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If you could pay $1 to get $25 - $50 in return,
would you? Â
Welcome to ClaimQI.
ClaimQI provides the first-of-its kind (Patent Pending) and arguably most sophisticated AI-powered claims intelligence engine healthcare has seen to date. We have shown to uncover and identify improper claims that others miss, including Medicare. We're delivering known from the unknown, and doing so in ways that minimize risk while improving clarity.Â
Try a pilot for yourself and see the power and simplicity ClaimQI brings to your plan's table.Â
The Product Suite
Innovative modules driving maximum ROI
INTELLIGENT INSIGHTS
ClaimQI Insights
Full claims reporting & analytics
Payer and administrator analytics and reporting that surfaces trends, exposure, and ROI across the entire claims book.
Ready to see the suite in action? Pilot the full platform today.
ClaimQI Core
25x ROI*
By identifying complex recovery opportunities that traditional algorithms miss, ClaimQI Core enables payers to recapture significant leakage with minimal operational friction. Our sophisticated engine analyzes claims and coverage data and provides detailed explanation, with clinical citations at the root policy level.
* Based on a 5% capture rate and 60% conversion rate
Proven ROI Scenarios
for Health Plans
Empowering payers with AI-driven intelligence that turns claim complexity into financial clarity, delivering 25x to 50x* return on investment.
*Based on the programs purchased. Purchasing both programs generates higher ROI due to SaaS bundling discounts.
ClaimQI Prevent
46x ROI*
ClaimQI Prevent applies dynamic AI rules to flag anomalies before claims are paid. By moving from recovery to prevention, health plans reduce administrative costs and avoid the 'pay-and-chase' cycle entirely, ensuring maximum integrity of every payment.
* Based on a 3% capture rateÂ