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Merged in bugfix/Moline-NV-carveout-cd (pull request #758)

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handle multiple default_terms in one reimb_term

* handle multiple default_terms in one reimb_term


Approved-by: Katon Minhas
This commit is contained in:
Mayank Aamseek
2025-11-03 16:11:44 +00:00
committed by Katon Minhas
parent 07dc47e9d1
commit ee8314f574
1 changed files with 1 additions and 1 deletions
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fieldExtraction/constants/mappings/valid_carveouts.json
+1 -1
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@@ -17,6 +17,6 @@
"PROFESSIONAL_COMPONENT": "If Modifier 26 (professional component) is present.",
"DIAGNOSTIC_PROCEDURES": "Describes payments for diagnostic procedures.",
"READMISSIONS": "Describes payment for subsequent admission with the same diagnostic category of codes as the initial admission.",
"DEFAULT_TERM": "Indicates whether this service/methodology serves as a default/fallback payment rate when no other payment methods mentioned anywhere in the contract apply. The default/fallback/'end-of-the-line' payment rate may be a lower rate, often based on billed charges. It may be specific to certain services or applicable to all services. Do not classify as default if:\n- The methodology is the primary/base reimbursement approach, even if defined by exclusion\n- No default/fallback language is present\n\nExamples: \n- 'For any services not specifically listed in Exhibits A-D, reimbursement shall be 50% of billed charges.' \n- 'If there is no payment rate under the Medicare Fee Schedule, [alternative rate applies].'"
"DEFAULT_TERM": "Indicates whether this service/methodology serves as a default/fallback payment rate when other payment method does not apply. The default/fallback payment rate may be a lower rate. It may be specific to certain services or applicable to all services. Do not classify as default if:\n- The methodology is the primary/base reimbursement approach, even if defined by exclusion\n- No default/fallback language is present\n\nExamples: \n- 'For any services not specifically listed in Exhibits A-D, reimbursement shall be 50% of billed charges.' \n- 'If there is no payment rate under the Medicare Fee Schedule, alternative rate e.g. Medicare Rate applies.'"
}
}