diff --git a/fieldExtraction/src/investment/postprocessing_funcs.py b/fieldExtraction/src/investment/postprocessing_funcs.py index fde4f53..78e2be1 100644 --- a/fieldExtraction/src/investment/postprocessing_funcs.py +++ b/fieldExtraction/src/investment/postprocessing_funcs.py @@ -580,8 +580,10 @@ def fill_empty_reimb_pct_rate(df): pct_empty = string_utils.is_empty(df["REIMB_PCT_RATE"]) fee_empty = string_utils.is_empty(df["REIMB_FEE_RATE"]) conversion_empty = string_utils.is_empty(df["REIMB_CONVERSION_FACTOR"]) + applicable_methods = ["Billed Charges", "Fee Schedule", "Case Rate", "Cost"] + method_applicable = df["AARETE_DERIVED_REIMB_METHOD"].isin(applicable_methods) - fill_mask = pct_empty & fee_empty & conversion_empty + fill_mask = pct_empty & fee_empty & conversion_empty & method_applicable df.loc[fill_mask, "REIMB_PCT_RATE"] = "100" # Set to N/A for specific reimbursement methods diff --git a/fieldExtraction/src/prompts/investment_prompts.json b/fieldExtraction/src/prompts/investment_prompts.json index 7643894..880486c 100644 --- a/fieldExtraction/src/prompts/investment_prompts.json +++ b/fieldExtraction/src/prompts/investment_prompts.json @@ -40,7 +40,7 @@ "field_name": "REIMB_CONVERSION_FACTOR", "relationship": "one_to_n", "field_type": "methodology_breakout", - "prompt": "What is the conversion factor (a specific dollar amount) mentioned in the text? A conversion factor is a dollar amount used to determine payment for healthcare services, typically under a fee-for-service or Diagnosis-Related Group (DRG) reimbursement model. It serves as a multiplier that converts a relative value (such as a DRG weight or Relative Value Unit — RVU) into an actual payment amount. In the case of 'RBRVS', 'RVU', or American Society of Anesthesiology ('ASA'), any dollar amount mentioned refers to a conversion factor, and not to a flat fee rate. If no conversion factor is mentioned, return 'N/A'. If it is mentioned as a dollar amount, return it as a numeric value only (e.g., 1.25 for $1.25)." + "prompt": "What is the conversion factor mentioned in the text? A conversion factor is a dollar amount or multiplier value used to determine payment for healthcare services, typically under a fee-for-service or Diagnosis-Related Group (DRG) reimbursement model. It serves as a multiplier that converts a relative value (such as a DRG weight or Relative Value Unit — RVU) into an actual payment amount. In the case of 'RBRVS', 'RVU', or American Society of Anesthesiology ('ASA'), any dollar amount mentioned refers to a conversion factor, and not to a flat fee rate. If no conversion factor is mentioned, return 'N/A'. If it is mentioned as a dollar amount, return it as a numeric value only (e.g., 1.25 for $1.25)." }, { "field_name": "UNIT_OF_MEASURE", diff --git a/fieldExtraction/src/prompts/prompt_templates.py b/fieldExtraction/src/prompts/prompt_templates.py index ba37a73..026ba19 100644 --- a/fieldExtraction/src/prompts/prompt_templates.py +++ b/fieldExtraction/src/prompts/prompt_templates.py @@ -392,7 +392,6 @@ REIMB_TERM: Describes the method by which the price of the Service is calculated [EXCLUSIONS] - NEVER return reimbursement terms that are labeled as Examples or appear in an EXAMPLE section. These are not actual reimbursements and should not be included in the output. - NEVER return reimbursements from the Reciprocity Agreements section of the contract. These are not actual reimbursements and should not be included in the output. -- NEVER return Payment methodology metrics or reference-only tables (e.g., DRG weights, relative weights, LOS, thresholds). These are not actual reimbursements and should not be included in the output. [SPECIAL CASES] Some types of Reimbursements are special and require additional thought.