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CogniBill — AI Medical Billing Dashboard
Healthcare collections automation system for dental clinics.
Problem
A multi-site DSO group had Day Sales Outstanding of 81 days with no visibility into claim aging, denial patterns, or payer-specific performance. Manual Power BI reports were 5 days stale by the time stakeholders saw them.
Architecture & Solution
Event-driven architecture. Nightly cron jobs sync EMR data via REST API into PostgreSQL. Make.com orchestrates SLA tracking and routes exceptions, while the FastAPI backend serves real-time status to the React dashboard.
Data Model
Relational schema mapping patient ledgers to active claims, status events, and assigned billing agents. Uses materialized views for fast performance on complex aging calculations.
Failure Handling & Resilience
Dead-letter queues in Make.com catch API timeouts. Failing sync operations trigger automatic alerts to ensure the dashboard reflects ground truth.
Permissions & Security
Fully HIPAA-aligned workflow. PII/PHI is scrubbed before leaving the secure EMR boundary, and all dashboard access is governed by strict Role-Based Access Control (RBAC).
Implementation Decisions
- DSO reduction from 81 → 22 days via automated claim prioritization
- Compliance-driven workflow restructuring: minimum-necessary access controls per HIPAA
- Power BI dashboards replaced by real-time FastAPI + React dashboard updated on claim event
