HEALTHCARE PAYMENT INTEGRITY

Protecting America’s Healthcare Dollars

Quantilae is built for payers and healthcare organizations that need earlier detection of suspicious billing patterns, coding abuse, provider anomalies, duplicate claims, and repeated small leakages across high-volume claim environments.

View Payer Demo View Provider Demo

SYSTEM_STATUS: ALERT_FLAGGED

RISK_RATIO

84.2%

SYSTEM_CORE

2.41 GHz

ACTIVE_SCAN

PULSE_TRACE

LEAKAGE

ENGINE_LOGS

[INIT] quantilae_v4_core

[OK] db_injest_ready

[WARN] peer_drift_detected

[ALERT] CPT_unbundle_flag

ALERT_NODE

FLAGGED

FRAUD_DETECTION_ENGAGED

Anomalous billing pattern identified in CPT group

$100B+

ANNUAL PAYMENT ERROR EXPOSURE

0.00s

PRE-PAYMENT DETECTION LATENCY

100%

EXPLAINABLE SCORING FIDELITY

OFFICIAL URGENCY

Grounded in Public Authority

Quantilae's core engine is calibrated directly against official standards, GAO audits, and White House initiatives to eliminate waste, fraud, and abuse in Medicare and Medicaid program integrity.

White House

Eliminating Waste, Fraud, and Abuse in Medicaid

“State Directed Payments have rapidly accelerated, quadrupling in magnitude over the last 4 years and reaching $110 billion in 2024 alone.”

Official Statement

GAO

Program Integrity & Savings

“Both Medicare and Medicaid are susceptible to payment errors—over $100 billion worth in 2023.”

Official GAO Source

Explainable Claims Integrity

Decisions that can be traced, audited, and verified in real-time. No black boxes, only pure logic.

Neural Traceability Every claim decision is accompanied by a full logic map, detailing every feature and weight used in the computation.

Immutable Audit Blockchain-anchored logs ensure that claims data remains tamper-proof and mathematically verifiable.

Sub-ms Latency High-performance engine designed for instantaneous response when seconds mean billions.

Interconnected Ecosystem Seamless integration directly with existing institutional API and data lakes via military-grade API hooks.

Code Intelligence Flags suspicious CPT/HCPCS/ICD patterns, unbundling, upcoding, medically unlikely combinations, and repeated claim behavior.

Provider Behavior Compares providers against peer patterns, geography, specialty, claim mix, frequency, and historical risk movement.

EARLY ACCESS

Submit your interest.

For payers, TPAs, Medicaid-related organizations, payment-integrity teams, healthcare fraud investigators, and strategic partners interested in early access or pilot discussions.