Juliette

AI Adjudication Engine

Juliette is Lnkr's AI-powered adjudication engine that automates the evaluation and processing of insurance claims in real time. Designed to eliminate manual review, reduce errors, and accelerate reimbursement cycles across the healthcare ecosystem.

Intelligent Claims Adjudication

Automated, rule-driven processing that eliminates manual claims review and accelerates reimbursement

Real-Time Processing

Adjudicate insurance claims instantly as they are submitted, eliminating batch processing delays

Rule-Based Intelligence

Apply complex payer-specific rules, benefit structures, and eligibility criteria automatically and accurately

Automated Decisions

Auto-approve, pend, or deny claims based on configurable adjudication rules and clinical criteria

24/7 Processing

Process claims around the clock without human intervention, accelerating reimbursement timelines

How Juliette Works

Three steps from claim submission to adjudication decision

1

Claim Submission

A claim is submitted by a provider through the Lnkr platform, triggering Juliette's adjudication pipeline

2

Rules Evaluation

Juliette applies the payer's benefit rules, eligibility data, and clinical guidelines to evaluate the claim

3

Instant Decision

A real-time adjudication decision is issued — approved, pended for review, or denied with a structured reason code

Adjudication Capabilities

Juliette is built to handle the full complexity of healthcare claims adjudication

Eligibility Verification

Verify patient coverage and benefits in real time before and during claim adjudication

Clinical Validation

Apply diagnosis-procedure compatibility checks, pre-authorization requirements, and clinical coding rules

Financial Computation

Automatically calculate copayments, deductibles, coinsurance, and payer liability based on contract terms

Denial Management

Generate structured denial codes and explanations to support provider appeals and resubmissions

What Juliette Handles

Examples of adjudication scenarios processed by Juliette in real time

Real-time eligibility check on patient admission

Automated pre-authorization evaluation for surgical procedures

Copayment and deductible calculation at point of care

Diagnosis-procedure compatibility validation

Payer-specific benefit rule application across contract tiers

Structured denial generation with coded reason and appeal pathway

Integrate Juliette Today

Connect Juliette to your payer system or provider platform and start processing claims in real time. Our team will guide you through the integration.

Need a Custom Adjudication Setup?

Our clinical and technical teams can help configure Juliette's rule engine to match your payer's specific benefit structures and requirements.