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OpenSeva · सेवा — live visit simulation

A patient's journey — booking to payment

Simulation of a longitudinal ambulatory encounter, including clinical documentation, FHIR persistence, multi-claim submission, adjudication, and payment reconciliation.
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Step 0

Ready

Press “Start visit” to run the patient journey.
Choose scenario

What should this visit demonstrate?

Each path uses the same patient journey, but changes the incentive and administrative outcome: prior authorization, claim adjudication, or denial friction.

CS6440 lecture guide

AI for healthcare costs

Thesis: AI does not automatically reduce healthcare costs. It reflects and amplifies the incentive structure into which it is deployed.

ClaimsPrior authorizationFHIRTrust-centered design
Insurance basicsPremiums, cost-sharing, payer reimbursement, and why healthcare is not a normal market.
Claims lifecycleClinical service becomes ICD-10/CPT coding, claim submission, adjudication, EOB, and payment.
Prior authorizationCRD checks whether PA is needed, DTR retrieves payer criteria, and PAS submits the request.
Trust-centered AIGood AI reduces ambiguity upstream instead of accelerating denials and appeals downstream.