awacke1 commited on
Commit
a9be473
·
1 Parent(s): 6a97603

Update app.py

Browse files
Files changed (1) hide show
  1. app.py +50 -1
app.py CHANGED
@@ -4,7 +4,56 @@ st.set_page_config(layout="wide")
4
 
5
  st.markdown("""
6
 
7
- # In Context Learning:
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
8
 
9
  | Costly Condition | EDI 278A Request | ADT Message Type | ADT Event | Clinical Document Example |
10
  |---------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------|-----------|-------------------------------------------------------------------------------------------------------------------------------------------|
 
4
 
5
  st.markdown("""
6
 
7
+ ISA*00* *00* *ZZ*SENDERID *ZZ*RECEIVERID *220505*1200*^*00501*000000001*0*P*:~
8
+ GS*HI*SENDERID*RECEIVERID*20220505*1200*1*X*005010X217~
9
+ ST*278*0001~
10
+ BHT*0078*11*10001234*20220505*1200*16~
11
+ HL*1**20*1~
12
+ NM1*X3*2*PAYER NAME*****PI*PAYERID~
13
+ HL*2*1*21*1~
14
+ NM1*1P*2*PROVIDER NAME*****XX*PROVIDER NPI~
15
+ HL*3*2*22*1~
16
+ NM1*IL*1*LAST NAME*FIRST NAME****MI*MEMBERID~
17
+ TRN*1*REFNUM*ABCDEFGHIJ~
18
+ UM*HS*I*1~
19
+ HCR*A3*APPROVAL NUMBER~
20
+ DTP*472*D8*20220506~
21
+ HI*ABK:DIAGNOSIS CODE~
22
+ MSG*Prior authorization approved for the requested service.~
23
+ SE*13*0001~
24
+ GE*1*1~
25
+ IEA*1*000000001~
26
+
27
+ Description of each part:
28
+
29
+ ISA: Interchange Control Header segment, contains sender and receiver information.
30
+ GS: Functional Group Header segment, contains functional group information.
31
+ ST: Transaction Set Header segment, marks the start of the transaction set.
32
+ BHT: Beginning of Hierarchical Transaction segment, contains transaction set information.
33
+ HL: Hierarchical Level segment, used to define hierarchical structure.
34
+ NM1: Name segment, used to identify entities such as payer, provider, and patient.
35
+ TRN: Trace segment, contains reference number for the transaction.
36
+ UM: Health Care Services Review segment, contains review information.
37
+ HCR: Health Care Services Review segment, contains review decision information.
38
+ DTP: Date/Time Qualifier segment, contains relevant dates.
39
+ HI: Health Care Information Codes segment, contains diagnosis codes.
40
+ MSG: Message Text segment, contains human-readable messages.
41
+ SE: Transaction Set Trailer segment, marks the end of the transaction set.
42
+ GE: Functional Group Trailer segment, marks the end of the functional group.
43
+ IEA: Interchange Control Trailer segment, marks the end of the interchange.
44
+ For the four high-cost service packages (Diabetes, Heart Disease, Anxiety & Depression, Musculoskeletal Disorders), the diagnosis list and clinical evidence for prior authorization would be included in the HI and MSG segments, respectively. The diagnosis codes would be specified in the HI segment, while the clinical evidence and any additional information would be provided in the MSG segment.
45
+
46
+
47
+
48
+
49
+ # In Context Learning:| Costly Condition | EDI 278A Request | ADT Message Type | ADT Event | Clinical Document Example |
50
+ |---------------------------|-----------------------------------|------------------|-----------|----------------------------------------------|
51
+ | Diabetes | REF|1234567890|DOE^JOHN||20230505120000|19730101|M|123 Main St^^Anytown^NC^12345^^^||(555)555-1234|(555)555-5678||123456789|999-99-9999|||||||||| | ADT^A01 | A01 | Admitting a patient to the hospital for diabetes management |
52
+ | Heart Disease | RQ|111111|20181214|20181220|Acme Health Plan|1234 1st Street|Anytown|NC|12345| | | | | | | | ADT^A01 | A01 | Admitting a patient to the hospital for heart surgery |
53
+ | Anxiety & Depression | REF|1234567890|DOE^JOHN||20230505120000|19730101|M|123 Main St^^Anytown^NC^12345^^^||(555)555-1234|(555)555-5678||123456789|999-99-9999|||||||||| | ADT^A01
54
+
55
+
56
+
57
 
58
  | Costly Condition | EDI 278A Request | ADT Message Type | ADT Event | Clinical Document Example |
59
  |---------------------------------|-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|-----------------|-----------|-------------------------------------------------------------------------------------------------------------------------------------------|