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💡 How it works: the check is a salted hash of this machine's fingerprint plus your passphrase. Both the right machine and the right passphrase are required going forward — losing either means using "Reset Facility Lock" below to start over.
Clinical claims auditing, vetting and financial recovery — checked line-by-line against the Ghana STG, the NHML price list, WHO AWaRe, and the NHIA G-DRG tariff schedule.
Research, Grants & SeminarsKRGIE tracker plus staff training records
On-device EncryptionNHIS membership numbers never leave this browser
STG 2023BNF 85WHO AWaReNHIA G-DRGNHML
Runs entirely offline in your browser. No patient name is ever recorded — only encrypted NHIS membership numbers.
Sign in to your workspace
Facility account · v8.14
Running in compatibility mode (this browser/page didn't expose Web Crypto — likely because the file was opened directly from disk). Security still works, just a touch slower on sign-in.
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HEALTH INTELLIGENCE PLATFORM v8.14 · NHIS CLAIMS AUDIT · GHANA · BGE · ANALYTICS · TRAINING · SEMINARS · FRONT DESK · VERIFICATION
📁 No batch loaded0 claims0 flags—☁️ Synced: never⚡ Idle—
No file loaded
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Not parsed
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Audit pending
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0 edits
REFERENCE: STG 2023 · BNF 85 · WHO AWaRe 2023 · NHML MAR 2025
I.
Kumani Health Intelligence Platform
Import a facility's CXF, XML or CSV batch to audit diagnoses, prescriptions, and billing against Ghana STG 2023, BNF 85, WHO AWaRe 2023 and the NHIS codebook. Every flagged line can be corrected through a guided editor, then exported back to CXF or XML. Generates Quality Index, Epidemiological Intelligence, Financial Recovery estimates, and a CAPA priority matrix.
01 · FACILITY
Location & Level Upload
Set region, district, facility type, and G-DRG level on import — drives tariff multipliers and district-level epi alerts.
02 · FINANCIAL
NHML Price + Tariff Engine
Compares billed amounts against NHML March 2025 unit prices and NHIA G-DRG tariffs per facility level.
03 · QUALITY
5-Component Quality Index
Weighted score across coding, documentation, prescribing, lab compliance, and admin completeness.
04 · EPI
District-Specific Epi Alerts
IDSR-aligned outbreak alerts named by region and district. Typhoid ≥3% triggers actionable GHS notification.
05 · FIRSTLINE
First-Line Therapy Query
ERR-FIRSTLINE-001 flags when an alternative is used without a documented first-line medicine (Malaria, UTI, HTN, T2DM).
06 · RESEARCH
De-identification Export
Ghana DPA 2012 (Act 843) compliant CSV/JSON export for research submissions — removes all PHI, retains clinical codes.
Parsing file…
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I.
Multi-Facility Batch Import
Each file below is parsed and audited as its own separate batch, saved under whichever facility you assign it to — the same as importing one file at a time, just queued together. A file with no facility assigned is skipped when you process the queue. Suggestions marked "from filename" are a plain text match against your registered facility names/provider IDs, not read from inside the file — Kumani's real CXF/XML schema only carries a facility identifier for a referring facility on referral claims, not the submitting facility, so that tag can't be used to auto-detect whose batch this is.
✓
Report
II.
Facility Registry
Saved to this browser
✕
Register New Facility
Pre-register a facility so its name is ready to select next time you import a batch — no need to wait until import time.
🏥 Identity
⚙ Classification
📍 Location
💰 Claims Volume (feeds the BGE ROI Calculator for this facility)
claims submitted per month
GHS per claim, on average
III.
Facility Comparison
Latest batch per facility
IV.
NHIS Codebook
Medicines · GDRG · Procedures · ICD-10
ICD-10 Coding Guidelines
Manage the advisory companion-code rules shown during claims entry/editing and summarised in the audit report's "Coding Improvement Suggestions" tab. Super Admin only.
📗
Ghana STG 2023Standard Treatment Guidelines
📘
BNF 85British National Formulary
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WHO AWaRe 2023Antimicrobial Stewardship
🏷️
NHIA G-DRGTariffs Operation Manual v22
💊
NHMLMedicines List — dated per import
V.
Audit Rules
Enable or disable individual flag rules
VI.
Cloud Sync
Free WebDAV · no API keys · no subscription
How this works
Everything stays in this browser unless you set up a connection below. WebDAV is a plain HTTPS protocol supported by free providers (e.g. a free InfiniCloud or Nextcloud account) — your browser talks to it directly with a username and password; Kumani Claims never sends data anywhere else, and no Anthropic or third-party API is involved.
WebDAV connection
● Offline
Last sync: never
Local backup (no internet needed)
Download everything as a single JSON file — useful as a backup or to move data to another computer by hand, with no cloud account at all. Includes the FULL claims content of every batch, not just a summary, so restoring on a different browser or PC actually brings the claims with it.
There is no password reset for a backup file — if you forget this passphrase, that backup is permanently unreadable. Write it down somewhere safe, separate from the file itself.
Restoring always asks you to confirm Overwrite / Merge / Append, and a facility-specific backup only ever touches that one facility's data — every other facility saved in this browser stays exactly as it was. An encrypted backup will ask for its passphrase before restoring.
What will sync
Facilities
0
Batches
0
Codebook entries
0
Rules disabled
0
Merge conflicts (all-time)
0
Mutation Ledger
Every create/update/delete in this workspace is appended to an on-device ledger (IndexedDB) with a timestamp and user signature. Use this to audit who changed what, and to detect conflicts when two devices edit the same record before syncing.
Every entry is chained to the one before it with a SHA-256 hash, so an edited, deleted, or hidden entry becomes detectable — click "Verify ledger integrity" to check. This does not stop someone with DevTools access from editing IndexedDB directly; it makes doing so detectable after the fact.
Emergency Recovery
Download a complete point-in-time raw data dump of all IndexedDB stores plus this workspace's localStorage. Use it to restore your entire database after a catastrophic browser storage loss.
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Restore Backup File
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Import & Merge Claims
Combining batches exported from another device. Nothing is saved until you click Apply Merge.
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📋 Coding Guidelines Management
VII.
Claims Retention & Folder Retrieval
36-month active · Legal Hold · Payer Request Mode
Retention Policy (NHIA / Ghana Health Service)
Claims records are kept in active status for 36 months from date of service. After 36 months they are archived (read-only, compressed). A Legal Hold overrides both — records under legal hold are never deleted or archived until the hold is lifted. All access is logged. No patient-identifiable data is included in any export without explicit NHIA authorisation.
Retention Status
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Active (<36 mo)
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Archived (>36 mo)
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Legal Hold
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Total Batches
Retention tracking is based on batches saved in the Facility Registry. Run an audit to register a batch.
Legal Hold Manager
Place a batch on Legal Hold to prevent archiving or deletion pending appeal, litigation, or regulatory review. A hold overrides the 36-month retention rule.
Folder Retrieval Engine
Search saved audit batches by folder number, patient reference, diagnosis, date range, or facility. All results are from the on-device registry — no external lookup.
Payer Request Mode
Generate a complete, export-ready audit package for submission to NHIA or another payer — includes batch summary, all flags, per-claim financial breakdown, and corrective action plan. Requires an active audit batch to be loaded in the Audit tab.
Load an audit batch first, then click to generate.
Data Archiving — Compression (v8.10)
Batches ≥6 months old are eligible for compression (gzip, via the browser's CompressionStream API). Archiving shrinks the on-device storage footprint while keeping the batch searchable and restorable — it does not delete data, and Legal Hold batches are never archived.
Date From/To narrows any report by exact date — including Pharmacy Operations and Inventory reports, which read live POS & stock data and don't require Month/Year/Quarter or a loaded claims batch at all.
Select Primary Audience (controls tone & sections)
🏛️
NHIA / Payer
For submission to the National Health Insurance Authority. Includes flag breakdown, financial adjustments, and CAPA commitments.
✓ SELECTED
📋
Facility Board / Management
Governance-level overview with financial KPIs, Quality Index, benchmarks, and strategic recommendations.
Revenue recovery, claims value reconciliation, commodity working capital, and NHIA payment projection.
✓ SELECTED
📊
Configure & Generate a Report
Select report type, period, audience, and click Generate. Reports draw from all batches saved in the Facility Registry.
ARCH.Archived Reports (0)
Monthly, Annual, and Quarterly reports you archive are saved here for future reference and can be reopened or downloaded at any time. Individual catalog reports are not archived — only the full generated Monthly/Annual/Quarterly document.
KUMANI v7.0 — Golden Principle & Chain of Evidence Framework
Golden Principle: Never assume information that is not available. If information cannot be verified: Never fabricate. Never infer. Never penalise without evidence.
Instead, classify findings as: VERIFIED · NOT VERIFIED · CANNOT VERIFY · REQUIRES SUPPORTING EVIDENCE · REQUIRES FOLDER REVIEW · REQUIRES EMR REVIEW.
KUMANI is a Clinical Claims Intelligence & Evidence Verification Platform — not an EMR and not a point-of-care clinical decision support system.
Every audit finding follows the Chain of Evidence Framework below, ensuring each determination is traceable, reproducible, and defensible.
${[
['1. Observation','What was found in the submitted claim.'],
['2. Evidence Reviewed','Which claim fields or attachments were examined.'],
['3. Evidence Status','Verified / Partially Verified / Cannot Verify / Requires Additional Evidence'],
['4. Applicable Standard','NHIA rule, Ghana STG, formulary, or policy used.'],
['5. Assessment','Interpretation based strictly on available evidence.'],
['6. Recommendation','Approve / Request supporting evidence / Folder review / Reject where policy clearly supports.']
].map(([t,d])=>`
${t}
${d}
`).join('')}
Source: KUMANI Claims v7.0 System Principles — National Clinical Claims Intelligence & Evidence Verification Platform
Upload NHIA Vetting Report
⌗
Drop NHIA Vetting Report Here
XML · CSV · JSON — or click to browse
Paste Claims Vetting Summary Sheet (Any Facility)
Paste the "CLAIMS VETTING SUMMARY SHEET — Out-Patient" text exactly as copied from the NHIA report (Specialty / Attend. / Service / Medicine / Total for Submission, Adjustments, Amt Due, plus the GRAND TOTAL row). Works for any facility — the number and names of specialty rows are read from the pasted text, not fixed to one sample.
📋 Review Vetted Claims
Every reconciliation run below is saved to this workspace, so a claim's vetting outcome stays reviewable after you leave this tab or come back another day — not just immediately after clicking "Reconcile."
APL.
Appeals Management
Track · Adjudicate · Generate Appeal Letters
KUMANI HEALTH INTELLIGENCE PLATFORM
Health Commodity Management Report
⚕
Health Commodity Management
Monthly Report
Report Header
a. DEBTORS
Total (A) = GHS 0.00
b. CASH BOOK BALANCE
c. VALUE OF STOCK
Auto-calculated from the Stock Report below using Moving Average Cost (last 3 purchases); you may override manually.
d. CREDITORS
Total (D) = GHS 0.00
Working Capital (E = A + B + C − D)
GHS 0.00
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STOCK REPORT
Item
Category
Tracer
Closing Stock (Qty)
Latest Unit Cost (GHS)
MAC (3-purchase avg)
Stock Value (GHS)
Date of Expiry
Format: Item, Category, Tracer, Qty, Unit Cost, Expiry
PROCUREMENT PROJECTION — Macro-Economic Engine
PROFIT ANALYSIS
Turnover (NHIS claims received + cash received)
Opening Stock (value of stock at end of previous month)
Cost of purchases made from RMS
Cost of other purchases
Goods available for sale (Opening + Total purchases)
0.00
Closing stock value (from Stock Report above)
0.00
Cost of sales (Goods available − Closing stock)
0.00
Gross Profit (Turnover − Cost of sales)
0.00
Operating Expenditure (salaries, utilities, etc.)
Net Surplus / (Deficit)
0.00
SIGNATORIES
Facility In-Charge
Name: _______________ Signature: _______________
Pharmacist / Disp. Tech
Name: _______________ Signature: _______________
Accountant
Name: _______________ Signature: _______________
Date: _______________
Saved Reports
ENTRY.
NHIS Claims Entry
Manual claim creation — NHIS Tariffs Op. Manual v22 pp. 45–50 · Investigations: pp. 83–88 · v8.6
Access Restricted — You need the Claims Officer or Admin role to create new claims. Contact your workspace administrator.
Sections
1✓
Header
2✓
Client
3✓
Encounter
4✓
Clinical
5✓
Summary
1. Facility & Claim Header
A new code is required for every visit — never re-use the code from a client's previous claim.
2. Client Information
Accuracy rule: All fields must exactly match the physical NHIS ID card held by the patient. Mismatches are a common cause of NHIA vetting rejections.
Selecting a result fills the fields below from their last visit. The Form No. / Claims Code on Step 1 is a new code for this visit — enter it separately.
Recommended for children under 12 — enables exact mg/kg/day dose checking instead of an age-band estimate (ERR-PAED-001).
This platform has no live NHIA membership API — adding one would mean a paid integration this build deliberately avoids. NHIA provides two free USSD services instead: dial *842# from a phone number registered with NHIA under this facility to verify a member's status and generate the Claims Check Code (CCC) needed for submission; or ask the member to dial *929# from their own registered number to self-check or renew their policy. Neither requires airtime or a data connection. Record the result before submission — inactive membership is the leading cause of claim rejection.
3. Services & Encounter Details
🩺 Vitals & Point-of-Care Results (optional — enter only what was actually recorded on the folder)
4. Clinical — Diagnosis & G-DRG (left) · Medicines & Investigations (right)Side-by-side view for faster data entry
Patient Age—
🩺 Diagnosis & G-DRG
Multi-diagnosis support (v8.3): Enter the primary diagnosis first — search by ICD-10 code, description, or plain condition name (e.g. "diarrhoea") in one box. Secondary diagnoses (comorbidities, complications) are added as chips below — each unlocks higher-tier G-DRG payouts when applicable.
Primary Diagnosis
Give a code here and it's matched immediately — if the codebook doesn't have it yet, it's added to the ICD-10 codebook (governed, logged to change history). Leave the code blank to save as free text pending a coder's match later.
Give a code here and it's matched immediately — if the codebook doesn't have it yet, it's added to the ICD-10 codebook (governed, logged to change history). Leave the code blank to save as free text pending a coder's match later.
Procedures (optional)
No procedures added. Click below to add.
📝 SOAP Note (clinical evidence layer — optional, but the primary justification where there is no EMR)
Kumani is not an EMR. In facilities without one, this SOAP note — or the paper folder it's transcribed from — is usually the only clinical evidence behind a claim line. It is never fabricated or auto-filled, and its presence alone is not treated as proof; audit rules only check whether it exists and reference it as supporting context for a human reviewer.
Inserts empty brackets/blanks to complete yourself — never pre-fills a finding. Only touches fields that are currently empty.
📎 Scanned Paper Folder / Clinical Evidence
Photo or scan of the paper folder/SOAP sheet (max 3MB) — the primary evidence behind this claim where there is no EMR.
💊 Medicines (NHML)
How to add a medicine: ① Click + Add Medicine and search/select it from the NHML list. ② The Prescription Details popup opens automatically — enter dose, frequency and duration there (billable quantity is calculated for you). ③ To change dose/frequency/duration later, click ✎ Edit Rx on that row rather than the small inline boxes.
STG Compliance (v8.6): Medicines are validated against Ghana STG 2023 for the entered primary diagnosis on submission. Mismatches surface as advisory flags before saving.
Medicine (NHML)
Form/Strength
Dose
Freq/day
Days
Unit Cost
Qty
Total (GHS)
AWaRe
🧪 Investigations
Investigation Codes (v8.6): Type a code or keyword — all 161 NHIA investigation codes from the Tariffs Operation Manual v22, pp. 83–88 are available as suggestions. Select a code to auto-fill the description.
GHIMS Readiness — checks every facility's latest audited batch for the data-completeness fields NHIA's claims gateway expects before national submission: a populated PhysicianID on every claim, and a default Withholding Tax (WHT) rate applied for corporate/private payer reconciliation.
🔄 Patient Transfer Log — Facility-to-Facility
📞 Communication Log — Facility / Stakeholder Contact
Complete these details before parsing. They are stored with the batch for epidemiological intelligence and tariff calculation.
✕
Set Acting Role
This governs what you can do in this workspace (create/submit claims, audit, approve, manage users, etc.). Only roles an Admin or Super Admin has pre-authorized for this account are listed — the change applies for this session only.
✕
Edit Self-Switch Roles
✕
🕐 Patient Timeline
Cross-batch visit history for this patient, decrypted on-device for this lookup only. Not stored, cached, or synced separately from the batches it was read from.
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Searching saved batches…
✕
Quantity Billing Calculator
✕
Prescription Details
Prescription✎
🔍
Type to search common doses (1 tab, 500mg, 1g, 5ml…) or enter your own.
Billable quantity will be calculated automatically as dose × frequency × duration.
Prescription Context (optional)
A verbal order carries audit risk until a countersignature is recorded here — this is a documentation query, not grounds to reject the underlying claim.
Quantity is not auto-calculated for free-text prescriptions — enter the billable quantity to bill directly below.
✕
Kumani Health Intelligence Platform — How it Works
Step
Action
1. Set facility location
When you click Run Audit, a dialog prompts for facility type, G-DRG level, region, and district. This drives tariff multipliers and district-specific epi alerts.
2. Seed the codebook
Open Codebook → paste/import your NHML medicines (with price), GDRG codes (with base tariff), and procedure lists. A representative starter set is pre-loaded.
3. Import a batch
Drop a facility's CXF, XML or CSV file in the sidebar, then Run Audit — or click Load Demo Batch to see the engine work on realistic sample claims.
4. Review flags
Each flag cites the rule, clinical reasoning, and a CAPA block. Click Edit Claim on any flagged claim.
Check Epi Intelligence for disease burden, cluster alerts with district/region labelling, and IDSR-aligned outbreak notification text.
7. Financial Overview
The Financial Overview tab compares billed amounts against NHML unit prices and G-DRG tariffs — showing medicine variance, G-DRG variance, and a per-claim breakdown.
8. Financial Recovery
The Financial Recovery tab shows estimated exposure by severity — Reject / Review / Query. Administrative findings are QUERY only.
9. Research & De-ID
The Research tab shows disease burden, AWaRe summary, and age distribution. Export de-identified CSV/JSON for research submissions (Ghana DPA 2012 Act 843 compliant).
10. Correct via search-select
Diagnosis, GDRG, and medicines are chosen from your imported codebook — not typed freely — so exports stay valid.
11. Export
Export the amended batch back to CXF or XML. Originals are never altered in place.
12. Track trends
Every audited batch is saved to the Facilities registry for trend lines and cross-facility Compare.
Critical Rules — Must Never Be Violated
▸ ZOOM codes are gender-neutral/cross-MDC — males under ZOOM are NOT a coding error
▸ ANTESEIN1 = Anti-Tetanus Serum (ATS) — NOT anti-venom
▸ MATRALMI1 (antacid) = QUERY ONLY — no automatic deduction; never flagged on gender grounds
▸ True duplicate = same NHIS + same G-DRG + same date (all three required)
▸ PhysicianID absent = QUERY, never financial rejection
▸ NSAID dose ceiling calculated by calendar day, not summed across routes
▸ Typhoid rapid tests are clinically acceptable — do not flag ERR-LAB-001 for them
▸ IV followed by oral (same drug/class) is acceptable step-down therapy — not duplication
This tool runs entirely in your browser. No data leaves your device unless you explicitly set up WebDAV sync, and no paid services are used. The clinical reference set (Ghana STG 2023, BNF 85, WHO AWaRe 2023, NHML March 2025) is embedded and dated — update the codebook periodically as the NHIS list changes.
✕
Reset facility registry?
This clears all saved facility batches and trend history from this browser. The codebook (medicines/GDRG/procedures) is kept. This cannot be undone.
✕
📋 Submission Advice
Computed from your saved claims list — no fabricated figures. This does not block saving or submission; it flags things worth a second look first.
✕
🔧 Troubleshooter
Live checks run against this browser right now. Every result below is a real test outcome, not a simulated status.
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Duplicate claims found in this backup
These claims already exist locally (matched by id). Tick any you'd like to delete the local copy of and replace with the version from this backup file. Anything left unticked keeps the local copy and skips the incoming one.
✕
STG Compliance Override
The diagnosis is coded as non-specific / ill-defined in the Ghana STG 2023 reference set. Please provide a clinical justification before it can be saved on this claim.
Batch Audit Report
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New Appeal
Appeal Letter
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Add Grant Opportunity
✕
↩ Return / Refund Items
✕
📦 Receive Goods (GRN)
✕
🏧 Confirm Payment
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Terms and Conditions
1. Acceptance of Terms By using the Kumani Claims Intelligence Platform, you agree to these terms.
2. Data Privacy All data is stored locally in your browser (or IndexedDB on this device). No data is transmitted to any third party unless you explicitly use WebDAV sync.
3. Offline Use This platform is designed for offline use; you are responsible for backing up your data.
4. Clinical Decision Support Kumani provides audit and decision support, not clinical advice. Final clinical decisions remain with the treating clinician.
5. NHIA Compliance You are responsible for complying with NHIA rules and regulations. Kumani's audit rules are a decision-support aid, not a substitute for official NHIA adjudication.
6. Limitation of Liability Kumani is provided "as is" without warranty of any kind. The developers are not liable for any loss or damage arising from its use.
7. Updates This software may be updated; you are responsible for obtaining and reviewing the latest version and terms.