AuditShield.ai

We help patients access transparent and affordable healthcare by guiding them through the correct hospital, scheme eligibility, and step-by-step treatment process before they comm

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AuditShield.ai: Transparent Navigation for Cashless Healthcare

Team Name: AuditShield Contact Email(s): raushan22882917@gmail.com Team Members:

  • Raushan (age 19–24), University student
  • Mausam Kumari (age 19–23), University student Country / Region: India (Bihar)

Problem Statement

Who is affected

  • Patients and families seeking major but non-emergency medical procedures (such as knee or joint replacements) in private hospitals—especially middle- and lower-income households unfamiliar with hospital billing practices and government health schemes.
  • Elderly patients and their caregivers are the most affected, as decisions are made under emotional and medical pressure.

Where / when it happens

This problem occurs during:

  • Hospital selection
  • Pre-surgery consultations
  • Post-surgery billing Especially in private hospitals where pricing, inclusions, and exclusions are not disclosed clearly and upfront.

Evidence the problem is real (real incident)

On 14 November, I visited Nageshwar Ortho & Trauma Centre in Bhagalpur, Bihar with my father, whose knee condition had become extremely severe. After examination, the doctor recommended an immediate knee replacement surgery.

I clearly asked about:

  1. The total cost of surgery and hospital stay
  2. Whether Ayushman Bharat (PM-JAY) would apply

The doctor quoted ₹1,65,000 and mentioned that medicines and treatment would be managed by the hospital, implying that extra costs would be minimal.

Based on this, we agreed.

However, after surgery—when ₹1,65,000 was already paid—we were told:

  • Medicine charges were ₹7,000/day
  • Bed charges were ₹1,500/day
  • All injections, saline, and consumables would be charged separately

At this point, we had no choice; the surgery was already done. Due to extended stay and unexpected charges, the total cost increased drastically, and I was forced to take a loan of nearly ₹4,00,000.

This happened not due to lack of treatment but due to missing cost transparency and missing process guidance.

Why this reflects a systemic issue

  • Hospital “total cost” quotes often exclude critical components
  • Patients do not know what is included vs. excluded
  • Government scheme eligibility is unclear
  • Once surgery starts, decision-making power is lost This is a widespread healthcare navigation and transparency failure, not an isolated incident.

Purpose

Healthcare decisions involve trust, urgency, and vulnerability. Patients deserve complete information before treatment begins, not after.

This matters because:

  • Medical debt can financially damage families for years
  • Incomplete information undermines informed consent
  • Existing systems favor institutional knowledge over patient understanding

This project is driven by personal lived experience and aims to prevent families from facing financial distress due to unclear hospital processes.

Proposed Solution

AuditShield.ai helps patients access transparent and affordable healthcare by guiding them through:

  • Choosing the right hospital
  • Understanding scheme eligibility
  • Understanding step-by-step procedures before committing to surgery

Key features / user stories

  • Users describe their situation in simple language
  • The system checks eligibility for government schemes
  • It shows a clear, structured care pathway
  • It displays estimated costs and common hidden charges
  • It warns users about mistakes that lead to financial loss

What people do today

  • Ask doctors or hospital staff verbally
  • Search government websites or PDFs
  • Depend on agents, relatives, or informal advice

These methods are fragmented, inconsistent, and unreliable.

What’s different about HealthFlow

HealthFlow focuses on process transparency, not medical advice. It converts complex healthcare rules into an easy, step-by-step pathway patients can understand before starting treatment.

Feasibility & MVP

Minimum Viable Product (MVP)

A web-based platform solving one core use case: ➡️ Cashless or low-cost knee replacement under Ayushman Bharat (PM-JAY)

The MVP will:

  • Accept user input as free-text
  • Match it against verified healthcare rules
  • Output the correct hospital and process flow
  • Highlight typical excluded costs

Next steps

  • Collect and structure PM-JAY rules into decision flows
  • Build a rule-based decision engine (Python backend)
  • Create a simple chat-style interface
  • Deploy using Google Cloud (Cloud Run + Firestore)
  • Test with real patient scenarios

Risks & assumptions

Risk: Healthcare rules vary by state Mitigation: Start with Bihar only and clearly limit scope

Risk: Users may confuse guidance with medical advice Mitigation: Display clear disclaimers and navigation-only guidance

Success Metric

Primary Metric: ➡️ At least 70% of users correctly understand total expected costs and care steps within 2 minutes during first-time use.

Ethics & Inclusion

  • No medical diagnosis or treatment recommendations
  • Minimal personal data collection; stored only with consent
  • Clear disclaimers
  • Simple language for users with low digital literacy
  • Future support for regional languages and voice input
  • Curated, verified rule sets to prevent misinformation

References / Credits

  • Ayushman Bharat PM-JAY official resources
  • Public government healthcare guidelines
  • News articles and NGO reports on healthcare transparency

AI Tools Disclosure

AI tools were used only for brainstorming, structuring, and language refinement. All content was written, reviewed, and finalized by me in original wording. No AI-generated content was copied verbatim.

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