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.
Data is uploaded via our flexible data entry system and audited by data science specialists.
Our data entry tools cater for multiple requirements from live API updates and rolling bulk spreadsheet uploads to one-off claim audits.
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.
Assorted bulk data is collated into a single source of uniform raw data ready for quality assessment and enrichment.
Raw data is transformed into clean, lean, actionable data.
Raw data is:
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.
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:
AI and customisable behavioural rules work to detect anomalies and large-scale patterns.
Designed to uncover obscured information and reveal suspicious patterns of behaviour not easily detected by the human eye.
Individual claims are inspected for coherence based on the patient’s circumstances, history and standard medical practice.
Alerts generated for anomalies
Automated sweeps are carried out to analyse claims in a wider context, covering:
Cases generated for deviations and suspicious patterns
Reports give a high level overview. Summarising findings by upload, time period or claim type.
Results and tools that empower your experts to make optimal decisions across claim integrity management.
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.