stoploss fix

This commit is contained in:
Mayank
2025-12-11 15:00:28 +00:00
parent 290a1e7315
commit 93d3fa93e2
2 changed files with 2 additions and 0 deletions
@@ -209,6 +209,7 @@ def prompt_carveout_check(
instruction=prompt_templates.CARVEOUT_CHECK_INSTRUCTION(),
usage_label="CARVEOUT_CHECK",
)
logging.debug(f"Carveout/ special case check for {filename}: {llm_answer_raw}")
carveout_answer = string_utils.extract_text_from_delimiters(
llm_answer_raw, Delimiter.PIPE
@@ -996,6 +996,7 @@ VALID entries - return YES:
- "Lesser of" or "greater of" statements with clear and specific rates
- Capitation rates (PMPM, PMPY, per member costs)
- Flat rates per service or episode
- These Special cases: OUTLIER, STOP_LOSS, SEQUESTRATION, DISCOUNT, PREMIUM, RATE_ESCALATOR, FACILITY_ADJUSTMENT
INVALID entries - return NO unless there is VALID language as well:
- 'Empty' Reimbursements - have the same structure as a valid reimbursement but doesn't actually reference any specific rate or fee schedule (e.g. "Covered Services will be paid at the rates stated in the next section")