AI EMPLOYEES
Strengthen payment integrity with agentic AI
Detect improper payments before they happen and recover lost dollars automatically—with full transparency and auditability.
Payment Integrity (Payers)
Healthcare Payers
430
Running
70%
Reduction in payment errors
The hidden cost of payment errors
Improper payments
Billions are lost annually due to incorrect coding, duplicate claims, and overpayments that slip through manual checks.
7–10 % of total claims contain coding or pricing discrepancies
Manual, after-the-fact audits
Most payers find issues post-payment, leading to recovery delays, provider abrasion, and compliance risks.
10–15 % of payments require post-adjudication correction
Limited visibility
Without real-time insight into claims integrity, teams miss early warning signs of systemic leakage.
$1–3 M in annual leakage for mid-size payers due to missed anomalies
End-to-end payment integrity automation
Pre-payment validation
AI employees scan claims before payment to detect coding errors, duplicates, and out-of-policy billing.
Identify overpayments, generate recovery letters, and track recoupments automatically.
Spot anomalies, outliers, and potential fraud using adaptive AI models trained on historical payment data.
Generate audit-ready documentation for regulators and internal compliance teams automatically.
1) Detect anomalies in real time
AI employees analyze every claim against historical trends, provider profiles, and policy rules.
Stop leakage before it starts
70%
Reduction in payment errors
Prevent overpayments by catching anomalies at the source.
Typical time to go live
Deploy fast without heavy integrations.
100%
Audit-ready transparency
Every action is logged for compliance and internal QA review.
90%
Reliability on end-to-end workflows
Reduce operational costs while improving provider experience.
What healthcare payers are saying
“Payment integrity used to be entirely reactive. Magical catches overpayments before they happen and even automates recovery—millions saved in leakage already.”
“Instead of waiting weeks for post-pay audits, we’re catching issues before checks go out. It’s the first time our integrity team has gotten ahead of the problem.”
Security & compliance
HIPAA compliant
Magical processes all data locally with zero PHI storage
SOC 2 Type II certified
Enterprise-grade security with regular third-party audits
Secure Authentication
Single Sign-On (SSO) and multi-factor authentication options
See how Magical improves payment integrity
Does Magical detect fraud or just errors?
Both—our AI identifies improper billing patterns, outliers, and potential fraud scenarios using explainable logic.
Can it integrate with SIU systems?
Yes—Magical connects via API or works alongside your existing SIU analytics tools.
How is accuracy validated?
Each AI employee is monitored by AI judges that score precision, recall, and speed on every run.
How long to deploy?
Most payers are live within 3 weeks on a defined subset of claims.
Is data secure?
All workflows are HIPAA compliant and run within secure, auditable environments.
