Banam Varshini Priyamvada

Smart Health Insurance Claim Guidance and Rejection Prediction System: An Explainable Approach to Preliminary Claim Assessment and Fraud-Risk Analysis

Health insurance claim processing is difficult for both policyholders and administrative teams because a claim outcome depends on many interacting factors, such as policy validity, coverage limits, waiting periods, pre-existing conditions, clinical-code compatibility, documentation completeness, hospital-network status...