Doctor with Files

About Us

Redefining Payment Integrity and FWA,
Leveraging the Technology of Tomorrow, Today.

Company Overview

360 Health Systems is an innovative payment integrity, fraud, waste, and abuse solution provider. We empower health plans and payers organizations to effectively analyze and recover lost revenue with total visibility into their payment integrity initiatives.

 

Our AI-powered technology PORA applies predictive analytics to multiregional data promoting more thorough overpayment detection. Our neural network intuitively protects you from improper payments far beyond traditional models. 

Image by Graham Ruttan
Image by National Cancer Institute

What We Offer

  • Achieve superior claims cost containment and the payment integrity your business needs, how you want it, when you want it.

  • Reprice contracts, apply proper coding and correct reimbursement methods using retrospective error identification and analysis.

  • Innovative AI-powered, turn-key solution that delivers real-time reporting of paid claims data.

  • A platform that unites all your payment integrity efforts, streamlining your internal and external process through one solution.

  • Intuitively designed and developed tools that increase agility by putting business users in charge of the discovery and recovery process for payment errors and FWA with minimal reliance on IT staff into a centralized and user-friendly platform.

  • Capture new savings with insight into emerging schemes that single-payer data typically cannot predict.

  • Continuously monitor across more than 20,000 objectives, primary, and public data sources.

  • A complete real-time and historical database for all federal and state exclusions dating 9 years or more.

  • Solutions that easily integrate within your existing claims workflow providing multi-layered protection that offers retrospective claims review, as well as cost avoidance management.

  • Robust discovery engine that automates revenue recovery.

  • 240+ proprietary and highly scalable algorithms.

Friendly Business Team

Schedule a demo of our software and services