Bluespine
for Reinsurers
AI-powered, evidence-based, payment integrity technology to reduce stop loss payments
Accurately Detect Medical Overbilling
Bluespine’s payment integrity platform draws on diverse data sources—Summary Plan Documents (SPDs), Machine Readable Price Transparency Files (MRFs), and carrier billing guidelines—to uncover overbilling caused by policy and contract violations.
Perform claims reviews that maximize savings
Our proprietary AI-powered platform generates accurate, deterministic rules to identify overbilling, providing clear, defensible reports that cite specific source paragraphs for documented policy and contract violations.
Enhanced Precision, Greater Efficiency
Prevent unwarranted payments and generate savings with Bluespine
Enhance operational efficiency
Leverage AI to increase your capacity to review claims, without hiring additional investigators and auditors.
Eliminate early stop loss activations
Prevent premature triggering of stop-loss activations with an evidence-based methodology that protects your bottom line.
Initiate a pre-payment shield
Employ advanced AI upon stop-loss activations to pinpoint overbiling errors before issuing payment for unwarranted claims
Boost operational efficiency
Create more opportunities for claims cost savings, while increasing productivity and reducing the need for investigations.
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