From 191bd76db2560d5c2d353728b9d7367790545e78 Mon Sep 17 00:00:00 2001 From: pyr0ball Date: Mon, 11 May 2026 06:24:04 -0700 Subject: [PATCH] docs: initial product stub --- PRIVACY.md | 7 +++++++ README.md | 35 +++++++++++++++++++++++++++++++++-- 2 files changed, 40 insertions(+), 2 deletions(-) create mode 100644 PRIVACY.md diff --git a/PRIVACY.md b/PRIVACY.md new file mode 100644 index 0000000..afc7b9f --- /dev/null +++ b/PRIVACY.md @@ -0,0 +1,7 @@ +# Privacy Policy + +CircuitForge LLC's privacy policy applies to this product and is published at: + +**** + +Last reviewed: March 2026. diff --git a/README.md b/README.md index 817e2e2..fa7eba1 100644 --- a/README.md +++ b/README.md @@ -1,3 +1,34 @@ -# harrier +# Rufous — Insurance Navigation -harrier by Circuit Forge LLC — Insurance — prior auth, claim disputes, EOB reconciliation, appeals \ No newline at end of file +> *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).