LUMEN Pharma Demo@forgehealth/lumen-sdk
AI Claims Fraud DetectionWith Runtime Governance
Flag the fraud. Score the decision. Know it's defensible.
Claims Fraud Detection Use Case
A $47,000 oncology treatment claim is flagged by AI as potentially fraudulent. The model says 91% fraud probability. Should the claim be denied?
📋
Your Claims System
🤖
AI Fraud Model
🛡️
<50ms
👤
Claims Reviewer
Claims-agnostic·No system integration required·Evaluates in <50ms·Audit-ready
72/100REVIEW
🚫 WITHOUT
Governance
Raw AI fraud score goes straight to the denial queue. No bias check. No human review. No appeal pathway.
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🛡️ WITH
LUMEN SDK
AI fraud score evaluated against FDA AI/ML governance. Bias detected. Human review enforced.
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⚖️
Side-by-Side
Same claim, same AI. One governed, one not. See the difference.
Compare →
LUMEN is not a claims system. It's an API middleware SDK embedded by the AI vendor. Your claims platform and reviewer workflow stay untouched.
LUMEN SDK|v1.0.4