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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.
2024 FWA Market Report: State of Missouri
The State of Missouri’s Medicaid Audit & Compliance Team offers its insight and new approach.
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