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Your claims are adjudicated
by hand. Your margin pays.
Saudi insurers and hospital groups process millions of claims a year, lose margin to denials and rework, and now run on mandatory NPHIES rails. We auto-adjudicate the clean claims and catch the risky ones before payout. See it run.
Hands-on
Run a claim batch. Watch the leakage get caught.
Adjudicate a sample batch: each claim is validated against NPHIES, scored for denial risk, then auto-approved or routed for review with the evidence attached.
Eight live-style claims across inpatient, pharmacy, outpatient, dental and lab. Run them through NPHIES validation and denial-risk scoring.
Run the batch to auto-adjudicate the clean claims and catch the risky ones
A demonstration on sample claims: NPHIES validation, denial scoring and adjudication mirror the real product, simulated in your browser. In production it integrates with your NPHIES gateway and claims system inside your data-residency boundary, engineered to ISO 27001 and PDPL standards.
The fix
Three steps, built and operated by us.
01 · Validate
Every claim is checked against NPHIES coding and eligibility rules before submission, so first-pass acceptance climbs instead of bouncing back.
02 · Predict
A model scores each claim for denial risk and fraud signals, so the leakage is caught before payout, not chased after it.
03 · Adjudicate
Clean claims auto-adjudicate; the rest are routed to your team with the evidence pre-assembled. Your adjusters work exceptions, not every claim.
Proof, not a prototype
Document intelligence is our core.
The extraction and reconciliation behind this is the engine we built and operate on Imperapetro — turning heavy, fragmented documents into structured, transactable data. Claims are exactly that problem, with a denial-prediction model on top.
Document intelligence Predictive analytics NPHIES
The business case
Put your numbers in. See the leak.
This isn’t a quote — it’s your exposure, computed from your own claim volume. Adjust anything; the assumptions are shown.
The offer
- NPHIES-integrated claims intelligence on a live claim sample
- Denial-prediction and fraud-leakage flags, scored per claim
- Auto-adjudication of clean claims; exceptions routed with evidence
- Measured first-pass acceptance and leakage-recovered readout
- Expansion: build-and-operate, SAR 2–5M / year managed
The pilot
Prove it on your own claims.
Give us a representative claim sample and your NPHIES context; we return measured first-pass acceptance, caught denials, and a leakage-recovered number on your data. Then we operate it.