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Average Ratings 0 Ratings

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ease
features
design
support

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Description

NEMESIS is an advanced AI-driven technology for anomaly detection that specializes in identifying fraud and inefficiencies. This next-generation platform not only highlights opportunities for improved efficiency within your business management systems, but it also serves as a customizable enterprise solution that allows business analysts to quickly convert data into meaningful insights. By harnessing the capabilities of artificial intelligence, NEMESIS addresses challenges including overstaffing, medical inaccuracies, care quality, and fraudulent claims. With its continuous process monitoring, NEMESIS reveals various risks, from anticipating quality concerns to uncovering waste and misuse. Utilizing machine learning and AI, it effectively identifies fraudulent activities and schemes before they can impact your financial resources. Furthermore, NEMESIS enhances your ability to manage expenses and track budget discrepancies, ensuring ongoing transparency regarding waste and abuse. This comprehensive approach not only improves operational efficiency but also fosters a more accountable financial environment within your organization.

Description

An automated claims platform that operates seamlessly from start to finish, leveraging AI-driven decision models for tasks such as data collection, policy and coverage verification, medical coding, and consistency assessments. Our advanced AI models are designed to minimize losses and enhance your loss ratios by effectively detecting fraud, waste, and abuse in health and life insurance sectors. Qantev empowers insurers globally by improving operational efficiency, curbing losses, and elevating client satisfaction. By integrating artificial intelligence with deep medical knowledge, our dedicated team of data scientists and engineers has created cutting-edge solutions that streamline the claims management process while identifying fraudulent activities. Our specialized AI tools are adept at capturing, cleansing, enhancing, and digitizing data from a variety of claims documents in multiple languages. Additionally, we bolster the performance of your medical provider network with automated insights, identifying pricing gaps, recommending strategies, simulating different scenarios, and much more to optimize outcomes. This holistic approach ensures that insurers not only respond to claims effectively but also proactively prevent potential issues before they arise.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

Amazon Web Services (AWS) Yes 
IBM Cloud Yes 
Microsoft Azure Yes 

Integrations

Amazon Web Services (AWS) No 
IBM Cloud No 
Microsoft Azure No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours No 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) Yes 
In Person No 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) Yes 
In Person Yes 

Vendor Details

Company Name

Aviana

Founded

1994

Country

United States

Website

nemesisbyaviana.com

Vendor Details

Company Name

Qantev

Founded

2018

Country

France

Website

www.qantev.com

Product Features

Data Analysis

Data Discovery No 
Data Visualization No 
High Volume Processing No 
Predictive Analytics No 
Regression Analysis No 
Sentiment Analysis No 
Statistical Modeling No 
Text Analytics No 

Financial Risk Management

Compliance Management No 
Credit Risk Management No 
For Hedge Funds No 
Liquidity Analysis No 
Loan Portfolio Management No 
Market Risk Management No 
Operational Risk Management No 
Portfolio Management No 
Portfolio Modeling No 
Risk Analytics Benchmarks No 
Stress Tests No 
Value At Risk Calculation No 

Fraud Detection

Access Security Management No 
Check Fraud Monitoring No 
Custom Fraud Parameters No 
For Banking No 
For Crypto No 
For Insurance Industry No 
For eCommerce No 
Internal Fraud Monitoring No 
Investigator Notes No 
Pattern Recognition No 
Transaction Approval No 

Product Features

Insurance Claims Management

CRM No 
Claims tracking No 
Customer portal No 
Document management No 
EDI data exchange integrations No 
Electronic claims No 
Fraud management No 
Reporting No 

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