Health Payors

Claims Administration

Streamline complexity and accelerate operational efficiency

Managing health claims remains one of the most resource-intensive functions for insurers – complicated by diverse benefit definitions and plan designs, and fragmented rule and fee structures. We help eliminate manual bottlenecks by enabling pre-configuration of health benefit definitions, claims guidelines, and provider payment arrangements – so claims can be automatically and accurately processed in one go. Reduce administrative friction, improve adjudication speed, and enable faster and more accurate payments with consistently automated rule applications and pre-authorisation checks.

Payment Integrity

Uncover hidden fraud, waste, and abuse with precision


Traditional fraud detection systems often stop at surface-level checks. Our solution goes deeper – analysing not just claim headers, but every line item and historical claim pattern to identify suspicious behaviour, billing outliers, and collusive networks. Explainable decision recommendations help assessors act quickly and confidently, minimising leakage while strengthening audit defensibility.

Provider Management

Build high-value networks with data-driven provider performance insights

Uncontrolled provider service variation can drive unsustainable claim costs. We help you assess provider efficiency and benchmarking costs for clinically comparable cases, detecting patterns of overcharging and over servicing, and identifying high-performing providers to include in optimised networks. Strengthen your contracting strategy and steer members to better-value care.

Health Claims Data Enrichment

Map unstructured claims data to standardised clinical codes

Most health claims contain unstructured free text data making comparisons across providers difficult. Our solution transforms varied claims data into a clean, standardised format enriched with clinical codes, enabling reliable downstream analysis for provider assessment, fraud detection, and operational reporting.

Business Intelligence

Transform siloed data into actionable health system insights

Siloed systems make it hard to see the bigger picture. Our solution consolidates fragmented claims, clinical, and provider data into a single data analytics and visualisation portal – that delivers interconnected analytics and consistent insights across all teams. With powerful visualisation tools and predictive analytics, your organisation can align around a single source of truth to optimise product strategies, improve operations, and unlock deeper health system understanding.