Medicare and Medicaid lose tens of billions to improper payments every year.E-HRIP identifies which claims are at risk — before and after payment —and explains every flag in plain language so reviewers can act on it.
Improper payments in Medicare and Medicaidrun into the tens of billions every year.Much of it is never recovered. The federalgovernment has formally identified this as anational priority — through statute, annualCMS reports, and executive action.E-HRIP addresses that problem at the level oftools any U.S. healthcare payer can use.
Most improper payments are documentation or eligibility errors — not fraud. E-HRIP is built around where the federal evidence actually is.
Most integrity tools hand reviewers a score and leave the reasoning to them. E-HRIPdoes the explaining — stratifying claims, surfacing anomalies,and telling reviewers exactly why each flag was raised
E-HRIP builds in phases — one working module first, then a methodology note,then validation as real data results accrue. Nothing is asserted before it exists.