Benefit Package Exclusion Token Pair Tool

Description

Compare serviceCode with included and excluded lists literally.

Health-policy indicators compare supplied populations, procedural clocks, rule evidence, or modeled phase-in schedules. A consistent component does not establish actual access, legal entitlement, program quality, or clinical need.

Compare serviceCode with included and excluded lists literally.

When to use this tool

Use Benefit Package Exclusion Token Pair when you need one documented policy-record or indicator component.

How to use the tool and how it works

Enter serviceCode, included, excluded, exclusionWins. Keep parallel arrays aligned. Use the units and conventions below.
Run the tool. Correct any format, range, or cross-field input error before interpreting the output.
Read included, excluded, conflict, covered. Inspect included, excluded, conflict, covered before interpreting the associated values.

Compare serviceCode with included and excluded lists literally. Return both flags and conflict; apply exclusionWins to coverage when requested.^[1]

Input field	Meaning and units	Accepted input
serviceCode	Service Code	Required. Text; maximum UTF-16 length 8192.
included	Included	Required. Array of text; maximum UTF-16 length 8192; maximum items 256.
excluded	Excluded	Required. Array of text; maximum UTF-16 length 8192; maximum items 256.
exclusionWins	Exclusion Wins	Required. Boolean.

Output field	Interpretation	Returned shape
included	Included	Required. Boolean.
excluded	Excluded	Required. Boolean.
conflict	Conflict	Required. Boolean.
covered	Covered	Required. Boolean.

json

{
  "input": {
    "serviceCode": "A",
    "included": [
      "A",
      "B"
    ],
    "excluded": [
      "A"
    ],
    "exclusionWins": true
  },
  "output": {
    "included": true,
    "excluded": true,
    "conflict": true,
    "covered": false
  }
}

Limitations and assumptions

The conflict flag remains meaningful even when coverage is true under the chosen rule; actual benefits, hierarchy of policy terms, and claim eligibility are not verified.
Inputs must satisfy both the field types and the cross-field conditions above. Invalid input causes an error; a successful false flag or documented placeholder is a different result.

Alternative or Complementary methods

Check authoritative program definitions, source records, and the complete policy evaluation before making an eligibility or service decision.

References

Calculation and input contract: health-policy/benefit-package-exclusion-token-pair — tool.io

Similar or alternative tools

Benefit Rule Coverage Share
Count distinct applicable rule IDs and distinct IDs with at least one applicable row having present, current evidence; divide or return zero with defined false.
Benefit Package Exclusion Base
Validate nonnegative listedCost, excludedCost, priorExclusionCost, and compatible overlappingExclusions.