Take Full Control of
Payment Integrity
A secure, transparent end-to-end Payment Integrity Platform for health plans seeking full control over edits, recovery, and compliance. Acting as a Zero-Pass authority, it integrates between adjudication and recovery to internalize rules and prevent leakage in real time. With rule driven vendor routing, AI assisted appeals management, and precise reconciliation, it ensures complete financial integrity through a single, self-hosted command center.
Deploy in your own secure environment for absolute data control.
Built-in LLMs to accelerate rule discovery and automation.
Prevent overpayments during adjudication, not just after.
Tailor rules and workflows to your exact operational needs.
Full visibility into every automated decision and calculation.
Empower teams to build and deploy edits without IT help.
The Payment Orchestration Lifecycle
A comprehensive approach to accuracy, from initial billing to final recovery, powered by intelligent automation.

Author
Initiate accurate billing entries.
Manage
Automated audit & validation.
Recover
Recover lost revenue instantly.
Prevent
Stop future leakage proactively.
How Qwik PI Works
QwikPI streamlines your end-to-end payment integrity lifecycle by integrating clinical expertise with automated data orchestration. From rule creation to recovery and prevention, we provide the tools you need to stop leakage at every stage.
Integrate
Experience real-time integration with your claim adjudication system for instant, zero-lag validation using our pre-built, out-of-the-box adapters.
Build
Tailor our library of 6,000+ pre-built rules or architect your own custom logic with our intuitive, user-friendly Rule Studio.
Analyze
Leverage non-destructive impact analysis to simulate and validate rule changes with total confidence before deploying to production.
Recover
Automate retrospective claim recovery while ensuring full adherence to state mandates, product guidelines, and provider contracts.
Prevent
Shift from recovery to prevention by deploying rules directly into the pre-payment workflow to stop erroneous payments before they occur.
Real-Time
Integration

QNXT / Facets / Others
Vendors
Providers
QwikPI acts as the central orchestration hub, seamlessly bridging the gap between your core adjudication systems, external vendors, and provider networks. Our secure infrastructure ensures absolute data integrity and real-time visibility across every junction of the payment lifecycle.
~6000 Out of Box rules
Rule StudioBuild|Analyze|Recover|Prevent
High Transparency

Prospective &
Retrospective PI
Unify retrospective recovery and prospective claim validation in one seamless workflow. As soon as a new rule is authored, historical claims are analyzed for recovery opportunities. Once approved, the rule drives retrospective recovery actions while simultaneously moving into prospective validation to deny future claims automatically.
Accelerated by AI,Governed by Humans

Automated Contract-to-Rules Conversion
Integrated AI Rule-Conditions
Intelligent Appeal Support
Use AI to accelerate and strengthen payment integrity workflows across rule authoring, validation, and appeals. AI can read documents, generate draft rules for human review, and support AI-driven validation within the rule engine while preserving reasoning and evidence for better decision-making. It also assists appeal specialists with deeper analysis, all within a governed human-in-the-loop framework.
Self-Service Letter Templates
Recovery & Appeals Management
Open Payables Recoupment
End-to-EndRecovery Platform
Manage the full post-pay recovery lifecycle from a centralized command center. Qwik PI enables clients to create recovery letter templates in Microsoft Word, automate letter generation and print-vendor delivery, track recovery timelines by state, line of business, or contract terms, and manage incoming checks, appeals, and offset workflows, all in one place for operational efficiency and visibility.
AutomatedReconciliation
Recovery Reconciliation
Check Reconciliation
Vendor Bill Reconciliation
Reconcile every recovery transaction from check, ACH deposit, or offset through final update in the claim adjudication system. Qwik PI tracks corrected claim resubmissions, traces each recovery effort to realized savings, links vendor billing directly to actual financial outcomes, and reports any inconsistencies to the appropriate teams for quick corrective action.