Comprehensive, web-based software designed to identify risky providers and allow full-stack investigation and analysis, as well as improve economic efficiencies.
Pulselight rapidly curates and loads all claim types (e.g., professional, institutional, pharmacy), encounters, provider enrollment, and recipient eligibility records with unmatched speed and agility. Unlock your data silos and make your data work for you so your team can deliver actionable results.
For Medicaid Program Integrity, Surveillance Utilization Review, and Medicaid Fraud Control Units, Torch offers powerful data analytics that automatically finds suspicious providers and alerts you to fraud schemes.
From impossible days to inpatient overlap to incorrect billing, Torch empowers users with a library of reports and ad-hoc analysis to explore conflicts and billing behaviors to improve economic efficiencies.
Investigations are the heart of Torch, with comprehensive tools designed for users of any technical skill level. There's no need to write queries. Complex questions can be answered in minutes, pointing users directly to evidence.
Torch's configurable case management component is integrated directly with the data analytics component. With true bi-directional automation, information in analytics is populated in case management and vice-versa, dramatically improving workflow efficiences.
Torch enables private health insurers to uncover instances of fraud, including suspicious providers and recipients. With a library of tools, Torch can be used to uncover any type of fraud scheme.
Explore dental claims, inpatient overlap, suspicious billing and more, from procedures to individual tooth-level analysis. Generate instant reports with a few clicks or send dental offices notices.
We love meeting with prospective clients and discussing how our products can help solve your specific needs.
