Master your Claims Integrity Programs with The Industry's first-ever Self-Manageable, Open-To-All Solution!

CoverSelf empowers every stakeholder in the healthcare claims ecosystem with a truly cutting-edge cloud-native, holistic, and customizable platform that prevents and adapts to ever-evolving claims and payment inaccuracies. Our unified, healthcare-dedicated platform enables greater collaboration between all partners along the claims continuum, reducing complexity and administrative costs.
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CoverSelf Payment Integrity Platform for Payers

A domain-specific platform with pre-configured industry policies and rules

It also empowers your team to configure policies in simple English or using simple policy-specific templates. Now, your release cycles occur within hours without any dependency.
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

Our modern software development techniques that make our platform intuitive and user-friendly set us apart. We have eliminated frustrating, time-consuming back-and-forth between policy configurators and business users while ensuring that rule logic is captured in context while maintaining continuity in downstream processes.

CoverSelf Payment Integrity Platform for Payers
CoverSelf Payment Integrity Platform for Payers
Modern UX/UI & Easy to configure & manage:

CREOL (patent pending), An intuitive, English-like domain-specific configuration language.

CoverSelf Payment Integrity Platform for Payers
Hyper-Customization & Versioning:

From LOB to plan level

CoverSelf Payment Integrity Platform for Payers
Payer-Specific Claims Auto-Correction:

Claims are corrected and processed automatically – no additional work for you.

CoverSelf Payment Integrity Platform for Payers
Speed to release:

Release in hours with an enforced workflow

CoverSelf Payment Integrity Platform for Payers
Continuous testing:

Designed for Quality-First but not an after thought

CoverSelf Payment Integrity Platform for Payers
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 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