Review Queue

Submissions requiring human review — confirm or overturn AI decisions

3 pending
#4 marisol.pdf incomplete high risk
View File Full Detail
Incomplete submission Glosa risk: high 3 failed check(s) 3 warning(s)
AI Summary: Incomplete claim submission. The document contains patient identification (Cédula), an ARS Yunen insurance card, and a dental prescription. However, it completely lacks the required fiscal invoice, NCF, RNC, and insurance authorization voucher.
Amounts
Voucher: 0.00
Receipt: 0.00
Copay: 0.00
ITBIS: 0.00
Failed Checks (3)
FAIL RNC (Registro Nacional de Contribuyentes)
FAIL NCF (Número de Comprobante Fiscal)
FAIL Dates
Warnings & Missing
Prescription date appears to be 30/9/26, which is in the future relative to the audit date of 2026-03-13.
Patient Cédula expired on 22 JUNIO 2024.
Prescription is missing a clinical diagnosis.
Missing: Factura Fiscal (Invoice)
Missing: NCF (Número de Comprobante Fiscal)
Missing: RNC (Registro Nacional de Contribuyentes)
Override with financials or add evidence...
Manual Financial Override

Edit values below to correct AI-extracted amounts. Changed fields are highlighted.

Add Evidence & Re-evaluate
+ Drop files here or click to browse PDF, PNG, JPG, TIFF — multiple files supported

Files will be merged with the existing submission and fully re-processed by the AI.

#3 marisol_2026030311475430 (1).pdf needs review high risk
View File Full Detail
AI flagged for review Glosa risk: high 1 failed check(s) 1 warning(s)
AI Summary: Financial amounts reconcile perfectly, demonstrating a clear breakdown of ARS coverage (70%), patient copay (30%), and the retail price difference passed to the patient. However, the required medical prescription is missing, which poses a high risk of a Glosa Administrativa.
Amounts
Voucher: 696.00
Receipt: 740.00
Copay: 208.80
ITBIS: 112.88
Failed Checks (1)
FAIL Prescription Validity
Warnings & Missing
Missing medical prescription (receta médica). This is a critical requirement for ARS reimbursement.
Missing: Medical prescription (receta médica)
Override with financials or add evidence...
Manual Financial Override

Edit values below to correct AI-extracted amounts. Changed fields are highlighted.

Add Evidence & Re-evaluate
+ Drop files here or click to browse PDF, PNG, JPG, TIFF — multiple files supported

Files will be merged with the existing submission and fully re-processed by the AI.

#1 fermin (1).pdf needs review high risk
View File Full Detail
AI flagged for review Glosa risk: high 1 failed check(s) 1 warning(s)
AI Summary: Financial and identification documents are perfectly consistent, but the required medical prescription is missing, posing a glosa risk.
Amounts
Voucher: 1,788.94
Receipt: 1,788.94
Copay: 536.68
ITBIS: 0.00
Failed Checks (1)
FAIL Prescription Validity
Warnings & Missing
Missing medical prescription (receta médica). This is a critical requirement for ARS audits.
Missing: Medical prescription (receta médica) with physician's exequatur and signature.
Override with financials or add evidence...
Manual Financial Override

Edit values below to correct AI-extracted amounts. Changed fields are highlighted.

Add Evidence & Re-evaluate
+ Drop files here or click to browse PDF, PNG, JPG, TIFF — multiple files supported

Files will be merged with the existing submission and fully re-processed by the AI.

Previously Reviewed (1)
# Filename Insurance Auth # AI Verdict Human Verdict Overrides Notes Reviewed
2 maria ysa_2026030312001136.pdf (+1 evidence) ARS YUNEN Y2614262495561 approved approved — — Mar 13, 14:58