EddieGalelwa/sha-claim-guard

SHA Claim Guard - Kenya Social Health Authority Claim Pre-Validation System # SHA Claim Guard **Production-ready claim validation system for Kenyan hospitals submitting to SHA (Social Health Authority).** ## Features - **OCR Scanner** - Extract text from claim forms (JPG, PNG, PDF) - **Dynamic Document Uploads** - Required documents appear automatically based on service type - **Field Validator** - 10 real validation rules (Patient ID, KMPDB, ICD-10, dates, amounts) - **Tariff Checker** - Compare billed amount against SHA limits with copay calculation - **Rejection Predictor** - 0-100% weighted scoring with color-coded results - **Hospital Dashboard** - Claim history, analytics, tariff/ICD-10 management - **Admin Panel** - System-wide analytics, hospital management, CSV export ## Quick Start ```bash # 1. Setup python -m venv venv venv\Scripts\activate # Windows source venv/bin/activate # Mac/Linux # 2. Install pip install -r requirements.txt # 3. Initialize database python init_db.py # 4. Load data python load_tariffs.py # 5. Run streamlit run sha_claim_guard.py ``` ## Default Logins | Role | Username | Password | |------|----------|----------| | Admin | `ADMIN` | `eddie2026` | | Hospital | `Nairobi General Hospital` | `nairobi123` | | Hospital | `Mombasa Coast Hospital` | `mombasa123` | ## Document Upload Feature When you select service codes in the Claim Validator, the system automatically detects the service categories and displays file uploaders for required documents: - **Imaging** → Imaging Request + Radiologist Report - **Surgery** → Consent Form + Operative Notes + Histology - **Lab** → Test Request + Test Results - **Maternity** → Antenatal Card + Delivery Notes - **Inpatient** → Admission Notes + Discharge Summary + Lab Reports - **Outpatient** → ID Copy + Prescription All documents are saved with the claim and checked during validation. ## Tech Stack - Streamlit (UI) - SQLite (Database) - EasyOCR (Document scanning) - Plotly (Charts) - bcrypt (Security) ## Offline-First No external APIs required. Works comple …