Elevate your program with personalized guidance, valuable recommendations, and tailored suggestions to empower and assist your teams.

With Klear.ai, predict adverse situations, forecast events, identify claims risks, foresee circumstances, preempt outcomes, and visualize challenges.

AI Models

Proven AI models and tailored algorithms, going beyond conventional approaches for a deep, personalized understanding of your data landscape.

Data Visualization

Empower your team to make informed, data-driven decisions through interactive dashboards that visually present key business indicators derived from AI modeling.

Workflow Automation

Workflow Automation cuts costs by streamlining time-consuming processes through end-to-end automation and a modular architecture.

Discover new capabilities using Native AI and ML

Predictive AI Models

Leverage Klear.ai’s predictive models to proactively anticipate potential risks, optimize decision-making, and enhance overall operational resilience.

Detection AI Models

Identifies overpriced provider bills through anomaly detection algorithms.

Prescriptive AI Engines

Tailored recommendations derived from the outputs of our AI models, enhancing decision-making and optimizing risk and claim strategies.

Severity Index

Predict claim severity with dynamic forecasting for Low, Medium, and High risk classifications, guided by sophisticated models.

Overbilling

Unveil suspicious situations, offering heightened scrutiny to identify potential instances of fraud, abuse, or waste.

Recommend Provider

AI connects patients with top providers for care that’s both personalized and efficient.

Reserve Adjustment

Continuous reserve forecasting organized by cost components, including medical, indemnity (partial & total), and other expenses.

Accelerated Billing

Identify providers / provider groups, who have exponential growth in billing between periods.

Recommend Nurse Case Mgr.

AI assigns nurse case managers for optimal care, enhancing recovery and patient satisfaction.

Claimant Fraud

Identify the likelihood of fraudulent activities by the claimant.

Injury & ICD Anomaly

Identify mis-matches between reported injury type and reported ICDs through Outlier Detection Algorithms.

Audit Recommendation

AI targets key areas for audit, safeguarding assets and ensuring financial accuracy.

Billing Fraud

Identify provider fraud by meticulously analyzing billing transactions against diverse data sources, employing sophisticated analysis.

Specialty Anomaly

Identify statistically rare CPTs and uncommon ICDs for a given provider’s specialty.

Recommend Settlement

AI predicts and advises on settlements for quicker, fairer resolution processes.

Litigation Propensity

Foresee legal action in a claim, utilizing advanced algorithms to predict litigation probabilities, enabling proactive risk management.

Examiner Provider Nexus

Identify possible nexus between examiners and providers / vendors.

Subrogation Opportunity

Predict subrogation opportunities through advanced analysis and sophisticated algorithms.