Clinical document#8921
Outpatient care
Medical report & treatment record
- Patient
- Demo patient
- Policy
- MED-483921
- Provider
- Partner clinic
- Care type
- Outpatient care
Patient and policy matched
AI Medical Claims
From medical records to
clear claim decisions.
Read the documents. Check the coverage. Connect the decision to your core system — with your team in control.
Claim documents03
KA · EN · RU
Financial document#8921
Treatment invoice
Itemised services & amounts
- Consultation
- 200 ₾
- Diagnostics
- 680 ₾
- Laboratory services
- 360 ₾
- Total billed
- 1,240 ₾
Amounts extracted and reconciled
Supporting document#8921
Prescription record
Supporting evidence for the claim
- Patient
- Demo patient
- Provider
- Partner clinic
- Linked claim
- MC-2024-8921
- Document status
- Verified
Supporting document linked to claim
Structured data extracted
Policy-aware AIYour rules. Every claim.
Your documents. Your infrastructure.
- 01
Read documents
Extract patient, treatment and invoice data
- 02
Check coverage
Apply policy terms, limits and exclusions
- 03
Connect the decision
Write back the result or route to your team
Every decision, traceable
Documents, rules and a full audit trail
Built around your claims process
Medical claims, decided in minutes instead of days
AI Medical Claims receives medical documents, invoices and records, extracts the insured person's data, verifies coverage, makes a reimbursement decision and writes the result straight into your core system.
- Medical records
- Invoices & receipts
- Prescriptions
- Discharge summaries
Capabilities
What's inside
Multi-format intake
Scans, photos, PDFs and structured files in Georgian, English and Russian.
Insured data extraction
Patient identity, policy number, provider, ICD-10 codes and line items.
Policy-aware decisions
Applies coverage rules, limits, waiting periods and exclusions automatically.
Fraud & duplicate checks
Detects re-submitted invoices, inconsistent dates and out-of-network providers.
Human in the loop
Configurable confidence thresholds send uncertain cases to your adjusters.
Full audit trail
Every extracted field and rule is logged for regulators and internal audit.
Integration
Connected to your core system
Connects to your policy administration and claims systems through REST APIs, message queues or file exchange. Decisions, payouts and documents are written back with the original references, so your existing reporting keeps working.
Industries
Where it's used
Book a Demo
See AI Service working on your own claims
In a 30-minute session we walk through the platform, run a few of your anonymised documents through AI Medical Claims and map the integration with your core system.