Our platform
Built to Inform Action
Medical payment integrity is about more than analytics. Kirontech’s software is supported by specialist services to empower your experts to make optimal decisions across claim integrity management.
How it works
Our scalable system combines software, services and tools to detect FWA in four steps.
01
Extract
Data is uploaded via our flexible data entry system and audited by data science specialists.
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Flexible Upload
Our data entry tools cater for multiple requirements from live API updates and rolling bulk spreadsheet uploads to one-off claim audits.
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Seamless System Integration
No matter where or how your data is stored, our data science and dev teams work closely with you to determine the data format, identify appropriate use cases, and define relevant fields.
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Simple Data Collation
Assorted bulk data is collated into a single source of uniform raw data ready for quality assessment and enrichment.
02
Enrich
Raw data is transformed into clean, lean, actionable data.
Raw Data Treatment
Raw data is:
- Mapped to correspond with our data system.
- Cleaned of errors and quality assessed.
- Encoded from written descriptions using MNLP.
- Enriched with reference data from KironMed.
Multiple sources are combined into one clean, accessible format. Data is standardised, enriched and highly usable. Ready for our core engine to ask deeper questions and uncover hidden patterns.
Raw Tailored Training + Support
Our data science specialists dive into the details of your data and the way your business works to help you make the most of our platform. They provide guidance on:
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Managing Data Integrity
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Controlling Technical Workflows
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Administering Reports
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Adding Your Reference Data to the System
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Enhancing the Quality of Your Data
03
Insight
AI and customisable behavioural rules work to detect anomalies and large-scale patterns.
Powered by Machine Learning
Designed to uncover obscured information and reveal suspicious patterns of behaviour not easily detected by the human eye.
01
Individual claims are inspected for coherence based on the patient’s circumstances, history and standard medical practice.
Alerts generated for anomalies
02
Automated sweeps are carried out to analyse claims in a wider context, covering:
- Complex multi-claim patterns
- Network analysis (providers/claimants)
- Behavioural pattern detection
- Peer group utilization
- Historical analysis
- Full claim context including treatment histories
Cases generated for deviations and suspicious patterns
Reports give a high level overview. Summarising findings by upload, time period or claim type.
04
Action
Results and tools that empower your experts to make optimal decisions across claim integrity management.
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Stored in the cloud or on Premise
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Systems calibrated to meet business requirements
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Advanced data search and retrieval
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Customisable rules and cases using IQL
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Auto-updating cases for new claims
Our Work Doesn’t End with the Results
To make lasting change, we continually work with you to contribute & support the workflows that depend on those results. We are constantly tweaking, iterating and improving our platform to make it as accurate, relevant and valuable to your business as possible.