Verify in real-time.
Not next quarter.
Audits find issues after the fact. Continuous verification checks claims, determinations, and payments as they happen—surfacing violations before they propagate.
Executable Logic Model
47 rules · Contract §4.2.1
Same error. Same system. Different outcome.
When configuration is wrong, every matching claim inherits the error. The question is when you find it.
Found at audit — 90 days later
Rule violation: Tier mismatch
Expected Tier 2 ($35) — Got Tier 4 ($75)
Why real-time errors persist.
Every organization has controls. None verify that outcomes match the rules as written.
tier_config.jsonerrorAll processed — all inherit error
Executes configured logic
Doesn't verify the logic is correct
Logic errors look “normal”
Catches fraud & outliers
Misses correctly-formatted errors
2,847 claims before detection
Reviews past claims
Finds issues weeks or months later
None of these systems ask: “Was this outcome correct?”
They execute logic—they don't verify it.
Your systems keep running.
We verify what they produce.
No system replacement. No workflow interruption.
Just a parallel check that catches what your systems miss.
Every rule. Every claim. Milliseconds.
Your logic—however complex—verified against every record in real time. Thousands of rules checked before the outcome is finalized.
Your system says “approved.” We verify why.
The difference between an alert and an answer.
Most systems tell you something might be wrong. We tell you exactly what failed, why, and what should have happened.
Pricing Exception
Alert #48291
Message
Claim amount exceeds expected range
Severity
Medium
Recommended Action
Review claim details
No rule reference. No expected value. No trace.
Rule Violation: Tier Override
CLM-2024-847291 · 2 seconds ago
Failed Rule
Contract §4.2.1 — Specialty Tier Override
Expected
$35.00
Tier 2 copay
Actual
$75.00
Tier 4 copay
Trace
Errors caught before they compound.
Real issues that would have slipped through—caught in minutes, not months.
tier_update.jsonchangedThe cost of delay isn't linear.
It cascades.
A logic error doesn't just affect claims—it triggers a cascade of operational, regulatory, and fiduciary consequences that compound with every passing day.
Each affected claim requires manual review, provider outreach, and potential member refunds—at 10x the cost of prevention.
Errors exceeding $1M typically trigger disclosure requirements, state reporting obligations, and elevated audit scrutiny.
Known systemic errors that persist create attestation risk—especially when the organization “should have known” sooner.
The question isn't whether errors exist in your system.
It's how long they run before you find them.
See value in days.
Not quarters.
No integration project. No workflow disruption. Start verifying claims against your contract logic immediately—we handle the setup.
See results on real claims data
Works alongside existing systems
Same input, same result, every time