Discover how EXL's AI-driven Smart Platform is helping healthcare payers move beyond outdated, manual processes to unlock savings and combat fraud, waste, and abuse.

The U.S. healthcare industry is losing billions of dollars annually to improper payments. For healthcare payers operating on thin margins, this isn't just an operational issue—it's a critical threat to financial stability. Legacy systems and manual reviews can't keep up with the scale and complexity of the problem, leaving your organization exposed to revenue loss.

It's time for a new approach.

Introducing the EXL Smart Platform for health, a transformative solution built to address payment integrity at platform scale. By combining artificial intelligence, machine learning, and decades of deep domain expertise, we help you proactively identify and prevent improper payments with unparalleled accuracy. Our platform, built on Databricks and Azure, unifies fragmented data, identifies erroneous claims with precision, and empowers your teams with intelligent tools. We process over 3.8 billion claims annually, and our powerful blend of predictive, generative, and agentic AI models has already unlocked $2.2 billion in savings for our clients.

Key benefits of EXL Smart Platform:

• Unified data foundation: We harmonize data from over 200 different formats and systems, eliminating silos and providing a complete view of claims activity.
• Advanced AI and machine learning fabric: Our proprietary models, trained on one of the industry's largest fraud databases, detect complex patterns that traditional methods miss, reducing false positives by up to 70%.
• Proven, measurable results: Our solutions deliver incremental savings, with a track record of identifying opportunities missed by other vendors.
• Built for healthcare: From our intuitive workflow interfaces to our rigorous HIPAA-compliant security framework, every aspect of our platform is designed for the unique needs of healthcare payers, reducing training time by 80% compared to generic analytics platforms.

Transform your payment integrity strategy from a reactive cost center into a proactive, value-generating capability that drives sustainable financial performance.