claim-processing

Here are 5 public repositories matching this topic...

HuzaifaAIDev / AI-Medical-Claim-Summary-Generator

AI-powered medical claim summary generator using FastAPI, React, PaddleOCR/Tesseract OCR, and the Groq API to analyze medical documents and generate professional claim reports.

Updated Jul 28, 2026
Python

Joya15 / oshc-insurance-claim-jdm-rules

Star

Business-rule OSHC insurance claim decision model using GoRules/JDM decision tables and a Python reference simulator.

python insurance health-insurance rules-engine business-rules decision-tables jdm claim-processing gorules

Updated Jun 20, 2026
Python

lp07 / 835-837-Remittance-Reconciliation-Pipeline

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Two-tier Python matching engine parsing raw 837/835 EDI files, auto-classifying payments into 6 categories and surfacing $430K+ revenue at risk across 1,200+ claims.

python healthcare claim-processing revenue-cycle-management denial-management healthcare-data-engineering edi-837 edi-835

Updated Apr 14, 2026
Python

lp07 / intelligent-claim-routing-engine

Star

Multi-factor denial risk scoring and queue assignment engine for healthcare RCM operations. Routes 1,200+ claims across 5 operational queues using a 7-factor weighted model.

python healthcare claim-processing revenue-cycle-management denial-management healthcare-data-engineering edi-837 edi-835

Updated Apr 14, 2026
Python

shilpamusale / claim-triage-ai

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An end-to-end ML system to automate Revenue Cycle Management (RCM) by predicting claim denials, analyzing root causes, and optimizing resolution workflows.

python machine-learning clustering xgboost mlops fastapi healthcare-ai claim-processing claim-denial revenue-cycle-management

Updated Oct 5, 2025
Python

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