Technology
MediClaim – our in-house claims software run by clinicians.
MediClaim is our proprietary, AI-enabled platform for international medical claims. It pairs machine-assisted adjudication and invoice auditing with in-house doctors and nurses – one system, one audit trail, from intake to settlement.
Inside the platform
Why we built our own software
Every insurer runs claims differently. Because we own MediClaim, we can set up your rules, reports and service levels ourselves, without waiting on a software vendor. Our tech team sits next to the claims team, so new features come from the people who use the system every day.
2,438
Cases this month
1.8d
Avg adjudication
98.4%
On-time settlement
What MediClaim does
AI-assisted adjudication.
Routine claims are pre-filled for a reviewer to approve. Cases that need medical judgement go straight to a clinician.
Invoice auditing and fraud checks.
Every invoice is audited and checked against contracted rates and known fraud patterns before we approve payment.
ICD-10, CPT and DRG coding.
Coding is validated inside the platform, so decisions stay consistent and ready for audit. ICD-10 is our standard, and CPT and DRG are available when a client's contracts use them.
Local-currency settlement.
Direct billing and payment in local currency through our own network across Europe and partner networks in 150+ countries, with no manual currency conversion.
Real-time dashboards.
Claims volume, turnaround, denial rates and costs update live, with reports set up for each client.
API-first integration.
Our REST API links MediClaim to your policy administration system, so member data, claims and reports move between us without manual work.
API documentationClinicians in the loop
Medical decisions stay with our doctors.
MediClaim handles the volume. Whenever a claim needs medical judgement, it goes to one of our in-house doctors or nurses, and they make the call.
How we handle claimsMedical necessity.
Licensed clinicians review medical necessity on every case that needs it.
Complex cases.
Complex and high-cost cases are case-managed from admission to discharge.
Audit trail.
Every decision is recorded with who made it and why.
Security and data protection
Your members' data stays protected
GDPR by design.
MediClaim is built around the GDPR, and we sign a data processing agreement with every client.
Data stored in the EU.
Patient and claims data is stored and processed within the EU.
Encryption and access control.
Data is encrypted in transit and at rest, access is limited by role, and our data-processing practices are independently audited.
Let our team and our platform handle your claims
Tell us your claim volumes, the countries you cover and how you handle claims today. We'll come back with a proposal.
Request a proposalMediClaim runs behind every service we offer. See our services