",
"Foster Care": "Foster Care",
"Intellectual and Developmental Disability (IDD)": "Intellectual and Developmental Disability (IDD)",
"Temporary Assistance Needy Families (TANF)": "Temporary Assistance Needy Families (TANF)",
"Chronic Condition Special Needs Plan (C-SNP)": "Chronic Condition Special Needs Plan (C-SNP)",
"Dual Eligible Special Needs Plan (D-SNP)": "Dual Eligible Special Needs Plan (D-SNP)",
"Institutional Special Needs Plan (I-SNP)": "Institutional Special Needs Plan (I-SNP)",
"Long-Term Services and Supports (LTSS)": "Long-Term Services and Supports (LTSS)",
"Program of All-Inclusive Care for the Elderly (PACE)": "Program of All-Inclusive Care for the Elderly (PACE)",
"Special Needs Plan (SNP)": "Special Needs Plan (SNP)",
"Medicare Advantage": "Medicare Advantage",
"Supplemental": "Supplemental",
"Administrative Services Only (ASO)": "Administrative Services Only (ASO)",
"Third-Party Administrator (TPA)": "Third-Party Administrator (TPA)",
"Self-Funded": "Self-Funded",
"Employer Funded": "Employer Funded",
"Platinum": "Platinum",
"Gold": "Gold",
"Silver": "Silver",
"Bronze": "Bronze"
}
}
fieldExtraction/src/constants/investment_values.py
+32 -27
View File
@@ -1,14 +1,18 @@
VALID_LOBS = [
"MEDICARE",
"MEDICARE ADVANTAGE",
"MEDICAID",
"NON-MEDICAID",
"MARKETPLACE",
"MEDICARE-MEDICAID",
"MEDICARE",
"MEDICARE-ADVANTAGE"
"COMMERCIAL",
"COMMERCIAL-EXCHANGE",
"MEDICAID-MEDICARE",
"GROUP",
"MARKETPLACE",
"CORRECTIONS",
"VETERANS AFFAIRS",
"CIVILIAN HEALTH AND MEDICAL PROGRAM",
"TRICARE"
]
VALID_CONTRACT_NETWORKS = [
@@ -32,30 +36,31 @@ VALID_AARETE_DERIVED_NETWORKS = [
]
VALID_PROGRAMS = [
'Aged, Blind, Disabled (ABD)',
'Children’s Health Insurance Program (CHIP)',
'Children’s Health Insurance Program Perinate (CHIP-Perinate)',
'Foster Care',
'Intellectual and Developmental Disability (IDD)',
'Temporary Assistance Needy Families (TANF)',
'Chronic Condition Special Needs Plan (C-SNP)',
'Dual Eligible Special Needs Plan (D-SNP)',
'Institutional Special Needs Plan (I-SNP)',
'Long-Term Services and Supports (LTSS)',
'Program of All-Inclusive Care for the Elderly (PACE)',
'Special Needs Plan (SNP)',
'Medicare Advantage',
'Supplemental',
'Administrative Services Only (ASO)',
'Third-Party Administrator (TPA)',
'Self-Funded',
'Employer Funded',
'Platinum',
'Gold',
'Silver',
'Bronze'
"AGED, BLIND, DISABLED (ABD)",
"CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP)",
"CHILDREN’S HEALTH INSURANCE PROGRAM PERINATE (CHIP-PERINATE)",
"FOSTER CARE",
"INTELLECTUAL AND DEVELOPMENTAL DISABILITY (IDD)",
"TEMPORARY ASSISTANCE NEEDY FAMILIES (TANF)",
"CHRONIC CONDITION SPECIAL NEEDS PLAN (C-SNP)",
"DUAL ELIGIBLE SPECIAL NEEDS PLAN (D-SNP)",
"INSTITUTIONAL SPECIAL NEEDS PLAN (I-SNP)",
"LONG-TERM SERVICES AND SUPPORTS (LTSS)",
"PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE)",
"SPECIAL NEEDS PLAN (SNP)",
"MEDICARE ADVANTAGE",
"SUPPLEMENTAL",
"ADMINISTRATIVE SERVICES ONLY (ASO)",
"THIRD-PARTY ADMINISTRATOR (TPA)",
"SELF-FUNDED",
"EMPLOYER FUNDED",
"PLATINUM",
"GOLD",
"SILVER",
"BRONZE"
]
VALID_AARETE_DERIVED_FEE_SCHEDULE = [
"CMS", "Medicare",
"State", "Medicaid",
fieldExtraction/src/investment/aarete_derived.py
+2
View File
@@ -39,6 +39,8 @@ def get_crosswalk_answers(crosswalk_fields, aarete_derived_answers_df):
aarete_derived_answers_df[from_field].map(lambda x: apply_crosswalk(str(x).upper(), crosswalk_mapping))
)
# Right
return aarete_derived_answers_df
fieldExtraction/src/prompts/investment_prompts.json
+25 -19
View File
@@ -68,6 +68,14 @@
"prompt" : "What is the Line of Business? Choose ONLY from the following: {valid_values}",
"valid_values" : "VALID_LOBS"
},
{
"field_name": "AARETE_DERIVED_LINE_OF_BUSINESS",
"relationship": "one_to_n",
"field_type": "crosswalk",
"prompt": "TBD",
"crosswalk" : "crosswalk_lob.json",
"base_field" : "CONTRACT_LINE_OF_BUSINESS"
},
{
"field_name" : "CONTRACT_NETWORK",
"relationship" : "one_to_n",
@@ -87,7 +95,15 @@
"field_name" : "CONTRACT_PRODUCT",
"relationship" : "one_to_n",
"field_type" : "dynamic",
"prompt" : "What is the Product? Look for the brand name of a health plan or product. Do not include values that should be in other fields, even if they are labeled as a Product. This field should also not include generic healthcare terms like 'Medicare', 'Medicaid', etc."
"prompt" : "What is the Product? Look for the brand name of a health plan or product. Do not include values that should be in other fields, even if they are labeled as a Product. Do not include the name of the entire healthplan (such as 'Molina', 'Centene' etc) - rather, look for the Product that these healthplans offer. This field should also not include generic healthcare terms like 'Medicare', 'Medicaid', etc."
},
{
"field_name": "AARETE_DERIVED_PRODUCT",
"relationship": "one_to_n",
"field_type": "TBD",
"prompt": "TBD",
"crosswalk" : "crosswalk_product.json",
"base_field" : "CONTRACT_PRODUCT"
},
{
"field_name" : "CONTRACT_PROGRAM",
@@ -96,6 +112,14 @@
"prompt" : "What is the Program? Choose ONLY from the following: {valid_values}. Note that 'Medicare' does NOT mean 'Medicare Advantage'. If only 'Medicare' is seen, do not write 'Medicare Advantage'.",
"valid_values" : "VALID_PROGRAMS"
},
{
"field_name": "AARETE_DERIVED_PROGRAM",
"relationship": "one_to_n",
"field_type": "crosswalk",
"prompt": "TBD",
"crosswalk" : "crosswalk_program.json",
"base_field" : "CONTRACT_PROGRAM"
},
{
"field_name" : "CONTRACT_CLAIM_TYPE_CD",
"relationship" : "one_to_one",
@@ -259,24 +283,6 @@
"prompt": "Convert the claim type value to appropriate code: Return H for 'facility' or 'hospital' or 'Institutional'. Return M for 'ancillary' or 'professional'. Claim type: {CONTRACT_CLAIM_TYPE_CD}. Return only 'H' or 'M' without any additional text.",
"crosswalk": "crosswalk_claim_type.json"
},
{
"field_name": "AARETE_DERIVED_PRODUCT",
"relationship": "one_to_n",
"field_type": "TBD",
"prompt": "TBD"
},
{
"field_name": "AARETE_DERIVED_LINE_OF_BUSINESS",
"relationship": "one_to_n",
"field_type": "TBD",
"prompt": "TBD"
},
{
"field_name": "AARETE_DERIVED_PROGRAM",
"relationship": "one_to_n",
"field_type": "TBD",
"prompt": "TBD"
},
{
"field_name": "CONTRACT_SERVICE_AREA",
"relationship": "one_to_one",