Healthcare claims integrity

A claim can look fine on its own. The pattern around it might not.

Sequrin gives medical schemes and claims-integrity teams a connected view across providers, members, facilities, timing and related activity, so an investigation can begin with the surrounding context instead of one record in isolation.

Sequrin overview · 68 seconds
See how Sequrin moves from a signal to connected investigation context. English captions included.

The problem

Risk usually is not sitting neatly inside one claim.

A claim can look completely ordinary until you notice the same provider, timing, member or facility appearing somewhere else. The pattern is often in the relationships between records.

Sequrin is being built to pull that context into view early enough for an investigator to ask a better question.

01

Find what stands out

Rules, statistics and models help surface activity that is actually worth a second look.

02

See what connects

Network analysis shows how claims, members, providers, facilities and events relate to one another.

03

Investigate in context

Bring the signal, evidence, relationships and case history together instead of rebuilding the story across separate tools.

The approach

A consistent path from connected data to accountable review.

Sequrin follows one governed workflow for connecting relevant data, detecting unusual activity, investigating it in context and recording the organisation's decision. The complete workflow lives on the Approach page.

Product maturity

A working product with a controlled path to scale.

Sequrin has active browser and desktop investigation experiences. The next milestone is to measure their usefulness with claims-integrity teams under defined operating and governance conditions.

Current

Connected investigation product

Browser and desktop interfaces bring claims review, signal rationale and relationship context into one workspace.

Evaluation

Scheme-led testing

A bounded evaluation can compare signal relevance, time to context and workflow fit with current practice.

Direction

Governed network intelligence

Cross-organisation collaboration remains a longer-term direction built on validated product and governance foundations.

Accountability

Governance principles for sensitive claims work.

Decision boundaries, access controls and reviewability are covered in one place.

Read the governance principles

Evaluation conversations

Discuss a bounded claims-integrity evaluation.

We can start with the question your team needs to answer, the data available and the evidence you would use to judge whether the product helped.