ClaimInsight is AMPS’ modern solution for prepay claim editing and physician-led high-dollar bill review—engineered to help health plans navigate the complex financial and operational challenges of 2025. As healthcare costs rise and margins tighten, ClaimInsight delivers real, measurable savings through clear, defensible processes—without the inefficiencies, opacity, or friction of outdated cost containment tools.
ClaimInsight's comprehensive payment integrity suite, offers scalable, defensible cost containment through two purpose-built tools: the Intelligent Payment Utility (IPU), a transparent, rules-based prepay editing platform, and High-Dollar Review (HDR), a physician-only review process for large, complex claims. While these tools deliver immediate value on their own, they are even more powerful when used together.
Our innovative approach is built on five pillars that ensure your success. With AMPS ClaimInsight, Health Plans are empowered to optimize their revenue cycle, streamline operations, and protect their bottom line, all while maintaining the highest levels of clinical excellence and operational integrity.
Our Intelligent Payment Utility (IPU) is designed to identify and correct overpayments before they happen—using a transparent, rules-based process that offers full visibility into how and why every edit is applied. With predictable PMPM pricing and no contingency fees, IPU helps protect your ROI while delivering clear, defensible savings.
ClaimInSight takes high-dollar bill review to the next level. Unlike vendors who rely on nurses or algorithms, we use only U.S. board-certified physicians to manually review complex claims—ensuring unmatched clinical accuracy and defensibility. Our physician-led approach catches errors that others miss, such as a Level 4 E&M code billed with only Level 3 documentation, and helps reduce costly overpayments that routinely bypass automated systems. Implementation is fast and seamless—no IT lift, no complex integrations.
At AMPS, we prioritize the patient experience by supporting Health Plans in delivering high-quality care without financial compromise. ClaimInsight’s precise claims auditing ensures that Health Plans can focus on patient care, knowing their billing processes are accurate and compliant. This commitment to operational excellence supports long-term success for Health Plans and the communities they serve.
AMPS stands out for its unwavering commitment to compliance, ensuring all claims are audited with the highest standards of accuracy and regulatory adherence. With ClaimInsight, Health Plans receive transparent, defensible, and compliant solutions that protect their revenue and minimize the risk of audits. Our proven track record in financial savings offers Health Plans ethical, reliable solutions that build trust and confidence.
AMPS is dedicated to your success with comprehensive strategic partnership support at every stage. From onboarding to ongoing management, our expert team provides real-time reporting, robust training, and dedicated account management. With ClaimInsight, we ensure Health Plans have the resources and support needed to optimize their revenue cycle and achieve long-term financial success.
ClaimInsight offers more than savings—it offers clarity, control, and confidence.
We approach every client relationship as a true partnership, focusing on collaborative problem-solving tailored to your unique needs. Our team doesn't believe in one-size-fits-all solutions — instead, we bring creativity, strategic thinking, and a deep commitment to your success. By working closely with you, we craft customized strategies that drive real results, ensuring that every step we take together is designed specifically for your goals.
Our unique value proposition exists in our three core solutions—PriceDynamix, ClaimInsight, and Drexi—designed to reduce costs and enhance the member experience. Whether working together or independently, these solutions offer the flexibility, precision, and savings that your organization needs.
PriceDynamix by AMPS delivers unparalleled savings through precise claim repricing powered by our proprietary technology. We combine member-centric care with unmatched accuracy, ensuring fair pricing, significant cost reductions, and a seamless healthcare experience for clients and members alike. Experience superior outcomes with PriceDynamix.
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ClaimInsight by AMPS offers industry-leading healthcare payment integrity solutions that maximize accuracy and reduce costs. Our robust claim editing solution, combined with a physician-led High-Dollar Medical Bill Review, ensures claims are processed efficiently and accurately, delivering significant savings and seamless integration
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Drexi is transforming pharmacy benefit management with a commitment to excellence and integrity. Our innovative technology solutions empower plans and members to take control of their healthcare by effectively managing prescription costs while delivering unmatched savings and benefits.
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