CognitoClaims reads medical documents, understands policy terms, and adjudicates health claims with a fully traceable decision trail — for insurers, providers, and TPAs.
Premiums are rising, claim volumes are climbing, and the adjudication layer between hospitals and insurers remains manual, opaque, and fragmented.
Complex inpatient and rider claims are still assessed by hand — slow, inconsistent, and expensive as volumes grow across the region.
Discharge summaries, itemised bills, and referral letters arrive in every format and language SEA can produce. Legacy OCR gives up where claims actually live.
Black-box scoring fails regulators, frustrates providers, and erodes policyholder trust. In this market, an unexplainable decision is an unusable one.
From raw document to explained decision — for payers assessing claims and providers submitting them. See the full platform →
Purpose-built OCR/ICR for the documents of Asian healthcare — handwritten referrals, mixed-language bills, scanned discharge summaries — normalised into structured claim data.
Diagnoses, procedures, medications and clinical context coded against medical knowledge — the engine reasons about what happened to the patient, not what's printed on the page.
Benefit schedules, riders, exclusions, panel rules and fee benchmarks applied automatically. Clean claims flow straight through; the rest get flagged for human eyes.
Every decision ships with its reasoning: the clauses applied, the benchmarks referenced, the signals weighed. Assessors override with one click — and the trail captures that too.
Hyper-accurate ingestion from any document type — including handwritten notes — with clinical extraction that understands the medicine.
CognitoAdjudicate™Adaptive policy enforcement with a semantic policy engine and dynamic decision support for consistent, compliant adjudication.
CognitoShield™Deep anomaly detection across claims, providers and time — routing what deserves human eyes with the evidence attached.
CognitoPredict™Proactive claims intelligence that identifies and flags denial risks before submission — boosting first-pass success rates.
CognitoBridge™AI-driven integration that harmonises data and generates dynamic APIs for interoperability across any system you run today.
Full platform →How the five products chain into one pipeline — from raw document to explained decision.
Most claims AI was built for other markets and other rules. CognitoClaims is engineered for the regulatory reality of Singapore and Southeast Asia — MAS FEAT principles, PDPA, and MOH's AI-in-healthcare guidelines — with deployment models that keep data inside your perimeter.
Private briefings for insurers, provider groups, and TPAs across Singapore and Southeast Asia.
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