Anomaly + network models
Fraud, Waste & Abuse Detection
Provider and member behaviour models that surface upcoding, unbundling, phantom billing and duplicate submissions, ranked by recoverable value rather than by anomaly score alone.
AI and analytics for health insurers, TPAs and healthcare providers, deployed inside your own infrastructure. Patient data is processed locally, never sent to a third-party model, and never leaves your jurisdiction.
On-premise, in your private cloud tenancy, or in an in-country data centre. You choose the location; it never changes without you.
Open-weight models hosted on your hardware. Nothing is sent to an external API, and nothing is used to train anyone else's model.
Identifiers are tokenised before any model sees a record, with re-identification restricted to your own key store.
An immutable, queryable audit trail covering who ran what, against which cohort, and when, ready for an inspection.
Security architecture
Health records are the most tightly regulated data most organisations hold. So the model comes to the data, not the other way around.
On-premise · private VPC · in-country data centre
Outbound egress denied by defaultDeployments are architected to support the data-residency and information-security requirements that apply to health data in the UAE, including UAE Federal Law No. 2 of 2019 on the use of ICT in health fields, ADHICS under DoH Abu Dhabi, and DHA requirements in Dubai, alongside HIPAA and GDPR obligations for international operations.
We provide the architecture, controls and audit evidence. Certification and sign-off remain a joint exercise with your information-security and compliance teams.
Solutions
Payers and providers look at the same encounter from opposite ends. We build for both, with models tuned to the decisions each side actually has to make.
Loss ratio, leakage and turnaround time, modelled against your own policy rules and claims history rather than a generic benchmark.
Anomaly + network models
Provider and member behaviour models that surface upcoding, unbundling, phantom billing and duplicate submissions, ranked by recoverable value rather than by anomaly score alone.
Policy-aware automation
Benefit checks, coverage validation and pricing run against your own policy rules, so clean claims settle untouched and only genuine exceptions reach an assessor's queue.
Actuarial-grade
Trend, severity and utilisation models to price renewals, set IBNR reserves and flag deteriorating cohorts well before they surface in the loss ratio.
For payers & TPAs
Most claims are unambiguous. The work is separating those from the ones that genuinely need an assessor, and doing it in a way you can defend to a regulator afterwards.
We instrument each stage of your pipeline, so you can see exactly where volume drops out, why, and what it costs to recover it.
Example shape only. Your baseline is measured during scoping.
Deployment
The right choice depends on your security posture and your regulator, not on what is convenient for us to host.
Models run on hardware inside your own data centre, managed by your infrastructure team. Nothing traverses a public network at any point.
Best when regulation or policy prohibits health data leaving your premises.
Deployed into your own tenancy in a UAE region. You own the subscription, the network boundary and the encryption keys. We deploy into it.
Best when you already run in cloud and need residency without new hardware.
For environments with no outbound connectivity. Models, updates and audit exports move on controlled media through your existing change process.
Best when the environment is isolated by design and must stay that way.
How we start
No data leaves your side of the table at any point in this sequence.
A working session with your clinical, claims and IT leads to agree the decision the model has to improve, and the constraints around it.
We review schemas, volumes and quality on your side of the boundary. Sample data never leaves your environment.
Models are fitted inside your infrastructure and benchmarked against your current process, with documented assumptions and back-testing.
Deployment, monitoring, retraining schedule and training for your team, so the system is yours to run rather than ours to rent back.
See it in action
Open, running software from this practice no sales call between you and the tooling.
We'll design around it. Book a working session with the team that builds the models, not a sales call.