ClaimGuard
CLI Tool
Autonomous medical billing denial prediction agent. Analyzes claims against CMS/NCCI rules to flag risks before submission. 100% local, HIPAA-safe by design.
TypeScript
Bun
SQLite
Claude AI
Medical Billing
CLI
TUI
Open Source
Key Features
- ICD-10 and HCPCS code validation against CMS database
- NCCI procedure-to-procedure edit conflict detection
- Medically unlikely edit (MUE) unit limit enforcement
- Add-on code and modifier validation
- Age/sex demographic appropriateness checks
- 0-100 risk scoring with severity breakdown
- All CMS rules data stored locally in SQLite
- No PHI leaves your environment, HIPAA-safe