Making AI Relevant for You

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

With, predict adverse situations, forecast events, identify claims risks, foresee circumstances, preempt outcomes, and visualize challenges. Predictive Suite employs advanced AI and Deep Learning Models to predict critical risk and claims parameters by processing both structured and unstructured data, through proprietary statistical models resulting in accurate insights

Adopt a Culture of “Proactive Risk and Claims Management”

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.

Ready to fully automate mundane tasks?

Ready to fully automate mundane tasks?

Discover insights and transparency with Analytics

Discover new capabilities using Native AI and ML

Predictive AI Models

Leverage’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.


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.

Leverage our extensive experience and expertise to integrate AI effectively into your organization—we understand how.


Find more detailed answers to your questions below or contact us directly.

What is Native AI and Why is it Better?

Native AI, in the context of insurance, refers to artificial intelligence systems that are seamlessly integrated into the core operations and processes…

What type of software solutions does offer? encompasses advanced features for efficient risk mitigation, claims administration, policy underwriting…

How does leverage AI to enhance operational efficiency in risk and claims management? leverages AI to automate tasks and boost operational efficiency…

How is your solution/product different from other competing solutions in the market? stands out from other vendors in the risk and claims management software…

What features support data-driven decision-making in risk and claims management? equips organizations with a powerful tool for navigating the intricate challenges of risk and claims…

Can Analytics be used as an independent module? is designed to offer flexibility in its usage. Whether integrated into a larger ecosystem or utilized independently…