ClaimInformatics

ClaimInformatics' vision is to provide independent claims analysis, payment integrity, and fiduciary compliance documentation for self-funded health plans and ecosystem partners (brokers and TPAs). Conflict-free and fiduciary-aligned, with no carrier affiliations, we help plan sponsors protect plan assets and document prudent processes. ClaimIntelligence™ reviews 100% of professional and institutional claims through a proprietary, conflict-free edit engine drawn from CPT®, HCPCS, ICD-10-CM, NCCI, AMA, and other authoritative coding, billing, and payment standards. Pre-Pay and Post-Pay are two layers of analysis with different coverage, not a choice between them. FOCUS™ documents the prudent process behind every dollar, with AI-driven CLEAR™ contract review, the eight ERISA fiduciary duties, and defensible records of every oversight action. Visit claiminformatics.com for more information.