AI Solutions for Healthcare


BlueCross BlueShield Health Plan

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BlueCross BlueShield health plan reduces medical and dental fraud, waste, and abuse.

A leading midwestern Blues healthcare payer aimed to curtail its own significant losses by improving its ability to detect and protect against outlier billing behavior, such as claims billed under medical insurance for non-traumatic dental services. Without the right technology, data, or clinical staff to catch this behavior early, the payer’s budget and bottom line was taking a big hit.

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Our Forensic AI Engine analyzes your data, detects problems, and builds connections across your data to provide actionable insights

Insight Scope

For everyone across the health plan

Clinical Scope

For clinical teams

Audit Scope

For everyone across the health plan and PBM

Network Scope

For network teams

Payment Scope

For payment integrity teams

Provider Scope

For network and payment teams

Fraud Scope

For SIU teams


We provide a full range of professional services, from data migration and ongoing customer success through flexible virtual SIU options.