> ## Documentation Index
> Fetch the complete documentation index at: https://docs.ospribrain.com/llms.txt
> Use this file to discover all available pages before exploring further.

# ClaimIQ 2

> Forensic medical billing analysis with compliance findings and policy research.

## Overview

ClaimIQ 2 performs forensic analysis of medical billing claims, identifying compliance issues, coding errors, and reimbursement optimization opportunities.

## Workflow

<Steps>
  <Step title="Upload claim package">
    Upload a PDF containing your claim documents:

    * CMS-1500 claim forms
    * EOB/ERA (Explanation of Benefits)
    * Clinical notes
    * Lab results
  </Step>

  <Step title="Optional: Set payer">
    Optionally specify the payer for more accurate policy research.
  </Step>

  <Step title="Analysis runs">
    The pipeline processes your documents:

    1. **Document ingestion** — Files are parsed
    2. **Stage 1 (Vision OCR)** — AI extracts structured data from the documents
    3. **Stage 2 (Analysis)** — AI analyzes coding, compliance, and payer policies
  </Step>

  <Step title="Review report">
    A comprehensive analysis report is generated.
  </Step>
</Steps>

<Note>
  **Alex's screenshot note:** Take a screenshot of the ClaimIQ page showing the upload area and the analysis pipeline progress indicator (Stage 1, Stage 2).
</Note>

## Report Sections

### Executive Summary

High-level paragraph summarizing key issues found and the overall assessment.

### Claim Summary

Service lines table showing:

* CPT code and modifiers
* Billed amount
* Allowed amount
* Paid amount
* CARC / RARC codes
* Disposition (paid, denied, adjusted)

### Clinical Documentation

Extracted clinical details:

* Chief complaint
* History of present illness (HPI)
* Review of systems (ROS)
* Assessment and plan
* Lab results

### Findings

Individual finding cards, each with:

* **Finding description**
* **Compliance risk level** (high, medium, low)
* **Payer policy support** — Relevant policy language
* **Recommendations** — Suggested actions

### Correct Coding

AI-recommended coding:

* ICD-10 diagnosis code recommendations
* CPT code approaches
* Excluded CPTs with rationale

### Policy References

Links to relevant payer policies with:

* Source
* Title
* URL
* Relevance score

### Recommendations

Organized into:

* **Immediate actions** — Fix right now
* **Prospective corrections** — Process improvements
* **Compliance monitoring** — Ongoing checks

### Conclusion

Summary of findings and next steps.

## History

The left panel shows past analyses:

* Patient name
* Payer
* Date of service
* Billed amount
* Number of findings
* Click to reload

## Export

Click **Export** to download the full analysis as JSON.

<Note>
  **Alex's screenshot note:** Take a screenshot of a completed ClaimIQ report showing the Findings section with 2-3 finding cards of different risk levels.
</Note>