AI Use case
Automated Claim Reimbursement Assistant
Application: Webapp
AI Frameworks: Google AI Studio, NLP & Machine Learning
AI Category: Document Processing & Validation, Claim Management Automation
AI Platform: Google Cloud Platform (GCP), Google APIs
New Claim Initiation
From the dashboard, users can easily start a new claim by clicking a “New Claim” button. The UI is built using React, offering a smooth and responsive form for entering required details. This step reduces the time and friction typically associated with claim filing.
Document Upload & AI Based Extraction
Users upload relevant documents (e.g., medical bills, prescriptions, receipts). Using Google AI Studio and integrated ML models, the system automatically extracts critical data, such as amount, provider name, and treatment date, validating it against required fields.
Document Upload & AI Based Extraction
Users upload relevant documents (e.g., medical bills, prescriptions, receipts). Using Google AI Studio and integrated ML models, the system automatically extracts critical data, such as amount, provider name, and treatment date, validating it against required fields.
Automated Claim Review & Recommendation
Once documents are uploaded, the AI reviews the completeness and accuracy of the claim. It provides a recommendation status such as “Approved”, “Declined”, or “Needs Review”. The system flags incomplete or mismatched data for manual intervention.
Escalation to Manual Review
In cases where the AI agent is uncertain or detects inconsistencies, the claim is automatically escalated for manual review by the support team. This ensures high accuracy and reduces false approvals or rejections.
Escalation to Manual Review
In cases where the AI agent is uncertain or detects inconsistencies, the claim is automatically escalated for manual review by the support team. This ensures high accuracy and reduces false approvals or rejections.
Real-Time Claim Tracking
Users can track the status and progress of each claim in real time via the dashboard. Visual indicators, statuses, and timestamps are shown. React components update dynamically without needing a page refresh.
AI Assistant Integration
A general-purpose AI assistant is available on the dashboard, powered by NLP. Users can ask questions like “What is the status of my claim?” or “How do I withdraw a claim?” and receive intelligent, contextual responses.
AI Assistant Integration
A general purpose AI assistant is available on the dashboard, powered by NLP. Users can ask questions like “What is the status of my claim?” or “How do I withdraw a claim?” and receive intelligent, contextual responses.
Claim Withdrawal Feature
Users can choose to withdraw any active or pending claims using the “Withdraw” option. The system confirms the action and updates the dashboard accordingly.
Profile and Notification Management
Users can manage personal details such as email, phone number, and payment information. Notification preferences (e.g., SMS, email alerts) can also be customized to ensure timely updates.
Profile and Notification Management
Users can manage personal details such as email, phone number, and payment information. Notification preferences (e.g., SMS, email alerts) can also be customized to ensure timely updates.
Tech Stack & Skills Applied:
React
Google APIs/ AI Studio
Machine learning
Natural Language Processing
