docs: initial product stub
This commit is contained in:
parent
37d2009ea9
commit
191bd76db2
2 changed files with 40 additions and 2 deletions
7
PRIVACY.md
Normal file
7
PRIVACY.md
Normal file
|
|
@ -0,0 +1,7 @@
|
|||
# Privacy Policy
|
||||
|
||||
CircuitForge LLC's privacy policy applies to this product and is published at:
|
||||
|
||||
**<https://circuitforge.tech/privacy>**
|
||||
|
||||
Last reviewed: March 2026.
|
||||
35
README.md
35
README.md
|
|
@ -1,3 +1,34 @@
|
|||
# harrier
|
||||
# Rufous — Insurance Navigation
|
||||
|
||||
harrier by Circuit Forge LLC — Insurance — prior auth, claim disputes, EOB reconciliation, appeals
|
||||
> *Part of the Circuit Forge LLC "AI for the tasks you hate most" suite.*
|
||||
|
||||
**Status:** Backlog — not yet started. Peregrine must prove the model first.
|
||||
|
||||
## What it does
|
||||
|
||||
Rufous handles the full insurance fight: prior authorization tracking, claim dispute drafting, EOB (Explanation of Benefits) reconciliation, internal and external appeal letters, and state insurance commissioner complaints.
|
||||
|
||||
## Why it is hard
|
||||
|
||||
Insurance disputes are engineered to be abandoned:
|
||||
- Prior auth processes have no standard timeline or format across insurers
|
||||
- EOBs are intentionally opaque — reconciling them against bills requires expertise
|
||||
- Appeal deadlines are short (30–60 days internal, 4 months external)
|
||||
- The regulatory landscape is complex: state insurance codes, ACA requirements, ERISA for employer plans
|
||||
|
||||
## Core pipeline
|
||||
|
||||
```
|
||||
Log claim / denial / prior auth request
|
||||
→ AI analyzes EOB + denial reason → Drafts appeal with clinical rationale
|
||||
→ Human review + attach supporting docs → Submit appeal
|
||||
→ Track deadline + escalation windows → External appeal / commissioner complaint if needed
|
||||
```
|
||||
|
||||
## Product code (license key)
|
||||
|
||||
`CFG-RFUS-XXXX-XXXX-XXXX`
|
||||
|
||||
## License
|
||||
|
||||
Discovery pipeline: **MIT**. AI assist features: **BSL 1.1** (free for personal non-commercial self-hosting; converts to MIT after 4 years).
|
||||
|
|
|
|||
Loading…
Reference in a new issue