No-code fraud rules and thresholds — including AI-generated rules from a plain-language description, always reviewed before activation.
Continuously improving fraud detection.
Network visualization, community detection and cross-community bridge provider analysis.
Explainable AI summaries and human-approved recommendations.
Risk ranking and anomaly detection.
Full investigation workflow with AI-assisted case review and a visual evidence timeline for every claim.
Executive dashboards and reporting.
Ask questions in plain language, by text or voice, and get an instant answer — no SQL, no dashboards, no analyst in the loop.
Flag known bad-actor providers, doctors and members the moment they appear in an alert, a case or the fraud graph — managed by your own team, with full audit history and no impact on unrelated claims.
Every alert is transparent, auditable and supported by risk scoring, graph analytics and AI-driven investigation. Our graph engine uncovers hidden provider networks, detects communities of related claims and flags cross-community bridge providers that connect otherwise separate fraud rings.
Our AI case agent proposes a decision and rationale for every case — but never acts alone: every recommendation requires human review and approval before it becomes a record, keeping investigators in full control and every decision auditable.
Executives can also ask the platform directly: our conversational AI assistant answers plain-language questions about claims, providers and alerts — by voice or text, in any of our 7 supported languages — running on an isolated, read-only connection so it can never modify your data.
Faster Reviews
SIU Productivity
Leakage Reduction
Detection Increase
Email: info@insurgraph.ai
LinkedIn: https://www.linkedin.com/company/insurgraphai/