Detail Portfolio
✕ Tutup
health-informatics·2026-10
SmartClaim — Claim Integrity Before Submission
A claim integrity platform that extracts the contents of an episode file, then checks the consistency of diagnosis, procedures, and financing codes before a claim is submitted.
Tahun
2026-10
Kategori
health-informatics
Status
Spotlight
A rejected claim costs time that cannot be recovered. SmartClaim moves the check to the point before submission: it reads an episode file, classifies its contents, and compares the recorded diagnosis, procedures, and financing codes.
What it does
- Extracts text from PDF and scanned episode files
- Classifies content with AI, backed by a four-layer retrieval store and a rules base
- Queues files as background jobs, so large batches do not block the interface
Findings are presented for human review — the platform flags, it does not silently approve.