What GauntletScore checks
CPT/ICD-10 Consistency
Verify procedure codes match diagnosis codes. Flag impossible treatment combinations.
Treatment Timeline
Check claim timeline against medical records. Detect geographic impossibility (treatment in two places).
Damage Calculations
Verify medical expense totals, loss of earnings calculations, and cost estimates.
Provider Verification
Check provider NPI numbers, credentials, and DEA registration against CMS and state boards.
Pattern Analysis
Detect upcoding, unbundling, and billing patterns consistent with fraud.
Medical Plausibility
Cross-reference PubMed for medical claims, drug interactions, and treatment protocols.
How it works
Submit Claim Document
Upload insurance claim, medical summary, SIU report, or litigation file. Any format.
Verify Medical Coding
Agents check ICD-10, CPT, provider credentials, and timeline consistency against databases.
Receive Fraud Assessment
Get verdicts on medical plausibility, coding consistency, and anomaly flags.
GauntletScore provides assistive verification and is not a substitute for professional judgment.