ACURO / ENGINE READY SYNTHETIC DEMO ENVIRONMENT

Where clinical documentation becomes audit intelligence.

AcuroIndia analyzes the relationship between what is documented, what is coded, and what deserves human attention — finding documentation-to-code mismatches before claims are submitted.

Explore the Engine Run Interactive Audit

Core Architecture EHR Semantic Signal Layer

Audit Paradigm Evidence-Linked Prioritization

Human Governance Full Decision Traceability

AcuroIndia Clinical Documentation Intelligence Visualization

EDITORIAL / FOUNDATION

Healthcare already has the data.

The challenge is understanding the relationships inside it.

01 / INPUT

Clinical Note

Unstructured narratives, subjective histories, objective findings, and provider assessments.

02 / CONTEXT

Clinical Context

Temporal status (active vs historical vs family), negation modifiers, acuity, and laterality.

03 / CODING

Assigned Codes

Pre-bill ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS modifiers.

04 / PROOF

Evidence & Review

Sentence-level proof links, rule confidence metrics, and prioritized human decision actions.

THE INTERVENTION SPACE

AcuroIndia operates in the gap.

Between clinical documentation and final claims generation lies an unaddressed gulf of semantic ambiguity, manual review fatigue, and pre-bill mismatch risk.

SOURCE 01

Clinical Documentation

EHR notes written for patient care, bedside communication, and clinical history — filled with complex shorthand, negation, and temporal subtleties.

ACURO INTELLIGENCE

SOURCE 02

Medical Coding & Claims

Structured code sets (ICD-10, CPT) required by payers — subject to strict coverage determinations, NCCI edits, and audit rules.

ENGINE ARCHITECTURE

The Automated EHR Audit Engine

An 8-layer computational pipeline transforming raw EHR text into auditable, claim-ready intelligence.

LAYER 01

Clinical Documentation

Ingestion of structured and unstructured records across EHR encounters.

LAYER 02

Semantic Understanding

Clinical NLP entity recognition, anatomical resolution, and procedure identification.

LAYER 03

Context Engine

Resolution of temporal status, clinical negation, and rule-out qualifications.

LAYER 04

Code Context

Alignment of pre-bill code candidates with primary and secondary encounter acuity.

LAYER 05

Audit Rules

Deterministic cross-checks against clinical coding guidelines and payer policies.

LAYER 06

Evidence Engine

Sentence-level exact highlight anchoring and bidirectional proof verification.

LAYER 07

Risk Prioritization

Dynamic risk scoring to filter false alarms and focus human reviewer bandwidth.

LAYER 08

Human Review Workflow

Human-in-the-loop decision interface: Accept, Dismiss, or Escalate with full audit logging.

INTERACTIVE VISUALIZATION

System Architecture Map

Click any node below to inspect how data flows through the Acuro intelligence pipeline.

→ → → → →

ACURO / INPUT Formats: Unstructured Text, FHIR Bundles, HL7 CDA

Input: Clinical Narrative & Structured Codes

Unstructured EHR physician notes, discharge summaries, emergency encounters, and assigned pre-bill ICD-10-CM/CPT code sets are ingested for real-time analysis.

SYNTACTIC PARSING

Reading the Note: Document to Signal

How raw narrative text is decomposed into structured semantic tokens and evidence markers.

Emergency Department Encounter Note

Patient: James Anderson | MRN: SYN-882104 | Provider: Dr. Michael Carter

ENC-49102

CHIEF COMPLAINT:

Acute onset right lower quadrant abdominal pain x 14 hours.

PHYSICAL EXAMINATION:

Abdomen is tender with localized guarding in RLQ. Rebound tenderness positive at McBurney's point.

IMAGING & LABS:

Ultrasound confirms non-compressible dilated appendix (7.8mm) consistent with acute appendicitis. WBC: 14.8k.

EXTRACTED CLINICAL ENTITIES

ANATOMICAL LOCATION

Right Lower Quadrant (RLQ)

CLINICAL ACUITY

Acute Onset / Urgent Surgical Indication

CORROBORATING OBJECTIVE PROOF

US Appendix 7.8mm + Elevated WBC (14.8k)

SEMANTIC CONTEXT

A word is not enough.

Clinical language changes meaning depending on context. The engine differentiates active conditions from historical mentions and explicit negations.

CONTEXT DIFFERENTIATION ACTIVE DIAGNOSIS — CODE I10 VALID

Assessment: Patient presents with uncontrolled essential hypertension. Adjusting Lisinopril to 20mg daily.

Condition is evaluated, treated, or managed during current encounter. Direct coding is supported.

NEGATION DETECTION

INPUT TEXT:

"Patient denies chest pain."

NEGATED FINDING

Acuro Audit Intelligence: Syntactic dependency parser identifies negation modifier "denies". Finding is classified as NEGATIVE EVIDENCE. Coding ICD-10 R07.9 is flagged as a direct mismatch.

REPRESENTATION

Code Intelligence Objects

Codes are not flat numbers. Acuro treats each diagnosis and procedure as a rich computational object with verified documentation support.

ICD-10 K35.80 Fully Supported

Unspecified acute appendicitis

Doc Support: Objective Ultrasound Confidence: 98%

ICD-10 I10 Temporal Question

Essential (primary) hypertension

Doc Support: Resolved PMH Only Confidence: 88%

CPT 99285 Complexity Aligned

Emergency department visit, high complexity

Doc Support: Urgent Surgical MDM Confidence: 94%

AUDITABLE OUTPUT

Evidence & Risk Spectrum

Concise, auditable findings backed by traceable sentence-level proof and calibrated risk categorization.

FINDING 0142

Documentation-to-Code Mismatch Detected

94% Confidence

Why this was flagged:

ICD-10 R07.9 (Chest pain) assigned as primary diagnosis, but ROS explicitly documents "Patient explicitly denies chest pain" with normal ECG and cardiac enzymes.

Documentation Evidence:

"Review of Systems: Patient explicitly denies chest pain, pressure, radiation..."

Review Recommendation:

Remove negated code R07.9 and re-index claim under confirmed diagnosis K21.9 (GERD).

RISK CALIBRATION

Multi-Factor Compliance Spectrum

Calculated from evidence strength, code relationship, rule severity, and documentation completeness.

Low Moderate High Critical

Status: Critical Mismatch (92/100)

Requires human coding specialist review prior to claim batch release.

PHILOSOPHY & GOVERNANCE

AI finds the signal. People make the decision.

AcuroIndia provides intelligence and prioritization. Human coding specialists retain complete authority over every billing decision.

STEP 01

Finding Detected

Engine evaluates clinical context against configured rules and surfaces potential discrepancy.

STEP 02

Evidence Inspected

Reviewer jumps directly to highlighted source text in the patient record with full confidence metadata.

STEP 03

Decision Recorded

Specialist accepts recommendation, dismisses false alarm, or escalates with immutable audit trail.

PUT THE ENGINE TO WORK

Experience the Audit Simulation

Explore 4 deterministic synthetic clinical scenarios, inspect interactive findings, and test the human review decision workflow in your browser.

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