Usage Policy
Last updated: 18 May 2026
This policy sets out the rules for acceptable and prohibited use of the CaladriusHealth.AI platform, including its AI features. It applies to all Customers and Authorised Users. Violations may result in suspension or termination of access.
CaladriusHealth.AI is a specialised B2B platform for revenue cycle management and health claims processing within India’s National Digital Health Ecosystem. Use outside this intended purpose is not permitted.
What the platform is for
The following uses are permitted:
- Processing billing and claims data for healthcare organisations registered under ABDM
- Using AI coding assistance, claim analysis, and workflow automation tools for their intended purpose of improving accuracy and efficiency in health claims processing
- Generating reports and analytics based on your organisation’s own claims and revenue data
- Integrating the Service with ABDM-compliant systems, EMR platforms, and health information exchanges for billing and claims purposes
- Processing claims under government health schemes including CGHS, PM-JAY, and state health schemes
Prohibited uses
General
- Fraud: Submitting false, fraudulent, or fabricated billing or claims data
- Unlawful use: Using the platform in violation of any applicable Indian law, including the DPDPA 2023, the IT Act 2000, and the ABDM Health Data Management Policy
- Unauthorised access: Accessing data beyond your assigned permissions
- Service interference: Introducing malicious code, conducting denial-of-service attacks, or disrupting the platform or its infrastructure
- Reverse engineering: Attempting to extract source code, algorithms, or AI model weights from the platform
- Unauthorised resale: Providing access to the platform to third parties outside your organisation without CaladriusHealth’s written consent
- Privacy violations: Collecting or processing personal data beyond what is necessary for the specified billing and claims purpose
AI features
- Out-of-scope data: Inputting clinical diagnoses, mental health records, or sensitive health data not required for billing purposes
- AI manipulation: Using prompt injection, adversarial inputs, or other techniques to circumvent safety controls or produce inaccurate outputs
- Unreviewed submission: Submitting AI-generated coding or claims outputs to payers or government schemes without human review — AI outputs are assistive tools, not final decisions
- Data extraction: Attempting to extract training data, model weights, or confidential system information from AI features
- Impersonation: Using AI features to fabricate or impersonate professional judgements
High-risk uses requiring additional safeguards
| Use case | Requirement |
|---|---|
| Government scheme claims (PM-JAY, CGHS, state schemes) | AI outputs must be reviewed by a qualified coder before submission. Users must comply with NHA and scheme-specific submission requirements. |
| ABDM HIP/HIU data exchange | All data exchanges must be conducted through ABDM-approved consent flows. Do not exchange health records outside these flows. |
| NHCX integration | Notify CaladriusHealth before activating NHCX integration to ensure compatibility with current standards. |
| Multi-facility bulk processing | Available at enterprise account level only. Contact CaladriusHealth before enabling bulk processing workflows. |
Enforcement
CaladriusHealth monitors the platform for policy violations using automated and manual means, with privacy safeguards in place. Where we determine that a Customer or user is in violation, we may issue a warning, suspend access, or terminate the Agreement. We will give notice and an opportunity to remedy before taking action except where immediate action is required to protect the security of the platform or Customer Data.
Reporting misuse
To report suspected misuse by another user or organisation, contact Connect@caladriushealth.ai.