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| title: Claim Adjudication Engine | |
| emoji: 🏥 | |
| colorFrom: blue | |
| colorTo: green | |
| sdk: docker | |
| app_port: 7860 | |
| # OPD Claims Adjudication API | |
| FastAPI backend running on Hugging Face Spaces. | |
| # Plum AI Automation Engineer \- Intern Assignment Package | |
| ## 📋 Overview | |
| Welcome\! This package contains everything you need to complete the OPD Claim Adjudication Tool assignment for the AI Automation Engineer intern position at Plum. | |
| ## 📁 Package Contents | |
| assignment\_package/ | |
| │ | |
| ├── README.md \# This file | |
| ├── plum\_intern\_assignment.md \# Main assignment document with requirements | |
| ├── policy\_terms.json \# Insurance policy configuration | |
| ├── adjudication\_rules.md \# Business logic for claim decisions | |
| ├── test\_cases.json \# Test scenarios with expected outputs | |
| └── sample\_documents\_guide.md \# Guide for creating test documents | |
| ## 🎯 Your Mission | |
| Build an AI-powered web application that automates the adjudication (approval/rejection) of OPD insurance claims by: | |
| 1. Processing medical documents (bills, prescriptions) | |
| 2. Extracting relevant information using AI/LLMs | |
| 3. Validating against policy terms | |
| 4. Making intelligent approval/rejection decisions | |
| ## 🚀 Getting Started | |
| ### Step 1: Read the Assignment | |
| Start with `plum_intern_assignment.md` to understand the full requirements and evaluation criteria. | |
| ### Step 2: Understand the Business Logic | |
| - Review `policy_terms.json` to understand coverage limits and exclusions | |
| - Study `adjudication_rules.md` to learn the decision-making process | |
| - Examine `test_cases.json` to see expected behavior | |
| ### Step 3: Set Up Your Development Environment | |
| \# Clone this assignment package | |
| \# Set up your preferred tech stack (React/Next.js \+ Node/Python) | |
| \# Get API keys for LLM services (OpenAI, Claude, or open-source) | |
| ### Step 4: Create Test Documents | |
| Use `sample_documents_guide.md` to understand medical document formats and create mock documents for testing. | |
| ### Step 5: Build Your Solution | |
| Focus on: | |
| - Document upload and processing | |
| - AI-powered data extraction | |
| - Rule engine implementation | |
| - Clean, intuitive UI | |
| - Comprehensive testing | |
| ## 💡 Pro Tips | |
| 1. **Start Simple**: Build a basic working version first, then add advanced features | |
| 2. **Use AI Tools**: We encourage using Cursor, Copilot, or other AI coding assistants | |
| 3. **Document Everything**: Clear documentation shows your thinking process | |
| 4. **Test Thoroughly**: Use all provided test cases and create additional ones | |
| 5. **Ask Early**: If something is unclear, ask within the first 24 hours | |
| ## 📊 Evaluation Focus Areas | |
| - **Core Functionality** (40%): Does it work correctly? | |
| - **AI Integration** (25%): How effectively do you use LLMs? | |
| - **Code Quality** (20%): Is the code clean and maintainable? | |
| - **User Experience** (15%): Is it easy to use? | |
| ## ⏰ Timeline | |
| - **Total Duration**: 2-3 days from receipt | |
| # intern-assignment | |