NIYAM

What it does

NIYAM sits between claim submission and the openIMIS adjudication engine. A rule engine checks each incoming claim against configurable integrity rules — coverage eligibility, provider authorization, service-code validity, temporal consistency, duplicate detection, cost-range checks. A claim adapter translates between the openIMIS data model and NIYAM’s internal schema, so the module drops into an existing deployment without modifying the openIMIS core. A review interface shows what got flagged, why, and what passed through.

The point is not to replace the adjudication workflow. It is to stop obviously bad claims from consuming reviewer time and to surface the ones that need a closer look.

How it got here

The project started at HackForUHC 2026. As team CLAIM∅ we won 1st place (June 18-19, 2026), and following that we were invited to present at the 10th anniversary openIMIS Community Meeting in Kathmandu (June 23-25).

After the hackathon the work continued at the Health Informatics Lab at Kathmandu University, under Prof. Rabindra Bista. The prototype grew into NIYAM — a more considered version with a proper validation engine, adapter layer, and interface.

On August 27, 2026, Aman Karn, Laxman Acharya, and I presented NIYAM at the AeHIN Hour webinar hosted by the Asia eHealth Information Network and openIMIS. The session covered the architecture, the data flow, and a live demo of the claim validation workflow.

Why it belongs here

Most of the projects in this portfolio are tools I built and shipped on my own terms. NIYAM is different: it started under time pressure at a hackathon, survived the transition into a real research setting, and ended up being presented to an international audience. The constraints changed at each stage, and the system had to hold up across all of them.