Fraud Detection Sentri

Fraud Detection · Sentri 03

Our agent catches the cheats before they cash out.

Our Sentries read every claim the way a seasoned investigator would — spotting the patterns that give fraudsters away, at a scale no human team could match.

The Fraud Detection Sentri is an autonomous AI agent that reads every claim like a seasoned investigator — scoring it against known fraud patterns, explaining what looks wrong, and routing the risky ones to your team.

Use CasesRequest a Demo

The problem

A $300 billion leak — barely watched by AI.

Fraud drains payers at a scale no manual review can keep up with — and almost no one has pointed modern AI at the problem yet.

$308B

lost annually to healthcare fraud in the U.S.

~50%

of healthcare fraud is billing fraud — exactly what the Sentri scans for

4.3%

of health firms use AI against fraud today — a wide-open field

Sources: NHCAA; Coalition Against Insurance Fraud / Forbes Advisor.

Fraud Detection

Use Cases

Select a use case to see its step-by-step workflow.

The big picture

How the Sentri investigates

  • Read everything

    Sentri ingests every claim, provider, and patient record in real time.

  • Spot the pattern

    Sentri compares each claim to known fraud fingerprints and normal behavior.

  • Score the risk

    Sentri rates how suspicious it looks — in real time.

  • Explain

    Sentri attaches a plain-English reason it looks wrong.

  • Escalate

    Sentri routes the riskiest cases to your investigators.

Every flag arrives with the evidence that raised it — never an opaque score.

Your investigators can review or override any flag at any time.

The payoff

Why this pays for itself.

Every dollar of fraud the Sentri catches is a dollar you keep — and recovering even a sliver goes straight to the bottom line.

Illustrative model

A regional insurer paying $2B in claims/year loses an estimated 3%–10% ($60M–$200M) to fraud. Recovering even 5% is $3M–$10M straight to the bottom line.

Illustrative estimate for discussion only — not a performance guarantee.

See what fraud is quietly costing you.

We’ll scan a sample of your historical claims and show you the patterns your current process is missing — before you commit to anything.

Request a demo