Claims
Submit, track, and reconcile claims across HMOs and providers. Each claim is scored at intake.
POST /v1/claims
Submit a claim with policy_id, provider_id, encounter details, and amount. Returns claim_id, fraud_score, and eligibility_confidence.
Adjudication updates
Listen for claim.adjudicated and claim.paid via webhooks. Status transitions are idempotent and replayable.