Bill all the care you give, and pay only for what you get.
Hospitals, pharma and device makers lose money in unbilled services, distributor claims and supplier spend. We find it in your clinical, sales and finance data, and keep the evidence auditors ask for.
01Where money leaks in life sciences and healthcare
Unbilled care
Procedures, consumables and days of care recorded but never billed.
Distributor and stockist claims
Chargebacks, free goods and price differences claimed above the agreement.
Third parties
Suppliers, distributors and payments to doctors that need checks for bribery and conflicts.
Stock and expiry
Batches written off near expiry, and stock that disappears between stores.
Twelve use cases across hospitals, pharma, supply and compliance
- Unbilled servicesClinical records, billing, consumables
- Package rate overrunsPackages, bills, length of stay
- Insurer claim rejectionsClaims, rejection reasons, documents
- Distributor chargebacksContracts, chargebacks, sales
- Gross-to-net by channelPrice lists, schemes, rebates
- Free goods and samplesSample issues, sales calls, territories
- Near-expiry write-offsBatch data, stock movements
- Cold-chain exceptionsTemperature logs, deliveries
- Purchase price varianceContracts, orders, invoices
- Payments to healthcare professionalsGrants, fees, events
- Supplier risk scoringSupplier master, registries
- Duplicate vendor paymentsVendor master, invoices
Each use case names the data it needs. Hospital information systems and distributor data usually sit outside the ERP.
One case: care that was given but never billed
Hospitals: the record shows the care. The bill doesn’t.
- Situation
- A hospital group; billing teams key charges from clinical notes, and audits check a few files a month.
- What a sample misses
- Each bill looks complete. What’s missing is a consumable or a procedure the clinical record shows and the bill doesn’t.
- Data and technique
- Clinical records, theatre notes and pharmacy issues matched to every bill; rules by procedure, and outliers by ward and doctor.
- Typical findings
- Implants and consumables issued but not billed; procedures charged at the wrong package rate; days of care missing from long stays.
- Control fix
- Charges captured at the point of care; a daily list of unmatched items sent to billing before discharge.
Unbilled care is revenue you have already paid to deliver.
Illustrative composite case, read-only access.
A hospital group finds care that was given but never billed → A pharma company watches its suppliers by what they do →
Hospitals and pharma: 12 tests to run first
| Hospitals | Pharma and devices |
|---|---|
| Consumables issued but not billed | Chargebacks above the contract price |
| Procedures billed below the package rate | Free goods above the scheme |
| Discounts given without approval | Stock written off near expiry, by depot |
| Insurer rejections by reason and department | Payments to doctors without a contract |
| Refunds and cancellations after discharge | Sales spikes at quarter end, then returns |
| Long stays with missing day charges | Suppliers that share an address or bank account |
Thresholds are set for each hospital and market, and tuned on the results.
05Earn $ and Save $ in life sciences and healthcare
A hospital group recovered USD 1.2 Mn a year in care that was given but never billed, across 6 hospitals.
Where is your money hiding?
06Other industries
Where is your money hiding?
Three minutes to an estimate. Thirty minutes to a plan. Six weeks to valued findings on your own data.