Platform
Thirty agents.
Four capabilities
Every agent is independently trained, tested and auditable. Each one is composed from the same skill library your team uses to build workflows.
Payment Integrity
See the capabilityEight detectors take the same claim in parallel, pre- and post-payment. Each returns its own finding, evidence and confidence.
- Duplicate Claims Exact, near and split-bill duplicates
- Unbundling Components billed apart from their parent code
- Geographic Outlier Service patterns impossible given distance and time
- Phantom Billing Services billed with no supporting encounter
- Provider Anomaly Billing that deviates from the provider’s peer cohort
- Service Pattern Temporal and volume irregularity in a service mix
- Rx Diversion Controlled-substance diversion and early refills
- Specialty Pharmacy Site-of-care and specialty drug policy breaches
Utilization & Clinical Review
See the capabilityA three-stage pipeline turning an operative note into a cited determination. Manual review of the same document takes an analyst 15 to 30 minutes.
- Document Intelligence Structure and provenance in an unstructured document
- Clinical Extraction Clinical and administrative entities, normalized
- Evidence Determination Whether the record supports what was billed
Stop-Loss
See the capabilitySix agents that share signals with each other, so a catastrophic-claim warning reaches renewal pricing without anyone re-keying it.
- High-Cost Claimant Identifier Members trending toward the specific deductible
- Aggregate Exposure Monitor Aggregate attachment point exposure across the group
- Specific Risk Predictor Probability a claimant breaches the deductible
- Catastrophic Claim Early Warning Emerging episodes before they mature into claims
- Renewal Pricing Validator Quotes inconsistent with the group’s actual risk
- Network Cost Optimization Avoidable cost in routing and site of care
Benefits & Leave
See the capabilityThirteen agents covering intake through adjudication through payroll.
- Intake & Classification What kind of leave a request actually is
- FMLA Eligibility Whether an employee qualifies under FMLA
- State PFML Entitlement under state paid leave programs
- WH-380 Certification Whether a medical certification is sufficient
- Designation How leave is designated, and against which bank
- Leave Coordination How concurrent entitlements stack
- Intermittent Leave Episodic usage against what was certified
- Statutory Notices Which notices are owed, to whom, and by when
- Operational Comms What each audience is permitted to be told
- Benefit Instruction What to pay, for which period, from which bank
- State-Portal Filing What the state has on record versus what we do
- Return to Work When a leave closes, and what true-up is owed
- Employer Onboarding Whether a plan configuration is complete
On accuracy
We do not publish
a single accuracy number
Detection performance is meaningful only against a stated population, a stated time window and a stated definition of a true positive. A figure quoted without those three things tells you nothing.
Instead, we run your own historic claims through the agents and show you what each one finds, with its evidence, before you activate anything. That is a number you can audit.