Easily Master your Claims Integrity Programs with The Industry's first ever Self-Manageable, Open-To-All Solution!
A domain specific platform where the majority of the industry policies and rules are already configured
Fully managed robust 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.
Data mine and analyze large claims with real-time pre-pay and post-pay alerts.
Our Differentiation
What makes us unique in this industry is that we’ve built our platform from the ground up using modern software development techniques to be intuitive. We’ve been successful in eliminating frustrating, time-consuming back-and-forth between those who configure and business users. This ensures that rule logic is captured in context without losing continuity in downstream processes.
CREOL (patent pending), An intuitive, English-like domain-specific configuration language.
From LOB to plan level
Claims are corrected and processed automatically – no additional work for you.
Release in hours with an enforced workflow
Designed for Quality-First but not an after thought
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 today and to address healthcare claims and payment integrity in a unified and holistic way. We aim to simplify and democratize the Healthcare Claims and Payment Integrity Industry by creating a fully-open and transparent solution that can be built upon in a spirit of collaboration rather than cause duplication of efforts to address the more than $900 billion in administrative waste & improper payments in the U.S. annually.
API-first platform:
FHIR compliant APIs. EDI adapters are available.
Scalable & Extendable platform:
Cloud-scale technology appropriate for all Payment Integrity approaches, and healthcare lines of business including Dental, Pharmacy, Workers' Compensation, Self-Insured/TPAs, and more!
Cloud Native & Cloud agnostic:
We integrate/deploy in your choice of cloud/hybrid-cloud/on-premises
Advanced BI platform:
Powerful reporting and visualization integrate smoothly with your existing BI platform.
Blockchain based audit control:
Tamper proof audit control
API/Stream/Batch data ingestion:
Real time processing with multiple data integrations
