Policy Traceability
Connects source passages, extracted requirements, generated rules, and evidence fields.
View in demo : Policy TraceabilityFEATURED APPLICATION
CMS Policy Rule Builder
Generate structured rules from CMS coverage policies, compare independent AI-generated results, and examine differences through traceability and testing.
Engineering challenge
CMS medical policies are complex and written for humans. Translating them into executable rules requires more than extracting text. Generated rules must preserve the intent of the source policy, handle conditions consistently, and support verification when results differ. This demonstration explores those challenges through independent rule generation, structured comparisons, source traceability, and synthetic test execution.
Key capabilities
Generation Comparison
Runs multiple independent generations, compares rule logic, and highlights differences.
View in demo : Generation ComparisonCase Evaluation
Executes saved rules against synthetic test cases and shows results, assertions, and disagreements.
View in demo : Case EvaluationPolicy Change Monitor
Compares saved source revisions and identifies affected rules and tests.
View in demo : Policy Change MonitorDOMAIN EXPERIENCE
15 years engineering
healthcare claims systems.
Experience developing and improving complex software used to process healthcare claims, apply coding and payment rules, and support consistent, reliable adjudication. Work has included application logic, data processing, integration points, testing, and performance investigation.
- Claim intakeReceive records from authorized sources
- Normalize & validateCheck formats, identifiers, and required fields
- Evaluate business rulesApply defined coding and payment edits
- Edit outcomes & exceptionsRecord findings and route review work
- Downstream systemsSend validated outputs through integrations