Back to the discharge queue
Sunita Desai, claim C-102
What this demo claim shows: Clause C8.2 needs an itemised pharmacy bill. The agent fetches it and finds Rs 690 of non-payable items.
Not run yet
1. Claim file
Synthetic patient and documentsInsurer and policy
Sahyog General Insurance (fictional), Arogya Shield Plus, sum insured Rs 5,00,000
Policy since
2019-07-01
Room
General ward, Rs 4,000 a day for 4 days
Desk note
Family waiting at billing counter
Documents in the file
2. Bill lines and evidence
Not checked yet| Line | Description and code | Amount | Evidence |
|---|---|---|---|
| L1 | General ward, 4 days ROOM-GW | Rs 16,000 | Not checked |
| L2 | Physician visits x4 PRF-VISIT | Rs 3,200 | Not checked |
| L3 | Dengue NS1 + serial platelet counts LAB-NS1-PLT | Rs 4,600 | Not checked |
| L4 | Pharmacy charges (summary) PHA-IP-SUM | Rs 18,450 | Not checked |
3. Policy checks
Deterministic rules engine, not the language modelThe rules run when the agent calls the policy tool. Each result cites the clause it comes from.
4. Agent trace
0 tool callsLLM planner, gpt-4.1-miniThis deployment has a model configured. The language model will choose each tool call; you will see its reasoning notes.
Press Run the agent. Every card is a real tool call with its input and output; nothing is pre-recorded.
7. Messages with the insurer
Hospital and insurer go back and forth here until the claim is approved or rejectedLoading the conversation.