01 / What's Broken Today
Health plans lose $145B+ to fraud, waste, and abuse (FWA) each year — despite spending $10B+ on prevention tools.
The tools themselves?
Fragmented. Noisy. Reactive.
SIUs are buried in false positives. Investigators are stretched thin.
And most platforms don’t adapt to the way your plan actually works.
02 / What We're Building
A modern AI co-pilot that helps SIUs move faster, think smarter, and prove impact.
5 integrated capabilities in one solution.
Cleaner
Claim Validation &
Data Integrity
Catch duplicates. Clean your data. Prevent wasted time.
Automatically flag duplicate claims, missing fields, and inconsistent data before they waste analyst or investigator time.
Smarter
AI Fraud
Detection
Reduce false positives. Adapt to your rules. Prioritize what matters.
Incorporate plan-specific policies, contracts, reimbursement logic, and CMS updates into our model for more precise scoring.
Faster
AI Case
Triage
Search smarter. Triage faster.
Surface and prioritize fraud cases using plain-language, conversational search. Filter and explore flagged claims with natural queries.
Stronger
AI Case Builder & Summary
Generate a draft. Make it yours. Improve the system.
Receive an AI structured summary for each fraud investigation—fully editable, and built to learn from your feedback.
Clearer
ROI
Tracking
Track outcomes. Quantify impact. Prove investigator value.
Track financial savings (exposure, recoupment, corrective), where time is spent, and how your SIU drives cost containment.
03 / Why We're Different
A next-gen solution built for how SIUs actually work — not how vendors wished they did
Yesterday
Rules-based
Post-payment ("pay and chase")
Siloed systems
Static rules
Today
Black box ML
Some pre-payment
Integrated dashboards
Quarterly retraining
Tomorrow (BlueStamp)
Explainable, contextual AI
Post-payment, then pre-payment
Unified, NLP-driven investigation hub
LLM-powered, continuous feedback loop
Supports Every Investigator–Not Just Data Scientists
Whether your team consists of data nerds, ex-FBI agents, medical coders or clinicians, our AI delivers actionable insights to complement every skillset.
Adapts to Your Health Plan
Fraud isn’t one-size-fits-all—and neither are we. Our risk scoring models learn from your claims, providers, and historical patterns to deliver plan-specific precision.
Built to Explain Itself
No black-box scores or mystery flags. Every decision is backed by transparent logic—tied to your plan, your policies, and your risk thresholds.
Integrates with Existing Workflows
No need to rip and replace. Our modular design plugs into your existing systems to streamline workflows—not disrupt them.
04 / Why You Can Trust Us
Backed by experience. Built with the field.
We’ve built fraud detection systems for some of the most sensitive domains in the world — including the IRS, CMS, and national security agencies. Now, we’re bringing that same power to healthcare.
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2 Design Partnerships in Progress
Co-building with a design partner working with multiple U.S. health plans and a leading regional health plan
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100+ Stakeholder Interviews
Informed by FWA leaders, SIU/Payment Integrity executives and investigators, and compliance experts
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Created by Technologists & Strategists
From ARPA-H, Deloitte, Samsung, MIT and Stanford
05 / Who We Serve
If you fight medical fraud and waste, we’re building for you.
Vendors
Consulting firms
Audit partners
Payers
Health plans
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Third-party administrators (TPAs)
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Employer groups
Enablers
Health tech platforms
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Regulatory contractors
