Dual-Engine Claims Intelligence: Ground Field Verification & Board-Certified Doctor QC
Eliminate fraudulent admissions and inflated hospital billing from Day 1. Yuvika combines real-time boots-on-the-ground physical field detectives with board-certified Doctor QC clinical audits to provide forensic-grade evidence before claim disbursement.
Doctor QC & Medical Audit
Board-certified clinical chart scrutinizing, surgical justification, and line-item medical necessity protocols.
Ground Field Forensics
2-hour locus visits, midnight surprise bed occupancy checks, patient identity and employer physical verification.
Tariff & Consumables Matrix
Unbundling detection, surgical implant price caps, and benchmark variance scoring across 1,800+ hospitals.
Legal Repudiation Vault
Court-admissible doctor affidavits, geo-stamped photos, and digital evidentiary chain of custody.
Institutional Investigation Services
Built to neutralize leakages, inflated hospital billing, and syndication fraud across every touchpoint of the claim lifecycle.
CORE PILLAR: GROUND FIELD
Ground Field Claims Investigation
Pan-India physical locus visits, tamper-proof geo-tagged photographic evidence, insured and treating attendant cross-examinations, and discrete employer payroll verification.
HOSPITAL SURPRISE VISITS
Midnight Bed Check & Network Audits
Unannounced midnight physical admission verifications, phantom bed tracking, verifying treating doctor presence, and curbing hospital syndication networks.
CORE PILLAR: DOCTOR QC
Doctor QC & Medico-Legal Review
Panel of 120+ MBBS/MD medical specialists vetting line-item medical necessity, surgical justification, pre-existing disease concealment, and doctor prescription authenticity.
TARIFF AUDIT
Tariff & Consumables Benchmarking
Automated line-by-line audit stripping non-medical consumables, detecting artificial ICU length-of-stay expansion, and enforcing agreed GIPSA/payer tariffs.
The Yuvika Adjudication Architecture
How institutional claims move from intake ingestion to legal evidence recovery in under 36 hours.
2-Hour Rapid Field Dispatch
On-ground forensic detectives mobilized to hospital wards, clinics, and claimant workplaces within 120 minutes of trigger across Tier 1, 2, and 3 cities.
Doctor-Signed Legal Dossiers
Every suspicious claim is reviewed and counter-signed by board-certified MD physicians with court-admissible medical justification affidavits.
Plug & Play API Ingestion
Trigger field investigation or doctor audits directly via automated webhooks or REST API from your core claims adjudication platform in < 48 hours.
Zero Setup Pilot Batch
Test with your first 100 high-risk claims with zero platform lock-in. Transparent pay-per-investigation pricing tailored for growing InsurTechs and TPAs.
Anatomy of a Detected Fraudulent Claim
Detective conducted physical locus check at employer office. Biometric attendance verified patient was actively working during alleged 4-day ICU hospitalization.
MD panel verified treating doctor signature was cloned; CT scan report showed identical DICOM pixel hashes to unrelated patient; pharmaceutical dosages exceeded toxicological limits.
Why InsurTechs & Modern TPAs Choose Yuvika
A nimble, API-first fraud intelligence layer built for modern healthcare underwriters and growing digital claims teams.
Plug & Play API Integration
Connect directly with your core claims adjudication stack or ingest claims via webhook in under 48 hours.
Zero Setup Costs for Pilots
Test with your first 100 high-risk claims with zero platform lock-in, zero upfront engineering fees, and dedicated support.
Guaranteed 24-48h SLA
Physical ground visits, digital signatures, and hospital billing audits delivered before statutory claim discharge limits.
Transparent Pay-Per-Audit
Flexible, transparent usage-based pricing structured for lean startups, growing InsurTechs, and scaling TPAs.
Start a Risk-Free Pilot Audit. See How Much Leakage Yuvika Can Detect in Your First 100 Claims.
Deploy Yuvika's hybrid AI triggers and verified ground investigation across your live claims or back-test historical files. Zero setup fees for initial pilot cohorts.
Initiate Pilot Cohort
Connect directly with our Founding Investigations Lead.