90% ROI increase

AI Fraudulent Claim Investigation

Uncover fraud patterns in your claims data

V7 Go's agent assists Special Investigations Units (SIUs) by analyzing claims documents to flag suspicious activities identify inconsistencies and surface patterns of fraud waste and abuse.

Ideal for

Special Investigations Units (SIU)

Claims Managers

Shareholder agreement review

  • Mercedes-Benz logo
    SMC  logo
    Philips logo
    Bayer Logo
    Mars Logo
    Roche logo
    Sony logo
    Alaris logo

See Fraudulent Claims in action

Play video

Shareholder agreement review

  • Mercedes-Benz logo
    SMC  logo
    Philips logo
    Bayer Logo
    Mars Logo
    Roche logo
    Sony logo
    Alaris logo

See Fraudulent Claims in action

Play video

Shareholder agreement review

  • Mercedes-Benz logo
    SMC  logo
    Philips logo
    Bayer Logo
    Mars Logo
    Roche logo
    Sony logo
    Alaris logo

See Fraudulent Claims in action

Play video

Shareholder agreement review

  • Mercedes-Benz logo
    SMC  logo
    Philips logo
    Bayer Logo
    Mars Logo
    Roche logo
    Sony logo
    Alaris logo

See Fraudulent Claims in action

Play video

Challenge

Challenge

Investigating fraudulent claims requires manually sifting through mountains of documents to find subtle inconsistencies and connections—a task that is nearly impossible to do at scale.

Investigating fraudulent claims requires manually sifting through mountains of documents to find subtle inconsistencies and connections—a task that is nearly impossible to do at scale.

V7 Go's AI agent acts as a powerful analytical assistant processing thousands of documents to connect data points and flag suspicious patterns that indicate potential fraud.

V7 Go's AI agent acts as a powerful analytical assistant processing thousands of documents to connect data points and flag suspicious patterns that indicate potential fraud.

Time comparison

Time comparison

Traditional review time

4-8 hours

4-8 hours

With V7 Go

15-30 minutes

15-30 minutes

Average time saved

95%

95%

Why V7 Go

Why V7 Go

Pattern & Anomaly Detection

Analyze thousands of claims to identify suspicious patterns such as multiple claims from the same address or unusual treatment protocols from a specific medical provider.

Pattern & Anomaly Detection

Analyze thousands of claims to identify suspicious patterns such as multiple claims from the same address or unusual treatment protocols from a specific medical provider.

Pattern & Anomaly Detection

Analyze thousands of claims to identify suspicious patterns such as multiple claims from the same address or unusual treatment protocols from a specific medical provider.

Pattern & Anomaly Detection

Analyze thousands of claims to identify suspicious patterns such as multiple claims from the same address or unusual treatment protocols from a specific medical provider.

Cross-Claim Analysis

Connect disparate data points across multiple claim files to uncover organized fraud rings that would be invisible when looking at one claim at a time.

Cross-Claim Analysis

Connect disparate data points across multiple claim files to uncover organized fraud rings that would be invisible when looking at one claim at a time.

Cross-Claim Analysis

Connect disparate data points across multiple claim files to uncover organized fraud rings that would be invisible when looking at one claim at a time.

Cross-Claim Analysis

Connect disparate data points across multiple claim files to uncover organized fraud rings that would be invisible when looking at one claim at a time.

Evidence Link Analysis

Create a visual map of relationships between claimants providers witnesses and locations to highlight non-obvious connections and potential collusion.

Evidence Link Analysis

Create a visual map of relationships between claimants providers witnesses and locations to highlight non-obvious connections and potential collusion.

Evidence Link Analysis

Create a visual map of relationships between claimants providers witnesses and locations to highlight non-obvious connections and potential collusion.

Evidence Link Analysis

Create a visual map of relationships between claimants providers witnesses and locations to highlight non-obvious connections and potential collusion.

Narrative Inconsistency Detection

The agent compares statements from different parties or different documents within the same claim to flag contradictions in the timeline or description of events.

Narrative Inconsistency Detection

The agent compares statements from different parties or different documents within the same claim to flag contradictions in the timeline or description of events.

Narrative Inconsistency Detection

The agent compares statements from different parties or different documents within the same claim to flag contradictions in the timeline or description of events.

Narrative Inconsistency Detection

The agent compares statements from different parties or different documents within the same claim to flag contradictions in the timeline or description of events.

Social Media & Web Research

Use AI web search to find publicly available information that may contradict the claim such as a claimant's social media posts showing activities inconsistent with their reported injuries.

Social Media & Web Research

Use AI web search to find publicly available information that may contradict the claim such as a claimant's social media posts showing activities inconsistent with their reported injuries.

Social Media & Web Research

Use AI web search to find publicly available information that may contradict the claim such as a claimant's social media posts showing activities inconsistent with their reported injuries.

Social Media & Web Research

Use AI web search to find publicly available information that may contradict the claim such as a claimant's social media posts showing activities inconsistent with their reported injuries.

Automated Red Flag Scoring

Generate a 'fraud risk score' for each claim based on a customizable set of red flags allowing your SIU team to prioritize its investigative resources.

Automated Red Flag Scoring

Generate a 'fraud risk score' for each claim based on a customizable set of red flags allowing your SIU team to prioritize its investigative resources.

Automated Red Flag Scoring

Generate a 'fraud risk score' for each claim based on a customizable set of red flags allowing your SIU team to prioritize its investigative resources.

Automated Red Flag Scoring

Generate a 'fraud risk score' for each claim based on a customizable set of red flags allowing your SIU team to prioritize its investigative resources.

Get started

Get started

Analyze claim files, medical reports, and witness statements.

Identify inconsistent timelines, unusual patterns, and fraud indicators.

Get started

Import your files

Gmail

,

Google Drive

,

CoStar

Import your files from wherever they are currently stored

Import your files from wherever they are currently stored

First Notice of Loss (FNOL)

First Notice of Loss (FNOL)

Medical Reports & Billing

Medical Reports & Billing

Police & Incident Reports

Police & Incident Reports

Witness Statements

Witness Statements

Damage Photographs & Estimates

Damage Photographs & Estimates

Social Media & Public Records

Social Media & Public Records

All types of documents supported

All types of documents supported

Inconsistent Timelines or Statements

Inconsistent Timelines or Statements

Unusual Medical Treatment Patterns

Unusual Medical Treatment Patterns

Links to Known Fraudulent Providers

Links to Known Fraudulent Providers

Prior Claims History Matches

Prior Claims History Matches

Mismatched Damage Reports

Mismatched Damage Reports

Suspicious Witness Connections

Suspicious Witness Connections

Address/Phone Number Overlap

Address/Phone Number Overlap

Anomalous Billing Codes

Anomalous Billing Codes

Contradictory Public Information

Contradictory Public Information

Use of Post Office Boxes

Use of Post Office Boxes

Once imported our system extracts and organises the essentials

Once imported our system extracts and organises the essentials

The difference

The difference

AI-powered fraud detection

for insurance SIUs

The difference

Insurance teams work is about to make it's biggest shift in a century

Before

ChatGPT

V7 Go

SIU investigators manually review claim files looking for red flags and trying to connect disparate pieces of information a process that is slow and often misses complex fraud rings.

Enhance your Special Investigations Unit (SIU) with an AI agent that analyzes claims documents to detect patterns of fraud waste and abuse.

Insurance teams work is about to make it's biggest shift in a century

Before

ChatGPT

V7 Go

SIU investigators manually review claim files looking for red flags and trying to connect disparate pieces of information a process that is slow and often misses complex fraud rings.

Enhance your Special Investigations Unit (SIU) with an AI agent that analyzes claims documents to detect patterns of fraud waste and abuse.

Insurance teams work is about to make it's biggest shift in a century

Before

ChatGPT

V7 Go

SIU investigators manually review claim files looking for red flags and trying to connect disparate pieces of information a process that is slow and often misses complex fraud rings.

Enhance your Special Investigations Unit (SIU) with an AI agent that analyzes claims documents to detect patterns of fraud waste and abuse.

Multiple agents available to do the work

Are there any clauses in our vendor contracts that create exposure or conflict with our standard terms?

Select and tailor agents to perfectly align with the specifics of your Fraudulent Claims

Multiple agents available to do the work

Are there any clauses in our vendor contracts that create exposure or conflict with our standard terms?

Select and tailor agents to perfectly align with the specifics of your Fraudulent Claims

Multiple agents available to do the work

Are there any clauses in our vendor contracts that create exposure or conflict with our standard terms?

Select and tailor agents to perfectly align with the specifics of your Fraudulent Claims

The difference

AI-powered fraud detection

for insurance SIUs

The difference

Insurance teams work is about to make it's biggest shift in a century

Before

ChatGPT

V7 Go

Analysts spend days manually reading 100+ page documents trying to spot subtle year-over-year changes in risk disclosures and MD&A.

Enhance your Special Investigations Unit (SIU) with an AI agent that analyzes claims documents to detect patterns of fraud waste and abuse.

Play video

Multiple agents available to do the work

Are there any clauses in our vendor contracts that create exposure or conflict with our standard terms?

Select and tailor agents to perfectly align with the specifics of your Fraudulent Claims

Play video

Customer Voices

Customer Voices

Building trustworthy AI, trained on your data

Join the world's best teams and Fortune 500s

Healthcare

Finance

Legal

Insurance

Logistics

Biotechnology

Manufacturing

Real Estate

Healthcare

Finance

Legal

Insurance

Logistics

Biotechnology

Manufacturing

Real Estate

Healthcare

Finance

Legal

Insurance

Logistics

Biotechnology

Manufacturing

Real Estate

Customer Voices

Features

Features

Results you can actually trust.
Reliable AI document processing toolkit.

Results you can trust.
Trustworthy AI document processing toolkit.

Supporting complex documents.

Up to 200 pages.

From handwritten notes to complex graphs, V7 Go reads and understands them all—even when layouts shift across documents. Process hundreds of documents and pages, transforming them into structured outputs with task-based workflows you can customize or build from scratch.

Input types

50+ languages

Handwritten

200 pages

Multi-modal

Document types

PDFs

URL

Tables

Graphs

Vendor_US.xlsx

3

Supply_2023.pptx

Review_Legal.pdf

Supporting complex documents.

Up to 200 pages.

From handwritten notes to complex graphs, V7 Go reads and understands them all—even when layouts shift across documents. Process hundreds of documents and pages, transforming them into structured outputs with task-based workflows you can customize or build from scratch.

Input types

50+ languages

Handwritten

200 pages

Multi-modal

Document types

PDFs

URL

Tables

Graphs

Vendor_US.xlsx

3

Supply_2023.pptx

Review_Legal.pdf

Supporting complex documents.

Up to 200 pages.

From handwritten notes to complex graphs, V7 Go reads and understands them all—even when layouts shift across documents. Process hundreds of documents and pages, transforming them into structured outputs with task-based workflows you can customize or build from scratch.

Input types

50+ languages

Handwritten

200 pages

Multi-modal

Document types

PDFs

URL

Tables

Graphs

Vendor_US.xlsx

3

Supply_2023.pptx

Review_Legal.pdf

Reach 99% accuracy rate through

GenAI reasoning.

Break down complex document processing into discrete steps. Choose from top GenAI models, OCR tools, custom Python code, or integrate your own model to achieve fast, accurate, and reliable results with outputs you can trust.

Model providers

Security note

V7 never trains models on your private data. We keep your data encrypted and allow you to deploy your own models.

Answer

Type

Text

Tool

o4 Mini

Reasoning effort

Off

Low

Mid

High

AI Citations

Inputs

Set a prompt (Press @ to mention an input)

Reach 99% accuracy rate through

GenAI reasoning.

Break down complex document processing into discrete steps. Choose from top GenAI models, OCR tools, custom Python code, or integrate your own model to achieve fast, accurate, and reliable results with outputs you can trust.

Model providers

Security note

V7 never trains models on your private data. We keep your data encrypted and allow you to deploy your own models.

Answer

Type

Text

Tool

o4 Mini

Reasoning effort

Off

Low

Mid

High

AI Citations

Inputs

Set a prompt (Press @ to mention an input)

Reach 99% accuracy rate through

GenAI reasoning.

Break down complex document processing into discrete steps. Choose from top GenAI models, OCR tools, custom Python code, or integrate your own model to achieve fast, accurate, and reliable results with outputs you can trust.

Model providers

Security note

V7 never trains models on your private data. We keep your data encrypted and allow you to deploy your own models.

Answer

Type

Text

Tool

o4 Mini

Reasoning effort

Off

Low

Mid

High

AI Citations

Inputs

Set a prompt (Press @ to mention an input)

Trustworthy results,

grounded in reality.

You can verify if AI-generated responses are true and which excerpts they were based on. AI models in V7 Go automatically highlight source areas in your documents. Human reviewers can focus their time on results with lower confidence scores and make corrections when needed.

Visual grounding in action

00:54

Deliberate Misrepresentation: During the trial, evidence was presented showing that John Doe deliberately misrepresented his income on multiple occasions over several years. This included falsifying documents, underreporting income, and inflating deductions to lower his tax liability. Such deliberate deception demonstrates intent to evade taxes.

Pattern of Behavior: The prosecution demonstrated a consistent pattern of behavior by John Doe, spanning several years, wherein he consistently failed to report substantial portions of his income. This pattern suggested a systematic attempt to evade taxes rather than mere oversight or misunderstanding.

Concealment of Assets: Forensic accounting revealed that John Doe had taken significant steps to conceal his assets offshore, including setting up shell companies and using complex financial structures to hide income from tax authorities. Such elaborate schemes indicate a deliberate effort to evade taxes and avoid detection.

Failure to Cooperate: Throughout the investigation and trial, John Doe displayed a lack of cooperation with tax authorities. He refused to provide requested documentation, obstructed the audit process, and failed to disclose relevant financial information. This obstructionism further supported the prosecution's argument of intentional tax evasion.

Prior Warning and Ignoring Compliance

02

01

01

02

Trustworthy results,

grounded in reality.

You can verify if AI-generated responses are true and which excerpts they were based on. AI models in V7 Go automatically highlight source areas in your documents. Human reviewers can focus their time on results with lower confidence scores and make corrections when needed.

Visual grounding in action

00:54

Deliberate Misrepresentation: During the trial, evidence was presented showing that John Doe deliberately misrepresented his income on multiple occasions over several years. This included falsifying documents, underreporting income, and inflating deductions to lower his tax liability. Such deliberate deception demonstrates intent to evade taxes.

Pattern of Behavior: The prosecution demonstrated a consistent pattern of behavior by John Doe, spanning several years, wherein he consistently failed to report substantial portions of his income. This pattern suggested a systematic attempt to evade taxes rather than mere oversight or misunderstanding.

Concealment of Assets: Forensic accounting revealed that John Doe had taken significant steps to conceal his assets offshore, including setting up shell companies and using complex financial structures to hide income from tax authorities. Such elaborate schemes indicate a deliberate effort to evade taxes and avoid detection.

Failure to Cooperate: Throughout the investigation and trial, John Doe displayed a lack of cooperation with tax authorities. He refused to provide requested documentation, obstructed the audit process, and failed to disclose relevant financial information. This obstructionism further supported the prosecution's argument of intentional tax evasion.

Prior Warning and Ignoring Compliance

02

01

01

02

Trustworthy results,

grounded in reality.

You can verify if AI-generated responses are true and which excerpts they were based on. AI models in V7 Go automatically highlight source areas in your documents. Human reviewers can focus their time on results with lower confidence scores and make corrections when needed.

Visual grounding in action

00:54

Deliberate Misrepresentation: During the trial, evidence was presented showing that John Doe deliberately misrepresented his income on multiple occasions over several years. This included falsifying documents, underreporting income, and inflating deductions to lower his tax liability. Such deliberate deception demonstrates intent to evade taxes.

Pattern of Behavior: The prosecution demonstrated a consistent pattern of behavior by John Doe, spanning several years, wherein he consistently failed to report substantial portions of his income. This pattern suggested a systematic attempt to evade taxes rather than mere oversight or misunderstanding.

Concealment of Assets: Forensic accounting revealed that John Doe had taken significant steps to conceal his assets offshore, including setting up shell companies and using complex financial structures to hide income from tax authorities. Such elaborate schemes indicate a deliberate effort to evade taxes and avoid detection.

Failure to Cooperate: Throughout the investigation and trial, John Doe displayed a lack of cooperation with tax authorities. He refused to provide requested documentation, obstructed the audit process, and failed to disclose relevant financial information. This obstructionism further supported the prosecution's argument of intentional tax evasion.

Prior Warning and Ignoring Compliance

02

01

01

02

Enterprise grade security

for high-stake industries.

Integrate V7 seamlessly with your existing tech stack. Our platform connects to your cloud infrastructure and ML frameworks while ensuring robust data security and compliance with rigorous standards.

Certifications

GDPR

SOC2

HIPAA

ISO

Safety

Custom storage

Data governance

Access-level permissions

Enterprise grade security

for high-stake industries.

Integrate V7 seamlessly with your existing tech stack. Our platform connects to your cloud infrastructure and ML frameworks while ensuring robust data security and compliance with rigorous standards.

Certifications

GDPR

SOC2

HIPAA

ISO

Safety

Custom storage

Data governance

Access-level permissions

Enterprise grade security

for high-stake industries.

Integrate V7 seamlessly with your existing tech stack. Our platform connects to your cloud infrastructure and ML frameworks while ensuring robust data security and compliance with rigorous standards.

Certifications

GPDR

SOC2

HIPAA

ISO

Safety

Custom storage

Data governance

Access-level permissions

Answers

Answers

What you need to know about our

Fraudulent Claims

What is insurance fraud?

Insurance fraud involves any act committed with the intent to deceptively obtain payment from an insurer ranging from exaggerated claims to organized criminal schemes.

+

What is insurance fraud?

Insurance fraud involves any act committed with the intent to deceptively obtain payment from an insurer ranging from exaggerated claims to organized criminal schemes.

+

What is insurance fraud?

Insurance fraud involves any act committed with the intent to deceptively obtain payment from an insurer ranging from exaggerated claims to organized criminal schemes.

+

How does the AI agent detect fraud?

The agent uses a combination of rules-based flagging and machine learning to spot anomalies. It looks for known red flags and analyzes data across thousands of claims to find new patterns of suspicious behavior.

+

How does the AI agent detect fraud?

The agent uses a combination of rules-based flagging and machine learning to spot anomalies. It looks for known red flags and analyzes data across thousands of claims to find new patterns of suspicious behavior.

+

How does the AI agent detect fraud?

The agent uses a combination of rules-based flagging and machine learning to spot anomalies. It looks for known red flags and analyzes data across thousands of claims to find new patterns of suspicious behavior.

+

Can the agent analyze unstructured data like adjusters' notes?

Yes this is a key strength. The agent reads and understands narrative text to find inconsistencies identify suspicious phrasing and extract key entities to build a relationship map.

+

Can the agent analyze unstructured data like adjusters' notes?

Yes this is a key strength. The agent reads and understands narrative text to find inconsistencies identify suspicious phrasing and extract key entities to build a relationship map.

+

Can the agent analyze unstructured data like adjusters' notes?

Yes this is a key strength. The agent reads and understands narrative text to find inconsistencies identify suspicious phrasing and extract key entities to build a relationship map.

+

Does the agent make the final decision on a claim's validity?

No. The agent is an investigative assistant. It surfaces evidence flags inconsistencies and highlights suspicious patterns for a human investigator. The final judgment always rests with the SIU professional.

+

Does the agent make the final decision on a claim's validity?

No. The agent is an investigative assistant. It surfaces evidence flags inconsistencies and highlights suspicious patterns for a human investigator. The final judgment always rests with the SIU professional.

+

Does the agent make the final decision on a claim's validity?

No. The agent is an investigative assistant. It surfaces evidence flags inconsistencies and highlights suspicious patterns for a human investigator. The final judgment always rests with the SIU professional.

+

How is this different from existing fraud analytics tools?

Many existing tools are rules-based and only look at structured data. V7 Go's agent is different because it analyzes unstructured documents and uses AI to find non-obvious connections.

+

How is this different from existing fraud analytics tools?

Many existing tools are rules-based and only look at structured data. V7 Go's agent is different because it analyzes unstructured documents and uses AI to find non-obvious connections.

+

How is this different from existing fraud analytics tools?

Many existing tools are rules-based and only look at structured data. V7 Go's agent is different because it analyzes unstructured documents and uses AI to find non-obvious connections.

+

Can we customize the fraud indicators the agent looks for?

Absolutely. Your SIU team can configure the agent's workflow with your own red flags and risk scoring parameters tailoring the system to the specific fraud schemes common in your line of business.

+

Can we customize the fraud indicators the agent looks for?

Absolutely. Your SIU team can configure the agent's workflow with your own red flags and risk scoring parameters tailoring the system to the specific fraud schemes common in your line of business.

+

Can we customize the fraud indicators the agent looks for?

Absolutely. Your SIU team can configure the agent's workflow with your own red flags and risk scoring parameters tailoring the system to the specific fraud schemes common in your line of business.

+

Pilot

Pilot

Curious how we can realise 90% ROI increase for you?

Curious how we can realise 90% ROI increase for you?

Send us a few samples, and we’ll deliver a custom demo with results—within 48 hours.

Send us a few samples, and we’ll deliver a custom demo with results—within 48 hours.

Vendor_US.xlsx

3

Supply_2023.pptx

Review_Legal.pdf

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Next Step

Next Step

Stop searching for needles in a haystack.

Stop searching for needles in a haystack.

Stop searching for needles in a haystack.

Delegate the document analysis to an AI agent and find fraud faster.

Delegate the document analysis to an AI agent and find fraud faster.

Delegate the document analysis to an AI agent and find fraud faster.

Uncover hidden liabilities

in

supplier contracts.

V7 Go transforms documents into strategic assets. 150+ enterprises are already on board:

  • Mercedes-Benz logo
    SMC  logo
    Philips logo
    Bayer Logo
    Mars Logo
    Roche logo
    Sony logo
    Alaris logo

Uncover hidden liabilities

in

supplier contracts.

V7 Go transforms documents into strategic assets. 150+ enterprises are already on board:

  • Mercedes-Benz logo
    SMC  logo
    Philips logo
    Bayer Logo
    Mars Logo
    Roche logo
    Sony logo
    Alaris logo