सWASTHYA – AI-Powered Medical Insurance Claim Assistant

सWASTHYA is a web-based AI assistant designed to streamline and simplify the post-treatment medical insurance claim process. The platform leverages document automation, AI-driven analysis, and multilingual interaction to ensure an accessible, transparent, and user-friendly experience for patients navigating complex insurance claims.

🧠 Problem Statement

Filing medical insurance claims is often a frustrating process—especially for patients from non-technical, rural, or underserved backgrounds. Many struggle with:

• Unclear documentation requirements
• Language and literacy barriers
• Time-consuming and error-prone manual submissions
• Lack of real-time assistance or status updates

💡 Our Solution

सWASTHYA combines AI automation, OCR technologies, and multilingual support to solve these problems effectively.

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🔧 Features

📄 Document Summarization

• Extracts and simplifies long medical reports
• Highlights key information necessary for claims

🤖 Insurance Advisor

• AI-driven insights to determine claim eligibility
• Personalized advice based on uploaded medical documents

🧾 Auto Document Generator

• Automatically creates professional claim letters, appeals, and emails

💬 Multilingual Patient Chatbot

• Real-time answers to queries
• Supports regional languages for greater accessibility

🔐 Secure Document Storage

• HIPAA-compliant storage of sensitive medical data

📊 Claims Dashboard

• Track status, progress, and timelines of submitted claims
• Visual indicators for pending and completed stages

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⚙️ How It Works

1. Upload Documents
   Upload your medical bills, prescriptions, insurance forms, etc.

2. AI Analysis
   Uses tools like pdfplumber and pytesseract to extract key information.

3. Review & Submit
   View the auto-generated documents and submit your insurance claim.

4. Track Progress
   Use the Claims Dashboard for real-time updates on your claim status.

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🛠️ Tech Stack

• Frontend: HTML, CSS, JavaScript (React or Vanilla)
• Backend: Python (Flask/FastAPI recommended)
• OCR Tools: pdfplumber, pytesseract
• AI & NLP: OpenAI / Hugging Face APIs (for document summarization & chatbot)
• Storage & Hosting: GitHub Pages (static) or AWS/GCP (dynamic)

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🚀 Getting Started

1. Clone the repository:

   git clone https://github.com/nilardri2006/Swasthya.git
   cd Swasthya

2. Install dependencies:

   pip install -r requirements.txt

3. Run locally:

   python app.py

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🧪 Demo

🔗 Live Demo

Explore how the AI advisor works, try out document uploads, and interact with the multilingual chatbot.

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📌 Future Enhancements

• Integration with hospital and insurer APIs for end-to-end automation
• Enhanced chatbot intelligence with context memory
• WhatsApp-based claim updates for rural users
• Speech-to-text document interpretation for illiterate users

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🤝 Contributors

• Nilardri (Frontend & Deployment)
• Shreesh Chakraborty (Project Analyst)
• Ankit Talukder(AI & Backend)
• Rishan Kumar(UI designer & DBMS manager)
• सWASTHYA – Hackathon Project, 2025

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📜 License

This project is licensed under the MIT License – see the LICENSE file for details.