maria ysa_2026030312001136.pdf (+1 evidence)

[{"type": "invoice", "page_start": 0, "page_end": 0, "description": "Pharmacy invoice and insurance authorization receipt from Farma Ole"}, {"type": "prescription", "page_start": 1, "page_end": 1, "description": "Medical prescription for Betauno and Coralat from Asociación Dominicana de Cardiología"}]

{"verdict": "approved", "confidence": 0.99, "summary": "Excellent claim documentation. Financial amounts reconcile perfectly with no ITBIS discrepancies. The medical prescription is valid, properly stamped, and matches the dispensed medications. ARS authorization is present and valid.", "checks": [{"name": "RNC Validation", "status": "pass", "detail": "RNC 132125509 is present and has the valid 9-digit format.", "reasoning": "Extracted RNC 132125509 from the FARMA OLE header. Counted 9 digits, which is the standard format for corporate taxpayers in the DR."}, {"name": "NCF Validation", "status": "pass", "detail": "NCF B0201356293 is present and valid.", "reasoning": "Extracted NCF B0201356293 from the receipt. The 'B02' prefix correctly identifies it as a 'Factura para Consumidor Final' (Consumer Invoice) and is followed by the correct number of digits."}, {"name": "Date Verification", "status": "pass", "detail": "All dates are consistent and prior to 2026-03-13.", "reasoning": "Prescription date is 2026-01-09. Dispensation/Invoice date is 2026-01-13. Both are before the audit date of 2026-03-13. The dispensation occurred 4 days after the prescription, well within the 15-day legal limit set by Decreto 665-12."}, {"name": "Amounts, Copay & ITBIS Reconciliation", "status": "pass", "detail": "Receipt and voucher amounts match exactly. No ITBIS applied.", "reasoning": "Step A: Extracted from receipt -> Subtotal: 1396.54, ITBIS: 0.00, Total: 1396.54, Patient Paid (Tarjeta): 418.96, Insurance Paid (Otros 1): 977.58. Extracted from voucher -> Total Reclamado: 1396.54, Seguro Cubre: 977.58, Pago Afiliado: 418.96. Step B: Receipt items (832.00 + 564.54) sum exactly to 1396.54. Step C: Voucher total (1396.54) exactly matches receipt total (1396.54). Voucher copay (418.96) exactly matches receipt patient payment (418.96). Step D: ITBIS is 0.00, which is correct as medications are marked 'E' (Exento) on the receipt. Step E: Perfect reconciliation."}, {"name": "Provider Informat

{"verdict": "needs_review", "confidence": 0.95, "summary": "Financial amounts and identification details match perfectly between the receipt and the authorization voucher. However, the required medical prescription (receta médica) is missing, which poses a high risk of administrative rejection (glosa) by the ARS.", "checks": [{"name": "RNC Validation", "status": "pass", "detail": "RNC 132125509 is present and valid.", "reasoning": "Extracted RNC 132125509 from the header. It is exactly 9 digits, which is the standard format for corporate taxpayers in the Dominican Republic."}, {"name": "NCF Validation", "status": "warning", "detail": "NCF B0201356293 is validly formatted but is for 'Consumidor Final' (B02).", "reasoning": "The NCF is listed as 00000000B0201356293 (padded). B0201356293 is a valid 11-character format. However, B02 is 'Factura para Consumidor Final'. ARS typically require 'Factura de Crédito Fiscal' (B01) to deduct the expense. This might be acceptable if the pharmacy submits a consolidated B01 invoice to the ARS later, but stands as a documentation warning."}, {"name": "Date Verification", "status": "pass", "detail": "All dates are 2026-01-13, which is prior to the audit date of 2026-03-13.", "reasoning": "Receipt date is 13/01/2026. Voucher date is 13 de Enero del 2026. Both match and are strictly before the current date (2026-03-13)."}, {"name": "Amounts, Copay & ITBIS Reconciliation", "status": "pass", "detail": "All amounts reconcile perfectly without ITBIS.", "reasoning": "Step A: Extracted amounts. Receipt: Subtotal=1,396.54, ITBIS=0.00, Total=1,396.54, Tarjeta (Copay)=418.96, Crédito (Seguro)=977.58. Voucher: Monto Reclamado=1,396.54, Pago afiliado=418.96, Seguro Cubre=977.58. Step B: Internal consistency. Receipt items (832.00 + 564.54) = 1,396.54. Subtotal + ITBIS = 1,396.54. Voucher items copay (249.60 + 169.36) = 418.96. Voucher items coverage (582.40 + 395.18) = 977.58. Step C: Cross-document. Receipt Total (1,396.54) = Voucher Total (1,39

{"verdict": "incomplete", "confidence": 0.95, "summary": "The submission consists solely of a medical prescription. It lacks the required fiscal invoice (NCF) and insurance authorization voucher necessary for factoring. Furthermore, the prescription itself is non-compliant with Decreto 665-12 due to missing patient identification (Cedula/NSS), missing diagnosis, and an incomplete date.", "checks": [{"name": "RNC (Registro Nacional de Contribuyentes)", "status": "pass", "detail": "RNC 4-30-12216-5 found on the institutional stamp.", "reasoning": "Extracted RNC 4-30-12216-5 from the blue stamp of 'ASOCIACION INSTITUTO DOMINICANO DE CARDIOLOGIA INC.'. Removing hyphens gives 430122165, which is a valid 9-digit format."}, {"name": "NCF (Número de Comprobante Fiscal)", "status": "fail", "detail": "No fiscal invoice provided.", "reasoning": "The document is only a medical prescription. No invoice with an NCF was included in the submission, which is mandatory for reimbursement and factoring."}, {"name": "Dates", "status": "fail", "detail": "Incomplete date on prescription.", "reasoning": "The date field at the bottom reads '9 / / 2026'. The month is missing, making the date invalid and unverifiable against the 2026-03-13 threshold or the 15-day dispensation window."}, {"name": "Amounts, copay & ITBIS reconciliation", "status": "not_applicable", "detail": "No financial documents provided.", "reasoning": "Cannot perform financial reconciliation because no invoice or authorization voucher with monetary amounts was submitted."}, {"name": "Provider info", "status": "pass", "detail": "Provider information is clearly printed in the header.", "reasoning": "Header contains 'ASOCIACIÓN DOMINICANA DE CARDIOLOGÍA (I.D.C.) INC.', address, phone (809 566 2219), and email. This meets the identification requirements for the prescribing institution."}, {"name": "Signatures & stamps", "status": "pass", "detail": "Doctor's signature, doctor's stamp, and institutional stamp are present.", "rea

[{"feature_type": "rubber_stamp", "confidence": 0.95, "description": "Circular blue rubber stamp on the left side, partially overlapping handwriting."}, {"feature_type": "rubber_stamp", "confidence": 0.9, "description": "Rectangular blue rubber stamp on the right side, containing doctor's name and specialty."}, {"feature_type": "signature_handwritten", "confidence": 0.98, "description": "Handwritten signature located above the 'FIRMA' line."}, {"feature_type": "letterhead", "confidence": 0.99, "description": "Printed letterhead at the top with the organization's name, address, and contact information."}, {"feature_type": "logo", "confidence": 0.99, "description": "Logo of the organization in the top left corner within the letterhead."}, {"feature_type": "form_layout", "confidence": 0.95, "description": "Pre-printed form layout with fields for 'NOMBRE', 'FECHA', and 'FIRMA' at the bottom."}, {"feature_type": "handwriting", "confidence": 0.99, "description": "Extensive handwritten text detailing the prescription, patient name, and date."}]

[{"feature_type": "rubber_stamp", "confidence": 0.95, "description": "Circular rubber stamp with text 'FARMA OLE' and 'RNC: 132125509' on the left side."}, {"feature_type": "rubber_stamp", "confidence": 0.95, "description": "Circular rubber stamp with text 'FARMA OLE' and 'RNC: 132125509' on the right side."}, {"feature_type": "signature_handwritten", "confidence": 0.98, "description": "Handwritten signature above 'FIRMA CLIENTE' on the left side."}, {"feature_type": "signature_handwritten", "confidence": 0.98, "description": "Handwritten signature above 'Firma del Afiliado' on the right side."}, {"feature_type": "barcode", "confidence": 0.99, "description": "Barcode located near the bottom left corner."}, {"feature_type": "handwriting", "confidence": 0.9, "description": "Handwritten number '3' near the top left corner."}]