TrueClaim provides an AI‑driven claims platform for health insurers and payers that continuously scans submitted claims to detect billing errors, adjudication mistakes, and care gaps. The system runs 24/7, automatically corrects issues, and offers a flexible, no‑code plan‑design interface plus AI‑powered member support, delivering around 7% average cost savings on processed claims.
Funding
$2.1M raised to dateRaised to date based on public sources. This may differ from the amount the company actually raised and is based only on what is publicly available on the internet.
- Startup funding source · Source unavailable
Founders
Product
Problem
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.
Solution
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.
Target Audience
Primary customers are health insurers, Medicare/Medicaid administrators, and large self‑funded employer health plans seeking to lower claim costs and improve processing accuracy.
Features
- 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