Quantidade excessiva de viscosuplementação
Overview
Detects excessive viscosupplementation (hyaluronic acid) material usage by comparing the total material quantity per beneficiary against the posology limit adjusted by the number of application procedures. effective_limit = poso_apps_max × num_applications Scope is defined by the posology artifact: only material items whose (code_type_predicted, id_evento_predicted) match the artifact are evaluated.
Architecture
| Field | Value |
|---|---|
| Name | Quantidade excessiva de viscosuplementação |
| Agent ID | C078 |
| Version | 0.0.0 |
| Nature | tech |
| Layer | — |
Inheritance
ExcessiveViscosupplementationRule → ExcessiveAmountRule → BaseAgent
Core Functionality
- load_artifacts
- prepare_data
- rule_assessment
Business Rules
Pertinência da cobrança
Constantes:
APPLICATION_PROCEDURE_CODE = "30713137"
Usage
from agents.excessiveviscosupplementationrule import ExcessiveViscosupplementationRule
rule = ExcessiveViscosupplementationRule()
violations_df = rule.rule_assessment(claims_df)
Configuration
Sem parâmetros configuráveis identificados.
Input Requirements
| Column | Type | Description |
|---|---|---|
EVENT_COLUMNS.id |
- | - |
EVENT_COLUMNS.id_fatura |
- | - |
EVENT_COLUMNS.id_evento |
- | - |
EVENT_COLUMNS.evento |
- | - |
EVENT_COLUMNS.dt_atendimento |
- | - |
Output Format
Glosa DataFrame Columns
| Column | Description |
|---|---|
agent_id |
C078 |
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.