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- # # CMS Coding Changes Mining for RCM 🏥
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- Building a forward-looking analytics platform to anticipate and interpret CMS regulatory changes using Agentic AI and Machine Learning.
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-
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- ## 🚀 Key Features
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-
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- - **Executive Intelligence Scorecard**: Real-time simulation of revenue impact from 250+ CMS rule changes with 12-month projections.
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- - **AI-Driven CDM Auto-Sync**: Batch auditors scan **2,500+ records** in seconds to prevent $2.45M+ in billing denials with automated file persistence and backups.
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- - **Predictive Denial AI**: High-accuracy risk scoring matching legacy billing codes against 2025 "Packaging" rules.
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- - **Advanced Financial Projections**: Full fiscal year impact modeling with automated 'Net Impact' trend analytics.
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- - **Agentic Reasoner**: Optimized 5-agent LangGraph system (Regulatory, Finance, CDI, CDM, Orchestrator) with executive-ready insights.
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- - **Billing-Ready Assets**: One-click, multi-sheet Excel export with full audit trails and data dictionaries.
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-
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- ## 📂 Project Structure
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- - `app.py`: Streamlit frontend with interactive dashboards, simulation lab, and AI advisor.
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- - `ml_engine.py`: Core Intelligence Engine containing Random Forest models, impact simulation logic, and CDM patching automation.
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- - `agent_graph.py`: LangGraph implementation for multi-agent collaborative reasoning.
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- - `data_generator.py`: High-fidelity synthetic data generation for claims, rules, and CDM.
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- - `data/`: Persistent storage for claims, rules, CDM, and FAISS vector index.
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-
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- ## 🛠️ Getting Started
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- 1. **Install dependencies**:
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- ```bash
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- pip install -r requirements.txt
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- ```
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- 2. **Generate base data** (Initializes FAISS index & training datasets):
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- ```bash
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- python data_generator.py
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- ```
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- 3. **Run the application**:
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- ```bash
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- streamlit run app.py
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- ```
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- ## 🧠 AI & Machine Learning Architecture
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- The system utilizes a hybrid AI/ML approach:
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- - **Predictive ML**: Random Forest Classifier for denial risk prediction based on categorical and numerical claim features.
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- - **Agentic AI**: A directed acyclic graph (DAG) of specialized agents exploring regulatory data using RAG (OpenAI + FAISS).
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- - **Automation Engine**: Algorithmic auditing and patching for Chargemaster (CDM) integrity.
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-
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- ---
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-
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- _Temple Health Unified Intelligence Hub | Deployment Edition_
 
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+ ---
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+ title: TemHealth
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+ emoji: 🏥
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+ colorFrom: blue
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+ colorTo: green
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+ sdk: streamlit
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+ sdk_version: "1.32.0"
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+ python_version: "3.10"
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+ app_file: app.py
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+ pinned: false
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+ ---