Tawuniya | Pre-Auth AI

{% if error is defined and error %}

Processing Error

{% endif %} {% if errors and errors | length > 0 %}

Pipeline Warnings

{% for err in errors %}

{% endfor %}

{% endif %} {% if approval_no %} {% set total_count = ui_output_8 | length %} {% set approved_count = namespace(value=0) %} {% for decision in ui_output_8 %} {% if 'Approved' in decision.get('Decision', '') and 'Disapproved' not in decision.get('Decision', '') %} {% set approved_count.value = approved_count.value + 1 %} {% endif %} {% endfor %} {% set rejected_count = total_count - approved_count.value %} {% set all_approved = approved_count.value == total_count and total_count > 0 %} {% set all_rejected = rejected_count == total_count and total_count > 0 %}

{% if all_approved %}All Services Approved{% elif all_rejected %}Services Rejected{% else %}Partial Approval{% endif %}

Decision based on CCHI policy guidelines and medical necessity analysis

{{ approved_count.value }} Approved {{ rejected_count }} Rejected {{ total_count }} Total

Request Info

Approval No {{ ui_output_1[0] }}

Request Date {{ ui_output_1[1] }}

Type {{ ui_output_1[2] }}

Processed

Patient Demographics

Full Name {{ ui_output_2[0] }}

DOB / Age {{ ui_output_2[1] }} ({{ ui_output_2[3] }}y)

Gender {{ ui_output_2[2] }}

ID/Iqama {{ ui_output_2[4] }}

Nationality {{ ui_output_2[5] }}

Insurance Info

Member ID {{ ui_output_3[0] }}

Plan Type {{ ui_output_3[1] }}

Health Dec. {{ ui_output_3[2] }}

Status {{ ui_output_3[3] | default('Active') }}

Provider Info

Facility {{ ui_output_4[0] }}

Physician {{ ui_output_4[1] }}

Specialty {{ ui_output_4[2] }}

License No. {{ ui_output_4[3] }}

Service Decisions

{% if ui_output_9 is string and ui_output_9 %} {{ ui_output_9 }} {% elif ui_output_9 and ui_output_9[0] is mapping and ui_output_9[0]['Category'] %} {{ ui_output_9[0]['Category'] }} {% endif %}

{% for decision in ui_output_8 %} {% set is_approved = 'Approved' in decision['Decision'] and 'Disapproved' not in decision['Decision'] %}

#{{ loop.index }} Code: {{ decision['Internal Code'] }} {% if decision.get('Category Description') %} | {{ decision['Category Description'] }}{% endif %}

{% if decision.get('Category') %}

{% endif %}

Requested

{% if is_approved %}{{ decision['Approved Qty'] | default(decision['Requested Qty'] | default(1)) }}{% else %}0{% endif %}

Approved

{% if is_approved %}A{% else %}D{% endif %}

Status

{% if not is_approved and decision.get('Rejection Code') %}

Rej. Code

{% endif %}

{% if decision['Justification'] or decision.get('layer_trace') %}

{% if decision['Justification'] %}

Justification

{% endif %} {% if decision.get('layer_trace') %}

Decision Audit Trail

{% for trace in decision['layer_trace'] %} {% set trace_status = trace.get('result', 'skip') | lower %} {% if 'pass' in trace_status or 'approved' in trace_status %} {% set trace_class = 'pass' %} {% elif 'fail' in trace_status or 'reject' in trace_status or 'disapproved' in trace_status %} {% set trace_class = 'fail' %} {% else %} {% set trace_class = 'skip' %} {% endif %} {{ trace.get('layer', trace.get('name', 'Layer')) }} {% endfor %}

{% endif %}

{% endfor %}

Clinical Assessment

Diagnosis Codes

Clinical Summary

Supporting Investigations

Radiology Findings

{{ ui_output_6[0] | default('No radiology findings available') }}

Laboratory Results

{{ ui_output_6[1] | default('No laboratory results available') }}

Past Medical History & Utilization Analysis

Historical Analysis

Communication Messages

{% if ui_output_0 %} {% if ui_output_0 is mapping %} {% if ui_output_0.english %}

English Message

{% endif %} {% if ui_output_0.arabic %}

الرسالة بالعربية

{% endif %} {% elif ui_output_0 is iterable and ui_output_0 is not string %} {% if ui_output_0[0] %}

English Message

{% endif %} {% if ui_output_0[1] %}

الرسالة بالعربية

{% endif %} {% else %}

No messages available

{% endif %}

ملخص خدمة العملاء (Customer Service Agent Summary)

{% if ui_output_10 %}

ملخص شامل للحالة

{% else %}

No customer service summary available

{% endif %}

Provider Response Messages

{% for decision in ui_output_8 %} {% set is_approved = 'Approved' in decision['Decision'] and 'Disapproved' not in decision['Decision'] %}

{{ decision['Service Name'] }} {% if is_approved %}Approved{% else %}Disapproved{% endif %}

{% if decision.get('Message Code') %} MSG: {{ decision['Message Code'] }} {% endif %} {% if not is_approved and decision.get('Rejection Code') %} {{ decision['Rejection Code'] }} {% elif is_approved %} Approved {% endif %}

{% if decision.get('Provider Message') or decision.get('Justification') %}

{{ decision.get('Provider Message', decision.get('Justification', 'No message available')) }}

{% endif %}

{% endfor %} {% if ui_output_8 | length == 0 %}

No provider response messages available

{% endif %}

Generated:

{% if metrics and metrics is mapping %}

TAT: {% if metrics.tat_seconds is defined and metrics.tat_seconds != 'N/A' and metrics.tat_seconds is not none %}{{ metrics.tat_seconds }}s{% elif metrics.elapsed_s is defined and metrics.elapsed_s != 'N/A' and metrics.elapsed_s is not none %}{{ metrics.elapsed_s }}s{% else %}N/A{% endif %}

LLM Calls: {% if metrics.llm_calls is defined and metrics.llm_calls is not none %}{{ metrics.llm_calls }}{% else %}N/A{% endif %}

Services: {% if metrics.services_processed is defined and metrics.services_processed is not none %}{{ metrics.services_processed }}{% else %}N/A{% endif %}

Provider: {% if metrics.llm_provider is defined and metrics.llm_provider is not none and metrics.llm_provider != 'N/A' %}{{ metrics.llm_provider | upper }}{% else %}N/A{% endif %}

{% endif %}