Health insurers and payers often experience high claim processing costs due to manual billing errors, adjudication mistakes, and undetected care gaps, leading to overpayments and inefficient operations.

TrueClaim offers an AI‑driven claims platform that continuously monitors submitted claims, automatically identifies billing and adjudication errors, and flags care gaps for correction. The system runs 24/7 without human intervention, delivering real‑time administration and customizable plan design tools that let payers quickly adjust benefit structures. Integrated concierge‑level, multi‑channel support enables members to receive assistance directly or through the insurer’s own tools. By embedding these capabilities into a single infrastructure, TrueClaim reduces claim expenses while improving accuracy and member experience.

Autonomous AI agents that scan every claim for coding errors, duplicate payments, and policy violations around the clock

Real‑time adjudication correction workflow that updates claim status instantly and notifies relevant stakeholders

Flexible plan‑design interface allowing payers to create, modify, and test benefit structures without coding

Multi‑channel member support suite (chat, email, phone) powered by AI to resolve inquiries and guide claim submissions

Analytics dashboard showing average savings (≈7 %) and total claims processed, supporting continuous cost‑optimization

Secure, cloud‑native architecture that scales to process millions of claims while maintaining compliance with healthcare data regulations

Primary customers are health insurers, Medicare/Medicaid administrators, and large self‑funded employer health plans seeking to lower claim costs and improve processing accuracy.