Claim Anomaly Detection Solution

Drive greater payment accuracy

Our claim anomaly detection solution helps you solve some of our industry’s most common challenges: wasted healthcare dollars, unnecessary administrative work, and a poor provider experience. We combine world-class analytics, accelerated claim resolution, and intuitive online tools so you can capture savings and address the root causes of overpayments.

Lines of business

•  Commercial
•  Medicare
•  Medicaid
•  Federal employee

curved lines graphic

The positive impact of faster anomaly detection

Identifying claim errors can feel like searching for a needle in a haystack. We help simplify the process with advanced analytics, dashboards, and intuitive digital tools.

Lower medical costs

Our solution helps your health plan save valuable claim dollars, and that helps improve the health of the healthcare system.

 

Deliver a better provider experience

A strong relationship with your providers is critical to your business. That’s why our solution is designed to help maximize results without creating friction.

 

Take control of your payment integrity program

When you partner with us, you’ll not only have control over your program, but you’ll also have access to results and insights through easy-to-read dashboards.

 

Inside our claim anomaly detection solution

We tailor our solution specifically for your plan, combining our next-generation analytics platform with industry-proven insights to identify overpayments.

Highly secure data platform

Online workflow collaboration tool

Analytics platform

Dashboards and reporting

Highly secure data platform

Online workflow collaboration tool

Analytics platform

Dashboards and reporting

How our solution works

Collect
We take in and store your claim data on our highly secure data platform.

Analyze
We leverage our advanced analytics to search your claim data for suspected errors.

Route
We automatically route overpaid claims back to you for recovery.

Enhance
We partner with you to monitor and adjust your program to optimize results.


Ask us about our claim anomaly detection solution

Health plan leaders, contact us to learn more about the possibilities and impact of our claim anomaly detection solution.

Are you a health plan member?

If you’re a health plan member and have a question about your health plan, please call the member services number on the back of your health plan ID card.