ClaimAid

About

## ClaimAid — Judges’ Overview **ClaimAid** is a full-stack clinical billing triage tool for post-acute care facilities. It helps billing teams quickly find which wound-care claims are likely ready to submit, which ones need review, and which ones are missing key documentation. ## Problem Wound-care billing documentation is often scattered across messy EHR records: diagnoses, coverage data, progress notes, structured assessments, and narrative notes. For a Medicare Part B claim to be submitted safely, billers need proof that the patient has an active wound, the wound is described clearly, measurements are documented, and the patient has the right coverage. Manually checking this across hundreds of patients is slow, repetitive, and easy to get wrong. Missing documentation can lead to lost revenue, while submitting unclear claims can create compliance risk. ## What We Built We built ClaimAid to automatically ingest patient records from the mock PointClickCare API, organize the data, analyze wound documentation, and display the results in a clear dashboard. The system: - Pulls patients across multiple facilities - Fetches diagnoses, insurance coverage, progress notes, and wound assessments - Handles API rate limits with retry logic - Stores raw records for auditability - Extracts important fields like patient ID, payer code, note type, and coverage status - Checks wound documentation for measurements, drainage details, note format, and missing or conflicting information - Shows results in a searchable dashboard for billers and judges ## How It Works ClaimAid starts by fetching patient rosters from each facility. For every patient, it pulls related records such as diagnoses, coverage, notes, and wound assessments. Because the mock API can return `429 Too Many Requests`, the backend includes retry logic so the pipeline continues instead of failing. After ingestion, the data is stored in a database with both raw JSON and structured fields. Then ClaimAid analyzes the clinical documentation. It looks for wound measurements like length, width, and depth, drainage descriptions such as light or moderate drainage, and messy data patterns that may require human review. The dashboard turns this into an operational workflow. Users can see total patients processed, Medicare Part B signals, API retry stats, documentation issues, and searchable patient-level details. ## Why It Matters ClaimAid matters because billers should not have to manually read hundreds of EHR notes to decide which claims are safe to submit. The tool saves time, reduces missed reimbursement opportunities, improves auditability, and flags uncertain records before they become compliance problems. ## Demo Notes In the demo, judges can run the pipeline, watch the live ingestion progress, review dashboard metrics, search patients by facility or payer, and open the documentation report to see measurement completeness, drainage detection, note formats, and records needing review. ## Final Summary ClaimAid turns messy wound-care documentation into a clear billing review workflow. It combines reliable ingestion, structured storage, documentation analysis, and a usable dashboard to help post-acute care teams review claims faster and more safely.