# Build a Claims Specification Prompt

Use only with a source-specific data dictionary, approved protocol/SAP material, and a human data owner. Do not upload patient-level or confidential raw claims.

```text
Create a claims implementation worksheet using assets/claims-implementation-worksheet.md.

Inputs:
- Protocol/SAP TRACE-IDs: [enter]
- Data dictionary and release information: [enter]
- Available enrollment, pharmacy, medical, death, and linkage fields: [enter]
- Existing code-list repositories / validation evidence: [enter]

Instructions:
1. Build MAP-ID, OBS-ID, CODE-ID, DATE-ID, DATA-ID, EXP-ID, OUT-ID, CENS-ID, and QA-ID records.
2. Map only fields present in the dictionary. Mark unavailable fields and capture
   gaps explicitly; do not infer completeness.
3. Distinguish paid, rejected, reversed, duplicate, and resubmitted transactions
   according to the data holder’s documentation.
4. Leave overlap, stockpiling, grace, runout, switching, and restart rules
   Unresolved until an approved strategy is supplied. Do not assume stockpiling.
5. State inpatient/outpatient date semantics and roll-up logic.
6. Register code-list terminology/release, provenance, approval, and endpoint
   validation evidence. If validation is absent, state that it is absent.
7. Add synthetic QA cases with expected results only where an algorithm is selected;
   where unresolved, describe conditional expected results instead.
8. Output the worksheet, an unresolved-decision register, and a programmer handoff
   keyed by stable IDs.
```