Conformidade Pacote Aberto

Overview

Rule to deny claims that provider and plan has negotiated pack, but it was unused and substituted by individual codes

Architecture

Field	Value
Name	Conformidade Pacote Aberto
Agent ID	C027
Version	4
Nature	audit
Layer	—

Inheritance

OpenPackRule → BaseRule → BaseAgent

Core Functionality

1. load_artifacts
2. prepare_data
3. break_package
4. prepare_package_composition
5. rule_assessment

Business Rules

Conformidade contrato

Consultar código-fonte para regras de negócio detalhadas.

Usage

from agents.openpackrule import OpenPackRule

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

Configuration

rule = OpenPackRule(
    pacotes_artefato=None,
    by_plano=[],
    logger=logger,
)

Input Requirements

Consultar expected_input_columns no código-fonte.

Output Format

Glosa DataFrame Columns

Column	Description
agent_id	C027
version	4
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.