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Our advanced AI programs are designed to support claims adjusters by effectively identifying and preventing costly errors and compliance issues
*Patent pending designs
Seamlessly designed to work together or independently depending on your needs
Diagnosis Drift
Tracks diagnosis changes compared to the initial diagnosis
Flags suspicious changes early
Offers monthly and quarterly reporting
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.
Provider Pattern Oversight& Risk Monitoring
Detects coding frequency outliers
Surfaces unusual billing patterns
On demand audits across your claimant database.