Benefit Rule Coverage Share Tool

Description

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.

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.

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.

When to use this tool

Use Benefit Rule Coverage Share when you need one documented policy-record or indicator component.

How to use the tool and how it works

Enter ruleIds, applicable, evidencePresent, evidenceCurrent. 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 applicableRules, coveredRules, share, defined. Inspect defined before interpreting the associated values.

Require aligned ruleIds and applicability and evidence flags. 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.^[1]

Input field	Meaning and units	Accepted input
ruleIds	Rule Ids	Required. Array of text; maximum UTF-16 length 8192; maximum items 256.
applicable	Applicable	Required. Array of boolean; maximum items 256.
evidencePresent	Evidence Present	Required. Array of boolean; maximum items 256.
evidenceCurrent	Evidence Current	Required. Array of boolean; maximum items 256.

Output field	Interpretation	Returned shape
applicableRules	Applicable Rules	Required. Safe integer.
coveredRules	Covered Rules	Required. Safe integer.
share	Dimensionless share under the stated denominator and exclusion convention.	Required. Finite number.
defined	Whether the associated ratio has its required denominator; inspect before using a zero placeholder.	Required. Boolean.

json

{
  "input": {
    "ruleIds": [
      "a",
      "b"
    ],
    "applicable": [
      true,
      true
    ],
    "evidencePresent": [
      true,
      true
    ],
    "evidenceCurrent": [
      true,
      false
    ]
  },
  "output": {
    "applicableRules": 2,
    "coveredRules": 1,
    "share": 0.5,
    "defined": true
  }
}

Limitations and assumptions

One supported duplicate row can cover an ID with other unsupported rows; flags are supplied and coverage of evidence does not establish legal entitlement or rule satisfaction.
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-rule-coverage-share — tool.io

Similar or alternative tools

Benefit Package Exclusion Token Pair
Compare serviceCode with included and excluded lists literally.
Study Description Support Share
Count required fields with both support flags, divide by requiredFields, or return zero with defined false for no requirements.