packages.py

"""
PMJAY package configuration — loaded from packages.json.

packages.json is the single source of truth: each package carries the mandatory
document checklist for both stages (pre-auth / claim) plus the "TMS rule" content
checks the STG asks processing doctors to verify. Edit the JSON to add packages,
documents, or rules — no code change required.

The verdict engine treats `documents` as a deterministic presence checklist, and
`rules` as content checks the LLM evaluates against OCR'd text.

Source PDFs: stg_guidelines/STGs_ps1/
"""

import json
import os

_DATA_PATH = os.path.join(os.path.dirname(__file__), "packages.json")

# Stage identifiers used across the app.
STAGE_PREAUTH = "preauth"
STAGE_CLAIM = "claim"


def _load():
    with open(_DATA_PATH, encoding="utf-8") as fh:
        raw = json.load(fh)

    stage_labels = raw.get("stages", {})

    packages = {}
    for pkg in raw.get("packages", []):
        code = pkg["code"]
        documents = {}
        for stage, items in pkg.get("documents", {}).items():
            documents[stage] = [
                {
                    "id": d["id"],
                    "label": d["label"],
                    "verify": d["verify"],
                    "note": d.get("note", ""),
                }
                for d in items
            ]
        rules = [
            {
                "id": r["id"],
                "check": r["check"],
                "expected": r.get("expected", "Yes"),
            }
            for r in pkg.get("rules", [])
        ]
        packages[code] = {
            "code": code,
            "name": pkg["name"],
            "procedure": pkg.get("procedure", ""),
            "specialty": pkg.get("specialty", ""),
            "price": pkg.get("price", ""),
            "documents": documents,
            "rules": rules,
        }
    return stage_labels, packages


STAGE_LABELS, PACKAGES = _load()


def dropdown_choices():
    """Return [(label, code), ...] for the Gradio dropdown, grouped sensibly."""
    # Count how many codes share each display name; only disambiguate with the
    # procedure when a name is used by more than one package (e.g. the 4
    # cholecystectomy variants).
    name_counts = {}
    for pkg in PACKAGES.values():
        name_counts[pkg["name"]] = name_counts.get(pkg["name"], 0) + 1

    choices = []
    for code, pkg in PACKAGES.items():
        label = f"{code} — {pkg['name']}"
        if name_counts[pkg["name"]] > 1 and pkg.get("procedure"):
            label += f" — {pkg['procedure']}"
        choices.append((label, code))
    return choices


def get_package(code):
    return PACKAGES.get(code)


def required_documents(code, stage):
    pkg = PACKAGES.get(code)
    if not pkg:
        return []
    return pkg["documents"].get(stage, [])