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A hospital Information management system to be interfaced with an insurance provider and fraud detection ML algorithm. The insurance providers are cushioned from fraudulent claims as they make commitment to pay legitimate claims on time so that healthcare providers are not crippled.

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K-HIF/HIMS

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🏥 Hospital Information Management System (HIMS)

A comprehensive and modern Hospital Information Management System designed to streamline operations, integrate with insurance providers, and detect fraudulent activities using machine learning.


🚀 Features

  • 🔐 User Authentication: Secure login.
  • 🏥 Patient Management: Registration, record tracking, history, appointments, and discharge summaries
  • 💊 Pharmacy & Inventory: Track medication stock and automate alerts
  • 💼 Billing & Payments: Auto-generate invoices and integrate with payment gateways
  • 🧾 Insurance Integration: Real-time communication with insurance providers for claim processing and validation
  • 🤖 Fraud Detection: Apply machine learning models to detect anomalies in patient records and insurance claims

🧠 Machine Learning Model

A supervised learning model is trained on historical claim data to:

  • Detect patterns associated with fraudulent claims
  • Flag suspicious records in real-time
  • Provide explainable insights using model interpretability techniques

🔗 Insurance Provider Integration

The system is interfaced with an external insurance provider through secure APIs:

  • OAuth2 for secure authentication
  • Claim submission, verification, and status tracking
  • JSON-based data exchange
  • Logs and audit trail for all transactions

🧑‍💻 Tech Stack

Frontend: React.js / Tailwind CSS
Backend: Django Database: PostgreSQL ML Model: TensorFlow
APIs: RESTful APIs with JWTauthentication
Hosting: Github pages (frontend) | Render (backend & ML model)


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A hospital Information management system to be interfaced with an insurance provider and fraud detection ML algorithm. The insurance providers are cushioned from fraudulent claims as they make commitment to pay legitimate claims on time so that healthcare providers are not crippled.

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