Take control of your payment integrity programs
CoverSelf empowers payers with a truly NEXT-GEN cloud-native, holistic & customizable platform preventing and adapting to the ever-evolving claims & payment inaccuracies. Reduce complexity and administrative costs with a unified healthcare dedicated platform.
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A domain specific platform where the majority of the industry policies/rules are already configured
It also empowers your team to configure your own policies in simple English or using simple policy specific templates. Now your release cycles are in hours without any vendor dependency.
- Fully-managed robust pre-pay and post-pay rules library
- Fully-auditable access control and workflow
- Auto-updates to code-sets and industry releases.
- Modern version management system & configuration with fine-grained control.
- Powerful content management tools to manage the library at one-place.
- Ideation platform and advanced FWA Analytics for real-time pre-pay, post-pay alerting.
Our Differentiation
Our difference is that we’ve built this platform from the ground up using modern software development techniques to be intuitive. We’ve also removed the frustrating, time-consuming back and forth between configurers and business users. This ensures rule logic is captured in real sense without losing the context in the downstream processes.
Modern UX/UI & Easy to configure & manage:
CREOL (patent pending), An English like domain specific language to configure
Hyper-Customization & Versioning:
From LOB to plan level
Speed to release:
Release in hours with an enforced workflow
Continuous testing:
Designed for Quality-First but not an after thought
Your own private rules repository:
Protect your proprietary rules and IP without sharing even with us
Technology first platform
Our vision is to make you a meaningful beneficiary of the generational architectural shift taking place in information technology and address payment integrity in a unified and holistic way. Simplify and democratize the payment integrity industry. Create an open solution which can build on each other rather than duplicating to address > $900 Billion in administrative waste & improper payments.
API-first platform:
FHIR compliant APIs. EDI adapters are available.
Cloud Native & Cloud agnostic:
We integrate/deploy in your choice of cloud/hybrid-cloud/on-premises
Blockchain based audit control:
Tamper proof audit control
Scalable & Extendable platform:
Cloud scale technology. All healthcare LOBs like Dental, Pharmacy, Workers' Compensation, Self-Insured/TPAs
Advanced BI platform:
Powerful reporting and visualization. Integrate with your existing BI platform as well
API/Stream/Batch data ingestion:
Real time processing with multiple data integrations