ClaimQI is purpose-built to improve healthcare affordability by reducing fraud, waste and abuse (FWA) across the healthcare system. As health plans identify opportunities to reduce unnecessary and improper claims payments, and providers have improved transparency on proper coding aligned to coverage details, the entire healthcare system benefits. And importantly, consumers win by experiencing better and more stable premiums and/or benefits. A simple equation:

 

Lower Loss Ratios = Lower Rates (all else equal)

​

ClaimQI helps payers identify and reduce improper claims payments across one or more lines of business and has been proven to identify more than Medicare and legacy systems/processes combined. In addition, depending on payer or administrator preference, improper payments can be identified before the payment is made, or used to identify improper payments and support a high-converting recovery process with detailed explanations. 

 

Best part yet, the financial risk is nominal compared to the reward ceiling via our value-based payment model. The ClaimQI platform has shown to deliver a return on Investment upwards of 50X! 

 

Step in small - win BIG