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ClaimFilterMedicalItem
allows Medical Officers to filter the Claims list based on a specific Medical Item (only one from autocomplete list)ClaimFilterMedicalService
allows Medical Officers to filter the Claims list based on a specific Medical Service (only one from autocomplete list)ClaimFilterAIProcessed
allows Medical Officers to display or hide the non AI-processed Claims (checkbox, decision if this is hidden or notdefault checked)
AI Categorisation Misclassification Report
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accuracy scores
number of True Positives results
number of True Negative results
number of False Positive results
number of False Negative results
Table with Claim that were fixed (
ClaimItem.json_ext.claim_ai_quality.ai_result != ClaimItem.ClaimItemStatus
- same for ClaimService)ClaimCode
CHFID (Insuree number)
ICDID (check if name can be entered)
Date from-to (DateFrom - DateTo)
Total items (ClaimItems + ClaimServices)
Fixed items
Reviewed date (ValidityFromReview)
Reviewed by (AuditUserIDReview → Username)
To generate this report, the user will have have to filter through the Review Claims search form and trigger the report through a button (label is “AI Misclassification Report”). Only the filtered Claims will be considered for the report.
The button should be hidden if ClaimStatus is Entered or Checked.
Deployment architecture
The two modules should be implemented as follow:
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