Learn how AI-assisted claim auditing actually works.
Educational material and credibility assets for teams evaluating AI in claim review — written to inform, not overclaim. Overviews and briefs are request-based: tell us who you are, and we send the current version by email.
Documents we send by email.
We keep these request-based so every evaluator gets the current version — and a direct line to the team for follow-up questions.
Platform Overview one-pager
What Audit Insights Assist (AIA), Medical Fraud Filter (MF2), and Anonymization Service (ANS) do, how the modules fit into one workflow, and how a pilot works.
Request by emailSecurity Brief
How the platform approaches PHI handling and minimization, application-level controls, and the deployment planning questions we work through with security and compliance teams.
Request by emailPilot Proposal Outline
The structure of a typical pilot: scope, success criteria you define with us, human control points, and the data-protection commitments that apply throughout.
Request by emailFrequently asked questions
Straight answers to the questions payers, TPAs, and compliance teams ask us most.
Does ClaimClean replace claim auditors?
No. ClaimClean is designed to assist auditors by surfacing review signals, organizing evidence, and generating reports. Final decisions remain with qualified human reviewers.
Who is ClaimClean built for?
ClaimClean is built for healthcare payers, TPAs, cost-containment firms, SIU teams, and claim audit teams reviewing medical claims. See our solution pages for healthcare payers and TPAs & cost-containment firms.
How does ClaimClean protect PHI?
ClaimClean includes anonymization and PHI minimization workflows designed to reduce unnecessary exposure of Protected Health Information before claim data enters downstream analysis. Every deployment is planned with clear data-retention, access-control, and audit-log expectations for the customer’s workflow. The Anonymization Service page and our trust approach cover this in more detail.
What are AIA, MF2, and ANS?
AIA stands for Audit Insights Assist, MF2 stands for Medical Fraud Filter, and ANS stands for Anonymization Service. Together they support claim data protection, screening, and auditor-ready insight generation.
Is ClaimClean HIPAA compliant?
ClaimClean is being built for HIPAA-aligned healthcare workflows, including PHI minimization and controlled data handling. Formal compliance representations are confirmed during customer diligence and legal review, so your team can verify the specifics before any data moves.
Can ClaimClean integrate with existing claim systems?
Pilot workflows run on secure data intake and export, so teams can start without deep integration work. Specific integrations are scoped based on the payer, TPA, or audit team’s environment — tell us about yours and we’ll walk through the options.
Guides we’re working on.
Short, practical pieces for audit, SIU, and compliance teams. We publish when a guide is genuinely useful — no invented statistics, no gated fluff.
CMS audit readiness
How payer audit teams can prepare for reviews aligned with Centers for Medicare & Medicaid Services (CMS) guidance — and where configurable policy and guideline checks help.
A practical guide to AI in healthcare fraud review
Where AI assistance genuinely helps with fraud, waste, and abuse review — and where human auditors stay essential to every determination.
PHI anonymization for claim workflows
Practical PHI minimization patterns for claim review, analytics, and AI-assisted workflows — what to redact, when, and how to keep records useful.
Follow the build.
Product updates, milestones, and what we're learning from payer and audit teams — straight from the ClaimClean company page.
Have a question we didn’t answer?
Send it over. A founder reads every message, and we answer plainly — including the questions we can’t fully answer yet.