Official Receipt Extraction Agent
Process, verify, and standardize receipts for accurate claims
Description
Challenge:
Claims and reimbursement processes rely on diverse official receipts such as hospital invoices, pharmacy bills, diagnostic reports, or premium receipts. Manual review is slow, prone to errors, and may miss duplicates, alterations, or non-compliant receipts. Inaccurate or fraudulent receipts can delay settlements, increase operational workload, and create compliance risks for insurers. Without automation, insurers face inefficiencies, financial leakage, and inconsistent reporting.
How It Works:
The Official Receipt Extraction Agent uses OCR, handwriting recognition, and contextual analysis to extract structured fields including provider name, receipt/invoice number, date, line items, quantity, amounts, discounts, taxes, and totals. Extracted data is cross-verified against policy coverage, claim records, provider databases, and taxation rules. The agent flags duplicates, inconsistencies, or suspicious alterations for manual review. Standardized JSON outputs ensure smooth downstream integration with claims adjudication, finance, and compliance systems, while maintaining a full audit trail.
Benefits:
Achieves 92–97% accuracy in structured data extraction from receipts
Detects 100% of duplicate submissions using historical claim data
Reduces fraudulent or altered receipt processing by 60–70%
Validates receipts in under 1 minute vs 10–15 minutes manually
Identifies tampered receipts with 80–90% accuracy using forensic tools
Enables faster claims adjudication, improved claimant experience, and compliance adherence
Features
This agent ensures that only authentic, complete, and compliant receipts enter claims and finance workflows, preventing errors, fraud, and settlement delays.
Features & Capabilities:
Document Extraction: OCR and handwriting recognition for PDFs, scanned copies, and handwritten invoices
Field Recognition: Extracts provider name, receipt number, date, line-item description, quantity, amounts, subtotal, discounts, taxes, and totals
Normalization: Standardizes currency, tax, and date formats
Validation: Checks receipt type, totals, duplicates, policy coverage, and provider network compliance
Tax Verification: Cross-checks GST, VAT, and service taxes against official rules Fraud/Tamper Detection: Identifies altered totals, font inconsistencies, and digital tampering
Integration: Outputs structured JSON to claims, finance, and compliance systems
Operating Blueprint
Knowledge Sources:
Official receipt documents (hospital, pharmacy, diagnostic, premium)
Claimant profile and policyholder data
Line-item expense details
Provider and network directories
Taxation repositories (GST, VAT, service taxes)
Fraud and risk databases
Business Rules:
Receipt Type Validation: Only final receipts accepted; temporary or duplicates rejected
Receipt Number Format Check: Must match provider billing formats
Line-Item Consistency Check: Ensure quantity × unit price = total
Duplicate Detection: Compare with prior claims/receipts
Coverage Alignment: Expenses must align with policy limits
Tax Verification: Cross-check with government tax rules
Provider Network Verification: Receipt must be from approved provider
Fraud/Tamper Check: Detect alterations, inconsistencies, or digital tampering
Tool Workflow:
Upload receipt (PDF, image, scanned, or handwritten)
Pre-process: OCR, handwriting recognition, noise reduction
Extract fields: provider, receipt number, date, line items, totals
Normalize formats for currency, tax, and dates
Validate totals, duplicates, coverage, provider, and tax compliance
Flag anomalies for manual review
Generate structured JSON output for downstream systems
Maintain audit logs for compliance and dispute resolution
Badges
Classification
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