Projects

Consumer Medical AI  Features

This project aims to build a fully open‑source, privacy‑respecting AI system that empowers patients, caregivers, and advocates to understand, verify, and challenge medical billing errors. The platform combines document intelligence, policy analysis, and automated drafting tools to bring transparency and fairness to an often‑opaque healthcare billing ecosystem.

Core Capabilities

1. Automated Interpretation of Scanned Medical Bills

• Uses open‑source OCR and document‑understanding models to extract line‑item charges, CPT/HCPCS codes, provider details, and billing totals from scanned or photographed medical bills.
• Applies AI‑driven normalization to correct OCR errors, detect missing fields, and standardize terminology for downstream analysis.

2. Cross‑Referencing Procedures Against Insurance Policies

• Parses insurance policy documents, EOBs, and coverage summaries to identify what should be covered, partially covered, or excluded.
• Matches billed procedures against policy rules, coverage limits, and negotiated rates to determine whether charges align with the user’s insurance plan.

3. Detection of Inconsistencies and Price‑Gouging Patterns

• Flags duplicate charges, unbundled procedures, upcoding, and unexplained price fluctuations.
• Compares billed amounts to regional benchmarks, Medicare reference rates, and historical pricing data to highlight potential overbilling or predatory pricing.

4. Automated Generation of Appeals and Legal Inquiry Letters

• Produces well‑structured, customizable insurance appeal letters citing relevant policy language, billing discrepancies, and regulatory protections.
• Generates formal inquiries for legal or compliance review, helping users escalate disputes when necessary.

Impact & Vision

By leveraging open‑source AI, this project democratizes access to tools typically reserved for billing specialists and legal professionals. It reduces administrative burden, increases billing accuracy, and empowers individuals to challenge unfair charges with confidence. The long‑term vision is a transparent, patient‑centric ecosystem where medical billing is understandable, verifiable, and accountable.