Rules & Contracts: review, sign-off, override

A contract is the PDF document a payer sends you that describes the per-member-per-month rates, the billable-day rules, and the special conditions (retroactive windows, termination handling, combined-benefit suffixes). A rule configuration is the structured representation of that contract that Rendum uses to decide who is billable and at what rate.

1. Uploading a contract

From the Contracts screen, choose the target payer and click Upload Contract. Acceptable formats: PDF up to 50 MB. Scanned PDFs are supported — Rendum runs OCR server-side.

2. What Layer 0 does

The AI pipeline stages:

1. PDF preflight — structural parse, page count, OCR if needed.
2. Rule extraction — an AI agent reads the contract and proposes a structured rule configuration.
3. Dual-pass validation — a second pass re-extracts independently. Fields that disagree are flagged for higher review.
4. Confidence scoring — each field receives a confidence tier: AUTO_ACCEPT, NEEDS_REVIEW, MANDATORY_REVIEW, HUMAN_REQUIRED.
5. Citation correlation — each extracted field is linked to the PDF region that supports it.

3. Reviewing

Open the contract. The review drawer has two panels: the PDF on the left with citation regions highlighted; the proposed rule configuration on the right with confidence-tier badges per field.

• 🟢 AUTO_ACCEPT — no reviewer attention required.
• 🟡 NEEDS_REVIEW — moderate confidence; glance and confirm.
• 🟠 MANDATORY_REVIEW — must explicitly accept or override before sign-off.
• 🔴 HUMAN_REQUIRED — could not extract; supply the value manually.

Every override writes an audit row tagged RULE_FIELD_OVERRIDE capturing the original agent value, your override value, your identity, and the timestamp.

4. Signing off

When every field is at AUTO_ACCEPT or has been overridden, the Sign Off button activates. Signing off:

• Marks the rule configuration as the active rule for the payer.
• Auto-deactivates the prior active rule for the same payer (visible UX toast).
• Writes a RULE_SIGN_OFF audit row.
• Triggers a recalculation of the current month's projected revenue.
• Triggers the rule-drift detector to flag unexpected deltas vs the prior rule.

5. Amendments mid-quarter

Upload the amended contract; Layer 0 extracts. Before sign-off, the amendment-simulator shows the dollar impact of the amendment on the current month's projected charges. Sign off when satisfied — the new rule becomes active, the old auto-deactivates.

6. Mid-cycle rule overrides

For targeted changes without a re-upload, OWNER and ADMIN can apply:

• Per-member rate adjustments (one cycle)
• Per-member billable-day overrides
• Per-billing-run retroactive corrections

Each override writes an audit row and is reflected in the decision-replay trace.

Audit footprint

• CONTRACT_UPLOADED
• RULE_EXTRACTION_COMPLETED
• RULE_FIELD_OVERRIDE (per manual override)
• RULE_SIGN_OFF (with sign-off note)
• RULE_AMENDED (with delta summary)
• RULE_OVERRIDE_APPLIED (mid-cycle overrides)
• RULE_REACTIVATED

Permissions

• Upload contract: OWNER, ADMIN, BILLING_MANAGER
• Review + override fields: OWNER, ADMIN
• Sign off: OWNER, ADMIN (BILLING_MANAGER can review but not sign off)
• Apply mid-cycle override: OWNER, ADMIN only
• View rules + history: every role