Pertinent Assistant Rule
Overview
Rule to validate the medical assistant quantity for procedures. Ensures that the number of assistants billed per event does not exceed the limits defined in technical artifacts based on service date and category.
Architecture
| Field | Value |
|---|---|
| Name | Pertinent Assistant Rule |
| Agent ID | C075 |
| Version | 0.0.0 |
| Nature | tech |
| Layer | — |
Inheritance
PertinentAssistantRule → PertinenceRule → BaseAgent
Core Functionality
- load_artifacts
- prepare_artifact
- prepare_data
- rule_assessment
Business Rules
Pertinência da cobrança
Consultar código-fonte para regras de negócio detalhadas.
Usage
from agents.pertinentassistantrule import PertinentAssistantRule
rule = PertinentAssistantRule()
violations_df = rule.rule_assessment(claims_df)
Configuration
Sem parâmetros configuráveis identificados.
Input Requirements
| Column | Type | Description |
|---|---|---|
EVENT_COLUMNS.dt_atendimento |
- | - |
EVENT_COLUMNS.id |
- | - |
EVENT_COLUMNS.id_evento |
- | - |
ARVO_COLUMNS.id_evento_predicted |
- | - |
EVENT_COLUMNS.evento |
- | - |
EVENT_COLUMNS.id_fatura |
- | - |
EVENT_COLUMNS.vl_pago |
- | - |
EVENT_COLUMNS.qt_paga |
- | - |
EVENT_COLUMNS.subcategoria |
- | - |
ARVO_COLUMNS.code_type |
- | - |
Output Format
Glosa DataFrame Columns
| Column | Description |
|---|---|
agent_id |
C075 |
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.