Anuly automates claims validation with AI-driven intelligence, delivering 3-5% cost savings for TPAs and health plans while dramatically improving provider relationships.
While automated claims editing is industry standard, current solutions create significant financial and operational friction.
Legacy providers take 6-8 weeks to incorporate the latest CMS and AMA guidelines, leading to payment errors and compliance risks.
Providers receive minimal explanations when claims are edited, causing disputes, abrasion, and damaged payer-provider relationships.
Basic edit reports fail to deliver actionable insights needed to understand root causes and improve payment accuracy proactively.
Anuly identifies and prevents overpayments before claims are paid, eliminating recovery costs and provider friction entirely.
Every feature designed to reduce costs, improve accuracy, and strengthen provider relationships.
System automatically monitors CMS, state Medicaid agencies, and commercial payers. No manual policy maintenance required.
Every edit includes complete policy citations and plain-English explanations. No more black box decisions.
AI chatbot handles 70-80% of routine inquiries automatically. Providers get instant answers with full documentation.
AI-powered medical record summarization validates inpatient claims and detects upcoding patterns automatically.
Machine learning identifies suspicious billing patterns, provider behavior anomalies, and potential fraud schemes.
Operational dashboards, provider benchmarking, denial trend analysis, and custom report builder.
Pre-payment prevention eliminates costly recovery processes. You save more, providers appreciate the transparency, and your team focuses on what matters.
In prevented improper payments through pre-payment validation
Pre-payment edits eliminate the $850+ cost per recovered claim
Transparent explanations reduce disputes and strengthen partnerships
Example Annual Savings
API integration with your existing claims platform. Works with Facets, QNXT, TriZetto, and custom systems.
Load your plan documents and policies. Our AI learns your specific rules and begins processing claims.
Real-time dashboards show savings as they happen. Detailed reports track ROI and validate results.
See how Anuly can reduce your claims costs while improving provider satisfaction. Get a personalized demo for your organization.