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Powering Healthcare Payers Across the Claims Lifecycle​

AI-powered payment integrity platform.

FWA detection & integrated case management.

Systems modernization.

Timely, actionable insights.

Serving Commercial & Government Health Plans

Payment Integrity
Platform

Pre-pay accuracy for improper payment prevention to post-pay FWA detection and recovery to case manager, our Al-powered platform offers a single source of truth data and analytics hub for an end-to-end claims solution.

Tech-Enabled Services

Using our powerful payment integrity / FWA platform, we support payers by providing outsourced SIU resources, pre-pay clinical reviews, post-pay recovery audits, and end-stage renal disease (ESRD) premium protection.

Technology
Optimization

We have unique expertise to modernize a health plan’s claims and other critical business systems, de-identify and secure PHI, accelerate value-based care strategies, and consolidate islands of payment data.

health plan
customers

35+

HEALTHCARE TECH
PROFESSIONALS

100+

COMPLIANCE & TECH
CERTIFICATIONS

9
Streamlining

Streamlining FWA identification to expand case creation by 10,000%”

False Positives

Our migration to the cloud was a top IT project that delivered incredible visibility”

Hours reduced

Resources for clinician and coder reviews speeds up our pre-pay process”