Delete training_data.jsonl
Browse files- training_data.jsonl +0 -60
training_data.jsonl
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{"input": "Transaction details:\n Rule Type: Transaction Rejection\n Patient Age: 5 years\n Items included: 100034654\n Diagnosis codes (ICD-10): P0730", "output": "Outcome:\n Required Prior Approval: No\n Result: Rejection\n Rejection Message: Baby Milk Diagnosis"}
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{"input": "Transaction details:\n Rule Type: Transaction Rejection\n Patient Age: 3 years\n Items included: 102865620\n Diagnosis codes (ICD-10): P0718", "output": "Outcome:\n Rule conditions not fully met for this specific rule.\n Result: Evaluate against next rules."}
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{"input": "Transaction details:\n Rule Type: Transaction Rejection\n Patient Age: 5 years\n Items included: 999999999\n Diagnosis codes (ICD-10): K90.8", "output": "Outcome:\n Rule conditions not fully met for this specific rule.\n Result: Evaluate against next rules."}
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{"input": "Transaction details:\n Rule Type: Transaction Rejection\n Patient Age: 5 years\n Items included: 100035673\n Diagnosis codes (ICD-10): Z99.9", "output": "Outcome:\n Rule conditions not fully met for this specific rule.\n Result: Evaluate against next rules."}
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{"input": "Transaction details for Rule ID 99 - Tawuniya Medical device Authorization Required:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: Yes\n Result: Based on rule: Tawuniya Medical device Authorization Required\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 133 - Sabic- Chronic Conditions:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Sabic- Chronic Conditions\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 100 - Sabic and Aramco Authorization Required Medical Device:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: Yes\n Result: Based on rule: Sabic and Aramco Authorization Required Medical Device\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 114 - Kidney dialysis Authorization Required:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: Yes\n Result: Based on rule: Kidney dialysis Authorization Required\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 43 - VITILIGO:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: VITILIGO\n Rejection Message: VITILIGO"}
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{"input": "Transaction details for Rule ID 234 - Diagnosis not covered for male members:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Diagnosis not covered for male members\n Rejection Message: Diagnosis not covered for male members"}
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{"input": "Transaction details for Rule ID 235 - Diagnosis not covered for female members:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Diagnosis not covered for female members\n Rejection Message: Diagnosis not covered for female members"}
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{"input": "Transaction details for Rule ID 96 - Contraceptive Medicines Require approval:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: Yes\n Result: Based on rule: Contraceptive Medicines Require approval\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 88 - Milk for Tawuniya:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: Yes\n Result: Based on rule: Milk for Tawuniya\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 89 - Milk is covered up to 2 years:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Milk is covered up to 2 years\n Rejection Message: Milk is covered up to 2 years"}
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{"input": "Transaction details for Rule ID 500 - prescription Expiration:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: prescription Expiration\n Rejection Message: prescription Expiration"}
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{"input": "Transaction details for Rule ID 501 - Approval max Limit:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Approval max Limit\n Rejection Message: Approval max Limit"}
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{"input": "Transaction details for Rule ID 10 - Dental Approval:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Dental Approval\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 11 - Maternity Approval:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Maternity Approval\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 12 - Infertility Female:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Infertility Female\n Rejection Message: Female infertility case not covered by insurance"}
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{"input": "Transaction details for Rule ID 13 - Acne (cosmetic):\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Acne (cosmetic)\n Rejection Message: Acne case not covered by insurance"}
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{"input": "Transaction details for Rule ID 14 - Alopecia areata & hair loss:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Alopecia areata & hair loss\n Rejection Message: Alopecia areata & hair loss case not covered by insurance"}
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{"input": "Transaction details for Rule ID 15 - Obesity:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Obesity\n Rejection Message: Obesity case not covered by insurance"}
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{"input": "Transaction details for Rule ID 16 - ED:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: ED\n Rejection Message: Erectile dysfunction case not covered by insurance"}
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{"input": "Transaction details for Rule ID 17 - Infertility male:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Infertility male\n Rejection Message: Male infertility case not covered by insurance"}
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{"input": "Transaction details for Rule ID 18 - Hypo & hyperpigmentation:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Hypo & hyperpigmentation\n Rejection Message: Hypo & Hyperpigmentation case not covered by insurance"}
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{"input": "Transaction details for Rule ID 19 - Scars and Kelloid:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Scars and Kelloid\n Rejection Message: Scars and Kelloid case not covered by insurance"}
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{"input": "Transaction details for Rule ID 20 - STD:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: STD\n Rejection Message: STD case not covered by insurance"}
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{"input": "Transaction details for Rule ID 21 - IVF and Infertility:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: IVF and Infertility\n Rejection Message: Reject \"IVF and Infertility case not covered by insurance"}
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{"input": "Transaction details for Rule ID 22 - Lactation Suppression:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: No\n Result: Based on rule: Lactation Suppression\n Rejection Message: Reject \"Lactation Suppression case not covered by insurance"}
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{"input": "Transaction details for Rule ID 150 - Contraceptive Require approval:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Contraceptive Require approval\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 94 - Psychiatric Diagnosis:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Psychiatric Diagnosis\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 233 - Medication require approval:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Medication require approval\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 102 - Medical Devices Bupa:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Medical Devices Bupa\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 174 - Sabic Exception require approval:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Sabic Exception require approval\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 147 - Aramco- Item Approvals:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Aramco- Item Approvals\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 200 - Mouth wash covered for periodontitis and gingivitis:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Mouth wash covered for periodontitis and gingivitis\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 106 - Approval Limit:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Approval Limit\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 172 - Bupa Milk authorization required:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Bupa Milk authorization required\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 173 - Herbal require approval Bupa:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Herbal require approval Bupa\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 97 - Prior Approval of free style libre:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Prior Approval of free style libre\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 32 - Treatment duration over 1 month:\n Type: Approval Required\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: YES\n Result: Based on rule: Treatment duration over 1 month\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 130 - Blocked Member:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Blocked Member\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 90 - Alcohol and Drug Abuse is not covered:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Alcohol and Drug Abuse is not covered\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 151 - Congenital not covered:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Congenital not covered\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 152 - Cosmetic is not covered:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Cosmetic is not covered\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 95 - Not Covered Diagnosis:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Not Covered Diagnosis\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 92 - Intentional harm is not covered:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Intentional harm is not covered\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 98 - Optical diagnosis:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Optical diagnosis\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 155 - Personal Risk is not covered:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Personal Risk is not covered\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 156 - screening diagnosis is not covered:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: screening diagnosis is not covered\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 157 - work related diagnosis is not covered:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: work related diagnosis is not covered\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 58 - Prescription validity:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Prescription validity\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 77 - Prescription validity chronic:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Prescription validity chronic\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 104 - Freestyle Libre:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Freestyle Libre\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 109 - Tablets for above 4 years old only:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Tablets for above 4 years old only\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 208 - Block Tadalafil on Policy:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Block Tadalafil on Policy\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 115 - Calamine lotion covered for Specific cases for BUPA:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Calamine lotion covered for Specific cases for BUPA\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 23 - Nocturnal Enuresis:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Nocturnal Enuresis\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 52 - Nasal saline coverage:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Nasal saline coverage\n Rejection Message: N/A"}
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{"input": "Transaction details for Rule ID 101 - Mebo Covered for Burn for BUPA:\n Type: Transaction Rejection\n # Add placeholders for other relevant details if available in the rule row", "output": "Outcome:\n Required Prior Approval: NO\n Result: Based on rule: Mebo Covered for Burn for BUPA\n Rejection Message: N/A"}
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