vendor

Founded in 2021, CoverSelf’s Payment Integrity Platform engages modern technologies to address payment leakage & claims inaccuracies while remaining transparent & accessible to Payers. The platform that empowers payers to prevent and adapt to the ever-evolving claims & payment inaccuracies. Reduce complexity and administrative costs with a unified healthcare dedicated platform.

It is purpose-built, utilizing multiple approaches to reduce administrative waste while identifying new savings opportunities. It empowers teams to configure their own policies, logics in simple English or using simple policy specific templates overcoming fear of losing IP. We’ve also removed time-consuming back and forth between configurers and business users. This ensures rule logic is captured in real sense without losing the context in the downstream processes.

Innovation & new concept releases occur quickly without technical dependencies.

Self Manageable Domain Specific Platform

A flexible domain specific platform that is built keeping all the use cases that are essential for creating, managing and updating the reimbursement payment policies for the payment integrity domain.
● In-built Industry codesets and policies
     ○ Pre-configured industry codesets and rules that auto-updates
● Do It yourself (DIY) or delegate
     ○ Configure policies with a user friendly platform to write your proprietary business
rules or delegate to us.
● Modulary Package
     ○ Complete flexibility to choose any library package or rules based on your need
● Tailor-made
     ○ Ability to customize from industry standard Library or health plan specific rules to payer specific tailored logics.
● Business Intelligence
     ○ Readily available, real-time claims monitoring and reporting system to assist
Executive Management for quick decision making and prioritization.

Ideation Platform

A platform that empowers domain experts to ideate, create, validate, test, and implement rules and new concepts on the fly without high technical dependency. Powered by our domain-specific language, CREOLTM
● What if, scenario
     ○ Ability to identify, create new savings opportunities and test the impact on historical
claims data. Create proprietary policies faster.
● Impact analysis
     ○ Measure the rules edits vs savings at various threshold before finalizing and
publishing a customized rule
● Data mining and analysis
     ○ Create scenarios to identify any anomalies without the need of technical teams, pull
claim fields to find patterns with SMEs innate knowledge.
● Query
     ○ Query across different claim data fields and its combination, quickly.

Contact:
Raghavendra Pawar
Co-Founder
415-319-8583
raghav@coverself.com

Contact:
Rajasekhar Maddireddy
Co-Founder
415-319-8099
raj@coverself.com

16192 Coastal Highway Lewes
County of Sussex, DE 19958
coverself.com