See the Pattern. Stop the Loss.
LOKI is designed to identify relationships across claims, participants, providers, attorneys, organizations, addresses and historical intelligence—helping investigators and claims professionals see what isolated file review cannot.
Fraud rarely announces itself. It leaves signals.
LOKI helps transform raw claims information into a connected intelligence picture so teams can decide where deeper review is warranted.
Cross-Claim Pattern Recognition
Identify recurring people, providers, attorneys, locations and organizations across apparently unrelated claims.
Entity Relationship Intelligence
Map connections among claimants, businesses, treatment providers, law firms, addresses, vendors and related entities.
Medical & Billing Pattern Review
Surface treatment, billing and referral patterns that may warrant further investigation or forensic review.
Hot Spots & Concentrations
Recognize geographic, organizational and participant concentrations across books of business.
Historical Intelligence
Compare incoming information against known intelligence and prior activity to help accelerate triage.
Human-in-the-Loop Investigation
LOKI supports investigator and claim professional judgment. It does not replace evidentiary review, legal analysis or professional decision-making.
From claim data to actionable intelligence.
Ingest
Bring claims and supporting data into a structured intelligence environment.
Connect
Resolve entities and relationships across files, participants and historical information.
Analyze
Surface indicators, clusters, relationships and anomalies that warrant attention.
Act
Escalate for claim handling, SIU investigation, forensic review or legal evaluation.