Healthcare Payment Integrity That Increases Accuracy Without Slowing Claims
Improve payment integrity across the claims lifecycle. HCFS analytics help healthcare payers identify improper payments before they are made and recover payments that require postpay review.
A Smarter Approach to Healthcare Payment Integrity
Real-time accuracy
AIShield helps your team catch issues immediately without delaying claims.
Claims-first design
Seamlessly integrates into pre-pay and post-pay workflows with automated processes.
Automation built in
Streamline detection, auditing, and reporting with intelligent workflows that reduce manual effort.
Dynamic rule tuning
Adjust detection thresholds without re-coding to improving accuracy and reducing false positives.
Unified view of risk
Merge multiple data sources and claim types for holistic, automated detection.
Continuous improvement loop
Built-in feedback and automation enhance detection quality over time.
Improve Results Without More Effort
What You Should Focus On First:
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Deploy AIShield® to reduce false positives and focus on high-impact claims |
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Automate pre- and post-pay reviews for better control without extra staff |
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Integrate PostShield® into existing workflows for immediate impact |
Your Ideal Next Step:
Schedule a walkthrough of a real claims lifecycle using HCFS tools
Post-Pay Analytics
Artificial Intelligence
