openimis-be-claim-ai-quality 1.0.0

The openIMIS Backend Claim AI Quality reference module.

openIMIS Backend Claim AI Quality reference module

This repository holds the files of the openIMIS Backend Claim AI Quality reference module. It is dedicated to be deployed as a module of openimis-be_py.

ORM mapping:

None

Listened Django Signals

• SubmitClaimsMutation: adds 'claim_ai_quality' key to the json_ext field on claim submissions

Services

• AiQualityReportService, loading claims used for misclassification report

Reports (template can be overloaded via report_template.tempalte)

• miscategorisation_report

GraphQL Queries

None

GraphQL Mutations - each mutation emits default signals and return standard error lists (cfr. openimis-be-core_py)

None

Additional Endpoints

• miscategorisation_report: generating report regarding ai misclassification in PDF format

Reports

• miscategorisation_report: AI Evaluation accurracy and list of misclassified claims

Configuration options (can be changed via core.ModuleConfiguration)

• claim_ai_url: AI Evaluation websocket endpoint, default ws://localhost:8000/api/claim_ai/ws/Claim/process/
• event_based_activation: if False claim bundles are send as scheduled job, if True bundle of claims is sent after each submission,
• bundle_size: number of claims in one bundle, by default 100,
• zip_bundle: if True claim bundle is compressed before sending, claim_ai module accepts both compressed and uncompressed bundles,
• connection_timeout: the maximum waiting time for a connection to websocket, if exceeded TimeoutError is raised,
• authentication_token: if authentication is required by server token have to be added in configuration,
• accepted_category_code: code for claim items and services positively evaluated by AI,
• rejected_category_code": code for claim items and services negatively evaluated by AI,
• reason_rejected_by_ai_code: rejection code for claims rejected by AI,
• date_format": date format used in FHIR response, by default YYYY-mm-dd

openIMIS Modules Dependencies

• core.websocket.AsyncWebSocketClient
• core.models.ModuleConfiguration
• core.models.InteractiveUser
• core.schema.signal_mutation_module_after_mutating
• claim.models.Claim
• claim.models.ClaimDetail
• claim.models.ClaimItem
• claim.models.ClaimService
• claim.models.gql_mutations.SubmitClaimsMutation
• api_fhir_r4.models.Bundle
• api_fhir_r4.models.BundleType
• api_fhir_r4.models.BundleEntry
• api_fhir_r4.serializers.ClaimSerializer
• location.models.UserDistrict
• report.services.ReportService