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Payer-Side Overpayment Agent
Payment Integrity Analyst
FeaturedAn AI-powered payment integrity workspace that helps health plans identify, investigate, and recover overpayments while keeping analysts in control. OPA unifies detection, compliance tracking, SIU routing, recovery workflows, and financial reconciliation in one workspace. The platform surfaces evidence, recommends next steps, tracks federal deadlines, and provides analytics for recovery yield, compliance risk, and operational efficiency.
Features
Overpayment detection with evidence surfacing
Case workflow with state transitions and approvals
SIU routing and compliance / deadline tracking
Recovery lifecycle and financial reconciliation
Provider notices and response management
Recovery-yield and compliance analytics
Tags
Payment IntegrityOverpaymentRecoverySIUComplianceHealth Plan
Ready for real data?
Take this prototype to production with SSO, RBAC, HIPAA-compliant infrastructure, and your own data integrations.
SOC 2 Type II
SSO & RBAC
EHR / claims integrations
Custom model fine-tuning