AI powered
Payment Integrity
is 100X better than
rules-based systems

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    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
    It helps
    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

    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.

    Schedule Demo

    Client
    Testimonials

    Synergen Health deployed AI driven, Underpayment Analytics from Health Sigma. The solution used readily available 835s and successfully identified significant underpayments very efficiently. The mapping of underpayment to contracts further made the appeals process easier.

    Sunil Konda

    Vice President, Product at SYNERGEN Health

    CFMC leveraged Health Sigma’s proprietary AI Analytics Platform for claims analytics and contract benchmarking. Health Sigma played a key role in improving CFMC’s overall financial performance

    Anthony Gutierrez

    Head of Revenue Cycle, Community First Medical Center