Enhancing Claims Accuracy with AI-Solutions!



Our advanced AI programs are designed to support claims adjusters by effectively identifying and preventing costly errors and compliance issues

*Patent pending designs

AlignmentSuite

Seamlessly designed to work together or independently depending on your needs

ICD-Anchor

Diagnosis Drift

Tracks diagnosis changes compared to the initial diagnosis

Flags suspicious changes early

Offers monthly and quarterly reporting

ImageLock

Leakage Detection

Detect payment of unrelated medical conditions before they drain resources.

Maintain claim integrity - monitors diagnostic consistency across the claim lifecycle.

Prevent unnecessary claim leakage -identify a deviation from the accepted medical conditions.

ReopenGate

Improper Reopenings

*extended gaps in treatment after closure

Retrospective -

Compares original > current diagnosis for relatedness

Prospective -

Requires Manager approval when closure gap exceeds threshold.

Offers monthly and quarterly reporting.

ProviderWatch

Provider Pattern Oversight& Risk Monitoring

Detects coding frequency outliers

Surfaces unusual billing patterns

On demand audits across your claimant database.