ClaimAi

Intelligent ICD-10 coding assistant for South African medical schemes

ClaimAi – The Intelligent ICD-10 Coding Assistant for South African Medical Billers Stop Claim Rejections Before They Happen Medical billing is complex, time-sensitive, and unforgiving. A single coding error can delay payments, trigger compliance flags, or result in a flat-out rejection. For South African billers navigating ICD-10, PMB regulations, and scheme-specific rules, the margin for error is razor-thin. ClaimAi is a privacy-first Chrome extension that sits inside your existing billing software (including iHealth, GoodX, and other web-based PMAs) and validates ICD-10 codes in real-time—before they cause a rejection. The Real Cost of Coding Errors Medical claim rejections are not just frustrating—they are expensive. Each rejection requires manual review, correction, and resubmission, wasting 15 to 30 minutes of biller time per error. Incorrect codes can delay payments by weeks or months, affecting practice cash flow. The South African ICD-10 system contains over 70,000 diagnosis codes and the most common errors happen with simple variations like confusing a planned C-section with an emergency one. PMB (Prescribed Minimum Benefit) codes are often missed or misapplied, leading to automatic rejection by schemes like Discovery or Bonitas. Scheme-specific rules such as dependent code validation and format requirements add another layer of complexity that manual processes often miss. ClaimAi catches these errors at the point of entry, reducing rejections and freeing up your team to focus on high-value work. How ClaimAi Works ClaimAi integrates seamlessly into your existing workflow. No new software to learn, no complex configuration. Real-Time ICD-10 Validation As you type a code into any input field, ClaimAi instantly validates it against the full, up-to-date ICD-10 database with over 70,000 codes. A floating badge appears, green for valid, yellow for warning, red for invalid. PMB (Prescribed Minimum Benefit) Detection Automatically flags codes that fall under PMB regulations, helping you ensure compliance and avoid rejections from medical schemes. Dagger and Asterisk Code Pairing Solves the specific problem of paired codes like detecting when a procedure code requires a specific diagnosis code, such as emergency versus planned C-section. ClaimAi suggests the correct pair and warns you before you submit. Age and Gender Validation Catches demographic mismatches. For example, ClaimAi will warn you if a code typical for female patients is entered for a male patient, or if a procedure is inappropriate for the patient's age. Injury External Cause Code Recommendations When you enter an injury code (S/T codes), ClaimAi automatically recommends the appropriate external cause codes (Chapter XX) to complete the claim, ensuring you do not miss a required element. Smart Code Normalization Handles variations like E119 to E11.9, M01.1 to M01.10, reducing manual formatting errors and ensuring your codes are always in the correct format. Right-Click Lookup and Side Panel Highlight any text on any page, right-click, and select Lookup in ClaimAi. The side panel opens instantly with code suggestions and descriptions. No alt-tabbing, no lost context. Privacy-First Telemetry All data stays local. The optional, anonymized telemetry helps improve the extension and is opt-in only. No patient data ever leaves your machine. Why ClaimAi is Different 100 Percent Offline and Private Unlike cloud-based AI tools, ClaimAi runs entirely in your browser. No data is sent to external servers, no clinical notes are uploaded, and no third party can access your claims. This makes it POPIA-compliant and safe for patient data. Purpose-Built for South Africa ClaimAi is not a generic international tool. It is built specifically for the South African medical billing landscape, with ICD-10 codes used in SA, SA-specific PMB rules, and support for local billing platforms including iHealth and GoodX. Affordable and Transparent ClaimAi is priced at R1,499 per practice per month, a fraction of the cost of hiring a full-time coder or absorbing the cost of rejections. No hidden fees, no percentage-based charges. Designed for Real Workflows Built with direct feedback from South African medical billers, ClaimAi solves the problems they actually face, like catching the C-section code mix-up, validating dependent codes, and flagging missing PMB codes. Who Should Use ClaimAi Medical billing companies handling thousands of claims across multiple schemes. Practice managers looking to reduce rejections and improve team efficiency. Individual coders who want to work faster and with fewer errors. Specialist practices such as optometry, ophthalmology, and general surgery with high volumes of ICD-10 claims. Any SA healthcare practice using iHealth, GoodX, or any web-based PMA. Install in Seconds, No IT Required ClaimAi is a Chrome extension. No installation on your desktop, no server setup, no API integration. Install the extension from the Chrome Web Store. Grant optional permissions if you choose to enable telemetry. Open iHealth, GoodX, or your billing platform. Start validating codes immediately. Get Started Today Medical billing is too important to leave to guesswork. With ClaimAi, you get instant validation, real-time feedback, and the confidence that your claims are accurate before they are submitted. Try ClaimAi free for 14 days. No commitment, no hidden fees. Features ICD-10 Validation: 70,000 plus codes, instant badge feedback PMB Detection: Flags Prescribed Minimum Benefit codes Dagger/Asterisk Pairing: Catches procedure-diagnosis mismatches Age and Gender Validation: Demographic mismatch warnings External Cause Codes: Recommends Chapter XX codes for injury claims Smart Normalization: Handles E119 to E11.9, M01.1 to M01.10 Right-Click Lookup: Highlight text, Lookup in ClaimAi Live Side Panel: Persistent assistant alongside your workflow Privacy Dashboard: View your telemetry data inside the extension Offline Mode: Works without an internet connection POPIA Compliant: No patient data leaves your machine Technical Requirements Browser: Google Chrome (latest version) Operating System: Windows, macOS, Linux Access: Works on any Chrome-based billing platform Internet: Not required after installation Privacy and Compliance ClaimAi is built with privacy-first design and is fully compliant with South African privacy regulations (POPIA). We never collect or store patient names, ID numbers, or contact details. We never collect or store clinical notes or medical history. We never collect or store medical aid numbers or scheme details. We never collect or store browsing history outside medical billing sites. All processing happens on your device. No data leaves your machine. Support For questions, feedback, or support, contact tshepangnduna03@gmail.com GitHub: https://github.com/TNduna/ClaimAi Privacy Policy: https://gist.githubusercontent.com/TNduna/e4848b586b6877cf7a76b46329c03a58/raw/327abbaa09437b2541b8b95a2548c290b5d6fe1a/claimai-privacy-policy.md ClaimAi – Smart Coding, Fewer Rejections.