EddieGalelwa/sha-claim-guard
Domaine:
healthcareType de record:
software
Créateur:
Edd
Hôte:
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 …