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.
Automated, rule-driven processing that eliminates manual claims review and accelerates reimbursement
Adjudicate insurance claims instantly as they are submitted, eliminating batch processing delays
Apply complex insurer-specific rules, benefit structures, and eligibility criteria automatically and accurately
Auto-approve, pend, or deny claims based on configurable adjudication rules and clinical criteria
Process claims around the clock without human intervention, accelerating reimbursement timelines
Juliette is built to handle the full complexity of healthcare claims adjudication
Verify patient coverage and benefits in real time before and during claim adjudication
Apply diagnosis-procedure compatibility checks, pre-authorization requirements, and clinical coding rules
Automatically calculate copayments, deductibles, coinsurance, and insurer liability based on contract terms
Generate structured denial codes and explanations to support provider appeals and resubmissions
Three steps from claim submission to adjudication decision
A claim is submitted by a provider through the Lnkr platform, triggering Juliette's adjudication pipeline
Juliette applies the insurer's benefit rules, eligibility data, and clinical guidelines to evaluate the claim
A real-time adjudication decision is issued — approved, pended for review, or denied with a structured reason code
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
Insurer-specific benefit rule application across contract tiers
Structured denial generation with coded reason and appeal pathway
Our clinical and technical teams can help configure Juliette's rule engine to match your insurer's specific benefit structures and requirements.