RH
Rebecca Hollis
Clinical Review · Syd Health
Pathway 1 — CAUTI Prevention
Pathway 2 — CLABSI Prevention (sample template)
Claims Analyzed
Dollars Reviewed
Total billed across pathway claims
Cost of Preventable Harm
Attributable to rule violations
SOC Compliance
Claims meeting all standards

Claim Classification

Click a tier or donut segment to filter the claim register below
EGREGIOUS CLAIMS
POTENTIALLY PROBLEMATIC
STANDARD OF CARE FOLLOWED

High Risk Providers

Ranked by computed risk index — click to drill into a provider's claims

Geographic Risk Heat Map

Provider groups by ZIP — tile color reflects violation-dollar intensity (full US bubble map in expansion scope)

Cost of Preventable Harm

Computed by quarter from violation-attributed dollars

Standards of Care Rules

Claim Register

Every classification is a rule-engine output — expand any claim to see the evaluation trace
ClaimProviderService DateDevice DaysKey CodesBilledClassification
Methodology. Cost of preventable harm = event-attributable treatment dollars (CAUTI T83.511A / CLABSI T80.211A following documentation gaps) + unnecessary diagnostic and antibiotic spend + full claim value of device insertions with no valid indication. Provider risk index = tier-weighted violations (Egregious ×3, Potentially Problematic ×1) per 10 claims within the selected pathway. Harm-cost constants are demonstration placeholders pending clinical validation. Synthetic data only — schema matches the ingestion spec so VAULT data drops in without model changes.