AI-Powered Payment Integrity Solution for Healthcare Payers
nēdl Pulse leverages advanced AI and automation to simplify the complex healthcare payment integrity value chain—cutting through inefficiencies and delivering measurable savings.
Claim Repricer
Comprehensive Medicare-equivalent repricing across all major payment schedules and claim types. Built for scale, performance, and compliance.
Contract Intelligence
Leverage AI to extract, structure, and understand complex provider contracts and reimbursement terms—ensuring correct application during claims processing.
Policy Intelligence
Continuously benchmark payer reimbursement policies against CMS guidelines and market standards to ensure alignment, reduce variation, and support strategic planning.
Payment Leakage Analysis
Conduct advanced post-payment audits to identify, quantify, and prevent overpayments, misaligned reimbursements, and compliance risks—powered by AI analytics and real-time insight.
25%
of total costs are related to waste & inefficiencies
60%
of reimbursements have inconsistencies between billed and allowed amounts.
$1.3T
annually lost to administrative overhead and claim errors.
80%
of claims are reviewed post-payment, missing proactive savings opportunities.
Repricing and Prepayment Validation
AI ensures error-free claims and compliance before payment
Post-Payment Analysis
Detects payment errors, enables recovery, and refines processes
Analytics & Intelligence
Delivers actionable insights and conversational agents for deep data analysis
Fraud, Waste & Abuse Detection
Identifies anomalies, patterns,and risks with precision
Contract Compliance
Aligns claims with policies and terms to minimize disputes
nēdl.ai Pulse is an advanced payment integrity platform built for payers.
Powered by compound AI, machine learning, and NLP, Pulse delivers accurate Medicare-equivalent claims repricing, contract compliance, and policy alignment—significantly reducing payment leakage.
Built to plug into your existing data and analytics workflows, Pulse delivers:
Seamless integration with claims and payment systems
Rapid deployment and low lift for IT teams
Actionable analytics and conversational AI for deeper insights
Measurable cost savings by reducing overpayments and leakage
Innovation
Continuously develop cutting-edge AI products, pushing technology boundaries and driving business transformation.
Customer-Centricity
Prioritize customers, addressing their needs and challenges with valuable technology and solutions.
Integrity
Uphold honesty, transparency, and ethical behavior in all interactions and decisions.
Excellence
Commit to the highest standards of quality and performance, always striving for continuous improvement.
Collaboration
Promote teamwork, learning, and knowledge sharing, fostering a collaborative environment for all stakeholders.