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Health Insurance Claim

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Streamline health insurance claims with intelligent document processing. Extract patient information, diagnosis codes, procedure details, and billing data automatically. Reduce processing time and improve claims accuracy.

health-insurance-claim.pdf

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JSON

claim_number

HIC-2024-567890

claim_date

2024-03-01

policy_number

GHP-2024-345678

group_number

CORP-5000

patient_name

Jennifer Martinez

patient_dob

1985-07-22

patient_member_id

JM785522

patient_address

123 Health Ave, Boston, MA 02101

provider_name

Boston Medical Associates

provider_npi

1234567890

provider_tax_id

04-1234567

date_of_service

2024-02-25

place_of_service

Office

diagnosis_codes

J06.9, R05.9

Procedures

2 items

cpt_code

description

charge

99213

Office visit, established patient

150

87880

Strep test

total_charges

195

prior_authorization

N/A

assignment_of_benefits

true

{ "claim_number": "HIC-2024-567890", "claim_date": "2024-03-01", "policy_number": "GHP-2024-345678", "group_number": "CORP-5000", "patient_name": "Jennifer Martinez", "patient_dob": "1985-07-22", "patient_member_id": "JM785522", "patient_address": "123 Health Ave, Boston, MA 02101", "provider_name": "Boston Medical Associates", "provider_npi": "1234567890", "provider_tax_id": "04-1234567", "date_of_service": "2024-02-25", "place_of_service": "Office", "diagnosis_codes": [ "J06.9", "R05.9"], "procedures": [ { "cpt_code": "99213", "description": "Office visit, established patient", "charge": 150 }, { "cpt_code": "87880", "description": "Strep test", "charge": 45 } ], "total_charges": 195, "prior_authorization": "N/A", "assignment_of_benefits": true }