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--- claim_contract_resolution [2024/10/25 10:42] – tina.robles
+++ claim_contract_resolution [2025/09/18 18:03] (current) – tina.robles
@@ Line 10: / Line 10: @@
   - SAME_CONTRACT_NAME_AS_RESOLVED_LINE
+NOTE:  Any contracts with a type of AUTOPAY will not be part of the auto matching process for claims to contract.
 -----
@@ Line 67: / Line 68: @@
 {{:pasted:20220214-113257.png}}
+-----
+**CONTRACT-TO-CLAIMS MATCHING ENHANCEMENT: Phase 1**
+__Intelligent Scoring Implementation__
+Project Overview
+We are implementing an advanced scoring algorithm for contract-to-claims matching, leveraging the proven methodology from our existing deduction matching system. This enhancement will significantly improve matching accuracy and establish the foundation for future automation capabilities.
+__Key Features & Benefits__
+**Enhanced Decision Intelligence**
+  * Scoring Algorithm: Implementation of a sophisticated scoring system that evaluates contract-to-claim compatibility
+  * Data-Driven Decisions: Provides quantitative metrics to support optimal contract selection for claim matching
+  * Future Automation Ready: Establishes the scoring framework necessary for automated matching in subsequent phases
+**Improved Search Functionality**
+  * Intelligent Date Range Logic: When accessing claim details via the provided link, the system automatically determines the optimal search parameters
+  * Dynamic Date Calculation:
+  *   * Uses the claim start date as the baseline
+  *   * Extends search period to January of the claim year
+  *   * Includes an additional 12-month lookback period
+  *   * Returns all qualifying contracts within this comprehensive timeframe
+**Technical Implementation**
+  * Search Scope: 24-month maximum search window ensures comprehensive contract coverage
+  * Performance Optimization: Focused date range reduces processing overhead while maintaining thoroughness
+  * User Experience: Seamless integration with existing claim review workflows
+**Expected Outcomes**
+  * Improved matching accuracy through quantitative scoring
+  * Enhanced user confidence in contract selection decisions
+  * Reduced manual review time for obvious matches
+  * Foundation established for Phase 2 automation capabilities
+{{:pasted:20250918-175201.png}}
+{{:pasted:20250918-175229.png}}
+**Scoring Framework Overview**
+The scoring algorithm employs a comprehensive point-based system where each successfully matched field contributes to the overall compatibility score between contracts and claims. The methodology distinguishes between header-level and detail-level matching criteria to ensure accurate assessment across all contract dimensions.
+__Scoring Architecture__
+**Point Allocation System**
+  * Base Scoring: 1 point awarded per successfully matched field
+  * Header-Level Scoring: Binary scoring (0 or 1) for company-level attributes
+  * Detail-Level Scoring: Proportional scoring (0.0 to 1.0) representing percentage match of claim elements against contract definitions
+__Scoring Criteria & Calculations__
+**Header-Level Matches**
+{{:pasted:20250918-175821.png}}
+**Score Interpretation**
+  * Higher Scores: Indicate stronger contract-to-claim compatibility
+  * Composite Scoring: Total score represents cumulative match strength across all evaluated criteria
+  * Decimal Precision: Detail-level scores provide granular matching insights for partial alignments
+**Implementation Roadmap**
+Phase 1: Foundation
+  * Deploy scoring algorithm for manual matching enhancement
+  * Establish baseline scoring metrics and validation
+Phase 2: Analytics & Optimization
+  * Conduct comprehensive analysis of matching outcomes versus scoring patterns
+  * Identify optimal score thresholds for automated decision-making
+  * Validate scoring accuracy through historical data correlation
+Phase 3: Automation
+  * Implement client-configurable score thresholds for automated matching
+  * Deploy intelligent auto-matching capabilities based on validated scoring criteria
+  * Establish monitoring and continuous improvement protocols
+**Expected Benefits**
+  * Enhanced Accuracy: Quantitative scoring reduces subjective matching decisions
+  * Scalability: Systematic approach enables future automation capabilities
+  * Transparency: Clear scoring methodology provides audit trail for matching decisions
+  * Customization: Client-specific thresholds accommodate varying risk tolerances and business requirements
+This scoring methodology establishes a robust foundation for intelligent contract matching while maintaining the flexibility to adapt to diverse client requirements and operational scenarios.
+-----
+__**Splitting Claims**__
+**Invoice Consolidation**
+When multiple records share the same invoice number, the system consolidates them under a single invoice identifier to maintain data integrity and streamline processing.
+**Claim Generation Framework**
+Claims are systematically generated based on the invoice structure and associated contract family relationships.
+__**Contract Family-Based Claim Splitting**__
+**Single Contract Family Scenario**
+**Condition**: All line items within an invoice resolve to the same contract family
+**Result**: One consolidated claim is created for the entire invoice
+**Multiple Contract Family Scenario**
+**Condition**: Line items within an invoice resolve to different contract families
+**Result**: The system creates separate claims for each distinct contract family represented
+__**Line Item Validation Process**__
+Each line item within a generated claim undergoes comprehensive validation based on the following criteria:
+**Contractee Identifier Verification**
+The system validates that the contractee identifier associated with each line item is accurate and properly mapped to the corresponding contract.
+**Eligibility Assessment**
+Each line item is evaluated for eligibility across two primary categories:
+  * SKU-Level Eligibility: Verification that the product/SKU is covered under the applicable contract terms
+  * Lumpsum-Level Eligibility: Confirmation that any lumpsum components are authorized and properly allocated within the contract framework
+**__Processing Workflow Summary__**
+  - Invoice Consolidation: Group records by invoice number under single invoice ID
+  - Contract Family Analysis: Determine contract family associations for all line items
+  - Claim Segmentation: Create claims based on contract family groupings
+  - Line Item Validation: Verify contractee identifiers and eligibility for each claim component

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