rekupr — Medical Bill Analysis

Why Add Your Insurance Policies

Adding your organization's insurance policies to reKUPR is one of the most impactful things you can do for your employees. When reKUPR knows the details of an employee's health plan — deductibles, copays, coinsurance rates, and out-of-pocket maximums — it can provide significantly more accurate bill analysis.

Instead of making general assessments, reKUPR can compare charges against your actual plan terms, identify when you've been billed beyond what your coverage requires, and flag errors that might otherwise go unnoticed.

Adding a New Policy

Create a new insurance policy by providing the key details of your plan.

Basic Policy Information

Plan name — a descriptive name your team will recognize, such as "Gold PPO Plan 2026" or "Employee HDHP"
Plan type — select from HMO, PPO, HDHP, or other plan types
Payer name — the insurance company providing the coverage
Group number — your organization's group number from the insurance card
Policy number — the policy or plan identifier
Effective date — when coverage begins
Expiration date — when coverage ends
Status — set to Active, Expired, Pending, or Archived depending on the policy's current state

Coverage Limits

Configure the financial limits for your plan to give reKUPR the details it needs for accurate analysis. Coverage limits are set separately for in-network and out-of-network providers.

In-Network Limits

Individual deductible — the amount one person must pay before insurance kicks in
Family deductible — the combined amount the family must pay
Individual out-of-pocket maximum — the most one person pays in a plan year
Family out-of-pocket maximum — the most the family pays in a plan year
Default coinsurance rate — the percentage you pay after meeting the deductible (for example, 20%)
Default copay amount — the flat fee for standard visits (for example, $30)

Out-of-Network Limits

Out-of-network coverage typically has higher limits. Configure the same set of fields — deductibles, out-of-pocket maximums, coinsurance, and copay — for services received from providers outside your plan's network.

Service Categories

For more detailed coverage configuration, you can add specific limits per service category. This allows reKUPR to apply the right coverage rules depending on the type of care.

Available Categories

Configure coverage details for categories such as:

Emergency Room visits
Primary Care visits
Specialist visits
Urgent Care
Mental Health services
Prescription Drugs
And other service types

Per-Category Settings

For each service category, you can specify:

Copay amount — the flat fee for that type of service
Coinsurance percentage — the percentage you pay after the deductible
Prior authorization required — whether the service needs pre-approval from the insurer
Notes — any additional details or exceptions for that category

Per-category settings override the default coverage limits, giving reKUPR the most accurate picture of your plan's structure.

AI-Powered Coverage Extraction

If you have your insurance policy document as a PDF, reKUPR's AI can save you significant time by automatically reading and extracting coverage details.

How It Works

Upload your policy PDF — drag and drop or browse to select your insurance policy document
AI reads the document — reKUPR's AI analyzes the policy and identifies coverage details, limits, and terms
Smart merge — extracted data fills in empty fields without overwriting anything you've already entered manually

Confidence Indicator

After extraction, reKUPR displays a confidence indicator showing how reliably the data was read from your document. Higher confidence means the AI found clear, unambiguous information in your policy.

What Gets Extracted

The AI looks for:

Deductible amounts (individual and family)
Out-of-pocket maximums
Coinsurance rates
Copay amounts
Service-specific coverage details
Prior authorization requirements

If a field already has a value you entered manually, the AI leaves it untouched. This means you can enter the details you know, upload your PDF, and let the AI fill in the rest.

Policy Documents

Keep your actual insurance policy documents organized alongside the policy record in reKUPR.

Upload PDF documents of your insurance policy, summary of benefits, or other related paperwork
Download anytime for reference when reviewing coverage or handling disputes
Documents are stored securely and accessible only to your organization's admins

Having the original policy document on hand makes it easy to verify coverage details or share documentation when an employee needs to file an appeal.

Assigning Policies to Employees

Once a policy is configured, you can assign it to the employees it covers.

Individual Assignment

Assign a policy to a single employee from their profile or from the policy's detail page. Simply select the employee and confirm.

Bulk Assignment

For policies that cover many employees, use bulk assignment to connect the plan to multiple team members at once. This is especially efficient when:

Setting up a new plan that covers your whole team
Onboarding a group of new employees onto an existing plan
Updating assignments after open enrollment

Tracking Assignments

Your policy list shows how many employees are currently assigned to each plan, making it easy to see coverage distribution at a glance. Only active policies are available for new assignments.

Keeping Policies Current

Insurance plans change over time, and keeping your policy information up to date ensures reKUPR continues to deliver accurate analysis.

Update policies when plan details change mid-year, such as adjusted copays or new coverage terms
Archive expired policies at the end of each plan year to keep your active policy list clean
Create new policies for each plan year with updated terms and effective dates

reKUPR tracks policy status so that only current, active policy information is used when analyzing your employees' medical bills. Archived policies remain accessible for historical reference but won't be applied to new analyses.

Employer Insurance Policies