Insurance Companies
Transform Claims Processing with AI-Verified Healthcare Data
Automated Claims Processing

Fraud Detection
AI flags suspicious patterns: duplicate claims, medically unnecessary procedures, upcoding, phantom billing. Cross-reference claims against patient's EMR to verify services actually delivered. Geo-location verification confirms the doctor and patient were claimed location during consultation. Estimated fraud reduction: 73%.

Real-Time Eligibility Verification
Patients' insurance eligibility verified at appointment booking, preventing coverage surprises. Pre-authorization workflows automated—submit request, receive approval, track status—all electronic. Reduces administrative calls by 60%.

Cost Containment
AI-powered vitals provide objective evidence of medical necessity. Generic drug substitution suggestions reduce medication costs. Preventive care program integration—reward providers who keep patients healthy, not just treat illness. Telemedicine coverage reduces ER utilization by 35%.
Network Management
Connect 500+ healthcare providers through one platform. Standardized data exchange (HL7-FHIR) eliminates format incompatibilities. Provider performance analytics identify high-quality, cost-effective network participants. Automated provider credentialing and re-credentialing.
Network Management
Connect 500+ healthcare providers through one platform. Standardized data exchange (HL7-FHIR) eliminates format incompatibilities. Provider performance analytics identify high-quality, cost-effective network participants. Automated provider credentialing and re-credentialing.
Business Impact
99.9% claim accuracy, 60% reduction in administrative overhead, 75% improvement in customer satisfaction scores, $15 million annual savings (typical for 2 million covered lives).
Business Impact
99.9% claim accuracy, 60% reduction in administrative overhead, 75% improvement in customer satisfaction scores, $15 million annual savings (typical for 2 million covered lives).