Powered by a first-of-its-kind digital platform, Kalderos Discount Monitoring is the only modern, cloud-based solution that applies intelligent algorithms to claims level data, identifying the noncompliance that other approaches miss.
Using machine learning techniques that scale to the size of any organization, Discount Monitoring uncovers past noncompliance and also identifies new noncompliant claims.
The Kalderos platform ingests a steady flow of data from both public and proprietary sources.
AI uses pattern recognition to identify an anomaly – indicating noncompliance – within the data.
The platform surfaces the noncompliant claim directly to the covered entity for verification in Kalderos Review. Covered entities want a compliant program, so it helps them to be able to identify and resolve issues.
The platform then routes the verified noncompliant claim to the manufacturer, which can build a dispute report using Kalderos Verify. They immediately have a clear picture of what to dispute with the state.
Using the platform, the manufacturer submits the dispute report directly to the state with high confidence. The state receives a verified noncompliant claim and has visibility into its history, easing the dispute resolution.
