Stop overpaying medical claims before they're approved
ProGini AI detects fraud, overbilling, and anomalies across millions of claims in real time — comparing each against benchmark pricing and flagging risk before the payment goes out.
Potential Savings
$2.4M
12,847
Total
342
Flagged
47
High Risk
Trusted by leading insurers and payer networks
The cost of undetected billing fraud
Insurers lose billions every year to overbilled, duplicate, and miscoded claims that slip through legacy review systems.
$300B+
Lost annually to U.S. healthcare fraud
1 in 4
Claims contain pricing anomalies
7%
Average claim leakage for payers
How ProGini AI works
Three steps from claim to confidence.
01
Ingest
Claims flow in via API, batch upload, or EHR integration. We normalize CPT, ICD, HCPCS codes.
02
Benchmark
Each claim is compared against regional pricing benchmarks across 50,000+ procedure codes.
03
Flag
AI explains anomalies, scores risk 0–100, and routes high-risk claims to your review team.
Built for modern payers
Enterprise-grade fraud detection with the simplicity of a consumer product.
Real-time analysis
Sub-second risk scoring on every submitted claim.
Benchmark comparison
Region-aware pricing across 5 U.S. markets.
AI anomaly detection
Natural-language explanations for every flag.
Fraud alerts
Severity-tiered alerts route to the right reviewer.
Built on enterprise-grade trust
ProGini AI is HIPAA-aligned, SOC 2 Type II in progress, and designed with a zero-trust architecture. All PHI is encrypted at rest and in transit.
"ProGini AI flagged $1.8M in overbilled claims in the first 90 days. The AI explanations made reviewer adoption effortless."
Dr. Elena Marquez
VP Claims Integrity, Meridian Health