Traditional
payment integrity
is broken

Only 2% of claims have overpayments. Audits rarely identify all cases

Traditional approaches merely mimic adjudication rules

It is highly resource-intensive and only provides static analysis
How AI makes a difference

AI exponentially
expands the
considerations criteria
for Payment Integrity
expands the
considerations criteria
for Payment Integrity
It helps
Payment Integrity
programs learn and
evolve as opposed to
static analysis.
Payment Integrity
programs learn and
evolve as opposed to
static analysis.
AI boosts human
productivity.
Reduces the use of
high-cost resources
such as nurses
productivity.
Reduces the use of
high-cost resources
such as nurses
Amplify your payment integrity
program outcomes with AI

No replication of your processing rules.

No random sampling. AI can analyze every claim.

We can get started with just your claims data.