ArvoAgentHub

Painel Geral

Pertinência de equipo Safeflow em Pronto-Socorro (Petro)

Overview

Deny valved infusion sets (Safeflow/Safeset) on Petro emergency department claims. Identifies Safeflow, Safeset, and Polifix valvulado materials via taxonomy regex matching and flags them for full glosa when billed under regime_atendimento = PRONTO_SOCORRO for partner petro. Agent ID: AI010

Architecture

Field Value
Name Pertinência de equipo Safeflow em Pronto-Socorro (Petro)
Agent ID AI010
Version 0.0.0
Nature tech
Layer —

Inheritance

PertinentSafeflowEquipoPetroRule → PertinenceRule → BaseAgent

Core Functionality

  1. load_artifacts
  2. prepare_data
  3. rule_assessment

Business Rules

Pertinência da cobrança

Constantes:

  • REGEX_POSITIVE = re.compile(
  • REGEX_NEGATIVE = re.compile(
  • MOTIVO_GLOSA_ARVO_TEMPLATE = (

Usage

from agents.pertinentsafeflowequipopetrorule import PertinentSafeflowEquipoPetroRule

rule = PertinentSafeflowEquipoPetroRule()
violations_df = rule.rule_assessment(claims_df)

Configuration

rule = PertinentSafeflowEquipoPetroRule(
    evaluated=True,
    evaluated=evaluated,
    artifact_loader=ArtifactLoader(self.logger),
    _target_keys=set(),
    DataFrame=pd.DataFrame(),
    raw_taxonomy=self.artifact_loader.load_taxonomy(familia_tax_1=["MATERIAL"]),
    taxonomy=raw_taxonomy[[EVENT_COLUMNS.id_evento,
    subset=[EVENT_COLUMNS.id_evento,
)

Input Requirements

Column Type Description
EVENT_COLUMNS.id - -
EVENT_COLUMNS.id_fatura - -
EVENT_COLUMNS.id_evento - -
EVENT_COLUMNS.evento - -
EVENT_COLUMNS.vl_pago - -
EVENT_COLUMNS.qt_paga - -
EVENT_COLUMNS.categoria - -
EVENT_COLUMNS.regime_atendimento - -
ARVO_COLUMNS.id_evento_predicted - -
ARVO_COLUMNS.code_type_predicted - -
ARVO_COLUMNS.partner_id - -

Output Format

Glosa DataFrame Columns

Column Description
agent_id AI010
version 0.0.0
id_arvo Original record ID
vl_glosa_arvo Glosa value
qt_glosa_arvo Glosa quantity
score_arvo Confidence score
motivo_glosa_arvo Detailed reason in Portuguese
motivo_glosa_ANS ANS standard code
data_dict JSON metadata with calculation details

Error Handling

  • DataFrames vazios retornam estrutura vazia com colunas obrigatórias.
  • Colunas ausentes geram warning mas não causam crash.
  • Conversões numéricas usam errors="coerce" para evitar falhas.