AI Solutions for Healthcare

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Reducing Provider Abrasion Through Proactive Provider Coding & Billing Education Programs

Reducing Provider Abrasion through Proactive Provider Coding & Billing Education Programs
Provider Scope is helping health plans and agencies bring down costs pre-claim with unique provider and facility insights. Provider Scope compares each provider’s claims and coding practices to their peers, identifies outlier behavior, and proactively engages providers to improve claim integrity and bring down pre-claim costs with a provider self-monitoring and communication portal.

FORENSIC AI PLATFORM

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

SERVICES

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