Applications
Control medical cost
one decision at a time
Each application covers one decision, from a contract rate to a medical necessity review. It runs first on a sample of your cases, then on every case. Your team decides on every finding.
No application matches this combination.
Contract intelligence
Answers what was agreed, rate by rate.
Rate benchmarking
Compares prices across your network.
Payment variance
Finds what was billed off contract.
Value-based contract performance
Tracks each program against its terms.
Contract modeling
Simulates new terms on real utilization.
Prior authorization review
Evaluates each request against criteria.
Prospective medical necessity review
Checks necessity before care starts.
Concurrent review
Follows the episode while it runs.
Utilization analytics
Surfaces over- and under-use patterns.
Risk stratification
Flags high-need members early.
Medical necessity review
Validates each charge against the record.
Fraud, waste and abuse detection
Uncovers improper patterns at scale.
Claims editing
Catches coding errors and duplicates.
Claims repricing
Prices every line exactly as contracted.
Denial and appeal management
Gives every denial and appeal its reasons.
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