Bluespine
for Governments
AI-powered, evidence-based, payment integrity technology to save taxpayers money and prevent FWA
Enhance Overbilling Detection Accuracy for Government Plans
Bluespine’s payment integrity platform harnesses a wide range of data sources, including provider contracts, Machine Readable Price Transparency Files (MRFs), and CMS billing guidelines. Our capabilities also extend to pharmaceutical claims using PBM contracts, formulary data, pharmaceutical pricing sources, and FDA/drug manufacturer guidelines. Bluespine’s - data driven AI technology scalably detects policy violations that contribute to overbilling, all while ensuring compliance with government programs.
Perform claims reviews that enhance FWA prevention
Our proprietary AI-driven platform creates accurate, deterministic rules to identify overbilling, delivering clear and defensible reports that document policy and contract violations with references to the exact source paragraphs.
Enhanced Precision, Greater Efficiency
Prevent improper payments and generate savings with Bluespine
Eliminate wasteful spending
Leverage price transparency data to analyze provider and facility rates, and identify anomalies in coding practices across providers.
Optimize healthcare spending
Reclaim unwarranted healthcare expenses and redirect savings toward preventative care initiatives or other social welfare programs.
Enhance trust and integrity
Significantly reduce FWA across government plans, and help plan members reduce their overall healthcare costs.
Boost operational efficiency
Create more opportunities for claims cost savings, while increasing productivity and reducing the need for investigations.
Start Saving Money Now
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