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Average Ratings 0 Ratings

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ease
features
design
support

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Description

NEMESIS is an advanced AI-driven technology for anomaly detection that specializes in identifying fraud and inefficiencies. This next-generation platform not only highlights opportunities for improved efficiency within your business management systems, but it also serves as a customizable enterprise solution that allows business analysts to quickly convert data into meaningful insights. By harnessing the capabilities of artificial intelligence, NEMESIS addresses challenges including overstaffing, medical inaccuracies, care quality, and fraudulent claims. With its continuous process monitoring, NEMESIS reveals various risks, from anticipating quality concerns to uncovering waste and misuse. Utilizing machine learning and AI, it effectively identifies fraudulent activities and schemes before they can impact your financial resources. Furthermore, NEMESIS enhances your ability to manage expenses and track budget discrepancies, ensuring ongoing transparency regarding waste and abuse. This comprehensive approach not only improves operational efficiency but also fosters a more accountable financial environment within your organization.

Description

An automated claims platform that operates seamlessly from start to finish, leveraging AI-driven decision models for tasks such as data collection, policy and coverage verification, medical coding, and consistency assessments. Our advanced AI models are designed to minimize losses and enhance your loss ratios by effectively detecting fraud, waste, and abuse in health and life insurance sectors. Qantev empowers insurers globally by improving operational efficiency, curbing losses, and elevating client satisfaction. By integrating artificial intelligence with deep medical knowledge, our dedicated team of data scientists and engineers has created cutting-edge solutions that streamline the claims management process while identifying fraudulent activities. Our specialized AI tools are adept at capturing, cleansing, enhancing, and digitizing data from a variety of claims documents in multiple languages. Additionally, we bolster the performance of your medical provider network with automated insights, identifying pricing gaps, recommending strategies, simulating different scenarios, and much more to optimize outcomes. This holistic approach ensures that insurers not only respond to claims effectively but also proactively prevent potential issues before they arise.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

Amazon Web Services (AWS)
IBM Cloud
Microsoft Azure

Integrations

Amazon Web Services (AWS)
IBM Cloud
Microsoft Azure

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

Aviana

Founded

1994

Country

United States

Website

nemesisbyaviana.com

Vendor Details

Company Name

Qantev

Founded

2018

Country

France

Website

www.qantev.com

Product Features

Data Analysis

Data Discovery
Data Visualization
High Volume Processing
Predictive Analytics
Regression Analysis
Sentiment Analysis
Statistical Modeling
Text Analytics

Financial Risk Management

Compliance Management
Credit Risk Management
For Hedge Funds
Liquidity Analysis
Loan Portfolio Management
Market Risk Management
Operational Risk Management
Portfolio Management
Portfolio Modeling
Risk Analytics Benchmarks
Stress Tests
Value At Risk Calculation

Fraud Detection

Access Security Management
Check Fraud Monitoring
Custom Fraud Parameters
For Banking
For Crypto
For Insurance Industry
For eCommerce
Internal Fraud Monitoring
Investigator Notes
Pattern Recognition
Transaction Approval

Product Features

Insurance Claims Management

CRM
Claims tracking
Customer portal
Document management
EDI data exchange integrations
Electronic claims
Fraud management
Reporting

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