ClaimInformatics, Inc. Information

Every dollar verified. Every duty documented. ClaimInformatics delivers independent payment integrity and fiduciary compliance for self-funded health plans, their TPAs, and their advisors. Trillions of dollars flow through U.S. healthcare every year, yet the organizations that fund coverage rarely get an independent line of sight into how their own claims are billed and paid. We close that gap — conflict-free, with no carrier affiliations and no contingency incentives — so plan sponsors can protect plan assets and prove they've met their fiduciary duty. We review both sides of a plan's fiduciary exposure: ▸ Every claim — measured against authoritative coding and payment standards. ▸ Every governing contract — ASO, SPD, PBM, and stop-loss agreements. And we document the prudent process behind each decision, so plan sponsors and their advisors hold a defensible record of the oversight ERISA requires. Whether an organization hires us to review their claims or licenses our platform to run integrity in-house, the commitment is the same: make healthcare claims transparent. For TPAs, that means white-label payment integrity — carrier-grade capability under your own brand, with new revenue potential and built-in fiduciary protection for your clients. By the numbers (trailing 6 months): ▸ $171M+ in errors identified ▸ 8.7% error identification rate ▸ 100% of claims reviewed — no sampling What we do: ▸ Independent claims analysis & payment integrity ▸ Contract review (ASO, SPD, PBM, stop-loss) ▸ Fee and cost transparency for plan sponsors Fiduciary duty requires more than trusting carrier self-reporting. It requires independent oversight — and the documentation to prove it. Learn more: https://www.claiminformatics.com · Bloomfield, CT