Neuro-Symbolic AI

The era of black box AI is over

The Compliance Vise: Speed × Audit × Litigation

Speed & Specificity
(CMS-0057-F)

HOURS

URGENT

📅Deadline: Active Jan 1, 2026
⚡Urgent: 72 Hours | Std: 7 Days
📝Mandate: Specific reasons required. No generic codes.

THE AUDIT EXPLOSION
(Medical Advantage)

THEN

550

NOW

📈Scope: 100% of eligible plans.
💾Depth: 35 → 200 Records per audit.
👁Risk: 10x Exposure Increase.

LITIGATION REALITY
(Provider abrasion)

90%

Reversed

Defensibility Gap

⚖Post-acute denials reversed.
🚫"Black Box" AI is indefensible.
💰Class action vulnerability.

"If your AI can't show its work, it's not automation. It's Liability."

Prediction ≠ Proof

Reason codes aren't rationales.

Black Box Output

Reason Code:CO-97

Rationale:"Not medically necessary"

Policy Cite:NULL

Rule ID:NULL

Calc Trace:NULL

PROBABILITY (NOT PROOF)85%

Not reproducible. Not auditable.

Auditor Demand

Contract Clause

Section + Effective Date

MISSING

Policy/LCD Logic

Rule + Exception

MISSING

Pricing Math

Fee Schedule + Modifiers

MISSING

Audit Trail

Rule Version + Timestamp

MISSING

You don't need higher confidence. You need receipts.

Bleed Time

Appeals loops + rework

Bleed Dollars

Reversals + extrapolated recoveries

Bleed Credibility

Provider abrasion + network tension

Probabilistic read + Deterministic decide

Neural learns patterns (System 1) || Symbolic creates reasoning (System 2)

Neural (Probabilistic)

Learns from Data

Turns messy documents into structured facts—fast.

Pattern learning (probability, not proof)
Extracts codes, dates, modifiers, context
Outputs facts + confidence

Symbolic (Deterministic)

Maps the World

Encodes policy, contract, and ontologies as executable logic.

Rules + exceptions + ontologies (explicit)
If X & Y → Z (stepwise reasoning)
Outputs decision + trace (reproducible)

Glass Box
Decision

Receipts: clause • math • rule ID

Speed at Scale

Automates reading + extraction across every document type.

Deterministic Reasoning

Same inputs → same output. Exceptions enforced every time.

Auditability

100% reproducible 'why': citations + rule trace + calculation.

Instant Updates

Change a rule when policy changes—no model retrain.

Regulated industries don't accept predictions. They require proof.

Healthcare • Finance • Legal

Glass Box PI Engine

From documents to executable rules to defensible decisions

INPUT

Healthcare Documents

Claim (EDI/835/837) Policy PDFs Contracts Clinical notes Medical Records

READ

Neural Extract

Identifies Entities Extracts Dates & Codes Relationships Context

DECIDE

Symbolic Reasons

Deterministic & Executable, Rules & Clauses, Zero Hallucinations

PROVE

Evidence Pack

Citations & Rationale Calculation Trace Audit-Ready

AI Read

Rules Decide

Evidence Proves

Same input → same output

Reproducible. Auditable. Defensible.

Decision + Proof → Operational Impact

Payment Integrity at speed and scale

Claim Edit

DENIED

Billed$12,500

Allowed$0.00

Adj-$12,500

REASON CODE
CO-97: Inclusive Proc

Evidence Pack

Contract CitationSec 4.2

"Bundling required for CPT 29881..."

Policy Logic

Rule: Medical_Necessity_B (L33898)

Clinical Excerpt

"Patient record indicates primary..."

Trace + Provenance

Calc_ID: 99281-X | Rule v4.5

Lower Provider Abrasion

The "why" is explicit, not just a code.

Higher Throughput

Evidence is autogenerated, not manually assembled.

Audit Readiness

Every decision is reproducible: citations + math + versioning.

Evidence isn't a report — it's theproduct

Reduce Abrasion | Stop Leakage | Stay Defensible

The strategic impact of Glass Box AI

See Neuro-Symbolic AI in Action

Bring your messy documents. We'll convert them into executable code.

( policies • contracts • clinical notes )

Neuro-Symbolic
Engine

Claims Adjudication

Automated pre-pay logic

Policy-as-Code

Docs to executable rules

Post-Pay Analytics

Audit & fraud detection

Evidence Pack

Full citations, math trace, and rule provenance in one artifact.

TRACEABLE

AUDITABLE

See it live at Booth #25

Every decision ships with an Evidence Pack: citations • math trace • rule provenance.

Prior Auth Validation

Pre-Pay Adjudication

Post-Pay Integrity

Fraud Detection

Policy Adherence

Contract Drift

DRG Validation

Network Analytics

Ashish Jaiman, Co-Founder & CEO

The era of black box AI is over

Speed & Specificity(CMS-0057-F)

THE AUDIT EXPLOSION(Medical Advantage)

LITIGATION REALITY(Provider abrasion)

Speed & Specificity
(CMS-0057-F)

THE AUDIT EXPLOSION
(Medical Advantage)

LITIGATION REALITY
(Provider abrasion)