Insurance

Extract claims forms to structured JSON

Claims forms like CMS-1500, UB-04, and ADA pack hundreds of fields into dense gridded layouts for healthcare reimbursement. A single wrong character means a denied claim. Use Sensible to get structured claims data for adjudication, compliance, and analytics.

FNOL intake | claims triage | adjuster workflows

Validated JSON

Schema-enforced output; every field matches your contract

Source coordinates

Every value links back to page + bounding box for audit

Per-document pricing

Predictable cost. No token-volatility surprises

Trusted by teams turning documents into production data

What makes claims forms hard to parse

Dense field grids, tiny print, and strict box positions leave no room for drift. We detect the form type, read every field and checkbox, and validate codes against your schema.

01

Dense Field Grid Parsing

Thirty-three numbered boxes on a single page. Sub-fields, checkboxes, multi-line entries crammed into tiny cells. Each box position is mapped precisely, with extraction anchored to the CMS-1500's physical layout.

02

Checkbox and Code Accuracy

ICD-10 codes, CPT codes, and NPI numbers are sequences where one wrong character changes the clinical meaning. Validation rules check format compliance on every code field, catching OCR misreads before they propagate.

03

Form Type Detection

CMS-1500 for professional claims. UB-04 for institutional. ADA for dental. Each form has its own box numbering and field semantics. Sensible detects the form type and applies the correct extraction configuration automatically.

Managed services

Don't want to build it? We'll write your configs from your samples.

Solutions engineers handle plan, build, deploy, and adjust on your behalf. You see clean JSON in your API response. Same engine as self-serve, just with the configuration work outsourced.

What's included

01Plan.Engineers review your samples and pick the right method

02Build.SenseML configs written from your samples

03Deploy.Same engine as self-serve, ready for production

04Adjust.We update configs when formats shift or new edge cases appear

05Integrate.Help with custom integration into your downstream systems

Fields we extract

We configure every claims form extraction to your exact schema, not a fixed field list. The fields below are the ones claims teams pull most often — tell us what your adjudication workflow needs and we map the rest.

01

Patient and provider

Patient name, DOB, member ID, group number, provider name, NPI, tax ID, referring provider, facility name/NPI

02

Diagnosis and procedure

ICD-10 codes (primary through quaternary), CPT/HCPCS codes, modifiers, place of service, dates of service, units, charges

03

Billing and authorization

Total charges, amount paid, balance due, prior authorization number, assignment of benefits, signature, employer information

config.json

SenseML

{ /* SenseML: CMS-1500 claims form extraction */
"fields": [
{
"method": {
"id": "queryGroup",
"queries": [
{ "id": "patient_name", "description": "patient name, patient's name, box 2" },
{ "id": "primary_diagnosis", "description": "primary diagnosis code, ICD-10, diagnosis 1, box 21" },
{ "id": "total_charges", "description": "total charge, total charges, box 28" },
{ "id": "billing_npi", "description": "billing provider NPI, NPI number, box 33a" }
// + more fields, mapped to your schema
]
}
}
]
}

Supported claims form types

Pre-built configurations cover CMS-1500 and UB-04. New claims form types can be configured in hours. Hybrid extraction handles both the structured box fields and any free-text clinical sections.

Healthcare

CMS-1500 (professional), UB-04/CMS-1450 (institutional), ADA Dental Claim Form, pharmacy claims (NCPDP)

Insurance

ACORD claims forms, state-specific first report of injury, workers comp forms, auto injury claims

Common Questions

Answers about CMS-1500 and UB-04 extraction, code validation, and form type detection.

What service line details does Sensible extract?

For each service line, Sensible captures date of service, place of service, CPT/HCPCS code, modifiers, diagnosis pointers, charges, units, and rendering provider NPI. The service-line fields are defined in configuration, so you can extend them or pare them back to match the claim data your adjudication needs.

What diagnosis information does Sensible extract from claim forms?

ICD-10 diagnosis codes, diagnosis pointers, date of onset, and related cause indicators are extracted by default, and on CMS-1500 all 12 diagnosis code fields are captured. If your workflow needs diagnosis data beyond this, the configuration is extended to pull it.

Does Sensible capture provider information from claim forms?

Yes. Sensible extracts billing provider name, NPI, tax ID, address, rendering provider, referring provider, and facility information from both CMS-1500 and UB-04 forms.

Does Sensible support both CMS-1500 and UB-04 claim forms?

Yes. CMS-1500 (professional claims) and UB-04 (institutional claims) both have pre-built configurations, each mapped to its own field layout. These are the two we've built; when you bring a claim form we haven't seen, a configuration is built to fit it. Sensible isn't limited to a fixed set of forms.

Do you support webhooks?

Yes. Sensible sends extraction results to your webhook endpoint when processing completes. You can also poll the API for status.

Does Sensible support human review?

Yes. Sensible flags extractions with low confidence for human review. You can configure review thresholds and workflows.

What security certifications does Sensible have?

Sensible is SOC 2 Type II certified and HIPAA compliant. Data is encrypted in transit and at rest.

How long is document data retained?

Document data is stored indefinitely by default. Custom retention policies are available and can be configured for same-day deletion if needed.

Is there a free trial?

Yes. Sensible offers a 14-day free trial on the Growth plan. No credit card required to start.

How is pricing structured?

Sensible uses per-document pricing for predictable costs. No token-based billing or usage surprises. Volume discounts are available for higher throughput.

How do I integrate with Sensible?

Sensible provides REST APIs and SDKs for Python and Node.js. Most integrations take a few hours. Webhooks, Zapier, and direct API calls are all supported.

What file formats does Sensible support?

Sensible processes PDFs (native or scanned), Microsoft Word (DOC, DOCX), spreadsheets (XLSX, XLS, CSV), single-page images (JPEG, PNG), multi-page images (TIFF), and email bodies with attachments.

How accurate is the extraction?

Accuracy depends on document quality and configuration. Most production deployments achieve 95%+ accuracy with proper validation rules and confidence signals.

How fast is document processing?

Processing speed depends on document size, page count, OCR requirements, and which extraction methods are used. Simple single-page documents process in seconds. Larger or more complex documents that use LLM-based extraction take longer.

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