Quantidade Excessiva de Materiais
Overview
Agent for detecting excessive quantity of enteral materials. This agent implements business rules to identify cases where the quantity of enteral equipment billed exceeds the technical recommendation based on patient length of stay, following ANVISA's Caderno 4 guidelines. Business Rule: The maximum quantity of enteral equipment that can be billed per invoice must be equal to the number of days of patient stay. Quantities above this limit are considered excessive and should be denied. Example: Patient hospitalized for 5 days = maximum 5 billable enteral equipment. If 8 equipment were billed = 3 excess equipment should be denied.
Architecture
| Field | Value |
|---|---|
| Name | Quantidade Excessiva de Materiais |
| Agent ID | C064 |
| Version | 1 |
| Nature | tech |
| Layer | — |
Inheritance
ExcessiveEquipoEnteralRule → BaseRule → BaseAgent
Core Functionality
- load_artifacts
- aplica_glosa_parcial
- prepare_data
- rule_assessment
Business Rules
Pertinência da cobrança
Consultar código-fonte para regras de negócio detalhadas.
Usage
from agents.excessiveequipoenteralrule import ExcessiveEquipoEnteralRule
rule = ExcessiveEquipoEnteralRule()
violations_df = rule.rule_assessment(claims_df)
Configuration
rule = ExcessiveEquipoEnteralRule(
logger=logger,
evaluated=False) -> None:,
)
Input Requirements
Consultar expected_input_columns no código-fonte.
Output Format
Glosa DataFrame Columns
| Column | Description |
|---|---|
agent_id |
C064 |
version |
1 |
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.