Healthcare Payment Integrity Platform
Dashboard
Interactive Demo Environment
Quantilae is the layer sitting above every claim, provider, rule, and investigation.
Quantilae combines deterministic rules with statistical pattern analysis to identify both known billing issues and emerging risk indicators across claims, providers, diagnosis trends, peer groups, and historical investigations.
Flagged Claim Value
$14.8M trending_up+12% vs prior weekClaims Screened
128,440 check_circleReal-time activeProvider Alerts
42 priority_high7 High PriorityPotential Leakage Held
$2.1M shieldPOC scenarioYour live dashboard
Expandable widget workspace
Claims review queue
Click any claim to open the full evidence packet.
| Claim ID | Provider | Flag | Risk | Score | Rule | Amount | Status |
|---|
Provider surveillance
Ongoing behavior pattern analysis.
High risk alert
Black lung disease testing request spike
Blue Ridge Occupational Clinic requested black lung disease screening across an unusually broad patient population. Quantilae flags it because volume, patient profiles, diagnosis linkage, and provider concentration do not match expected exposure indicators.
Pattern stats
Population patterns
Risk concentration across claim universe.
Coding intelligence
Rules engine.
Procedure-to-procedure conflict detection using code-pair edit logic.
Medically unlikely unit detection per CPT code and claim type.
Peer group comparison with anomaly scoring and longitudinal drift.
Volume and billing frequency spike detection by provider and region.
Run a rule check
Case management