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AlalayClaims Copilot
●  Concept demo

What case can I help you review?

Demo data only
Do not enter real patient information
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Here’s an initial preflightBased on the case details provided
PatientSenior citizen · Principal member
FacilityAccredited ambulatory surgical clinic
Likely packageCataract surgery package
Initial assessmentPotentially covered, subject to eligibility and package rules
Important: This is a preliminary administrative review. Final eligibility and payment remain subject to PhilHealth validation and the complete clinical record.

Items to verify before submission

  1. 1Confirm the facility and attending ophthalmologist are accredited on the procedure date.
  2. 2Verify laterality and diagnosis are consistent across the operative record and claim forms.
  3. 3Confirm the member has no overlapping cataract claim within the applicable package period.