For FW&A & Program Integrity Teams

Detect Fraud, Waste & Abuse Before It Becomes a Loss

Legacy SIU tools bury investigators in noise. Pamastay surfaces the schemes that matter—orphan DME, billing anomalies, provider outliers, and coordinated fraud patterns—so your team can act before payment.

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Platform Modules Built for SIU Investigators

Purpose-built tools for healthcare program integrity, not generic analytics.

Alert Prioritization

Focus your team on the highest-impact cases. Prioritization based on recovery potential, evidence strength, and case complexity.

Provider Profiles

Complete billing history, peer comparisons, and network relationships for every provider. Context that accelerates investigations.

Claims Investigation

Drill into claim details, related services, and supporting documentation. Everything you need to build a case in one place.

Case Management

Assign cases, track progress, document findings, and manage the full investigation lifecycle from alert to resolution.

Evidence Packages

Generate complete documentation for MFCU referrals, OIG reports, and internal audits with full evidence trails.

Recovery Tracking

Track overpayment identification, recovery efforts, and program ROI. Demonstrate the value of your program integrity investment.

Built for SIU Investigators

Investigation workflow that prioritizes efficiency over alert volume.

High-Signal Alerts

ML-driven prioritization surfaces the schemes most likely to result in recovery or referral. Less noise, more actionable investigations.

Provider Deep-Dive

One-click access to complete provider profiles: billing history, peer comparisons, flagged claims, and network relationships.

Case Management

Assign alerts to investigators, track case progress, document findings, and manage referrals—all in one workflow.

Regulatory Reporting

Generate MFCU referral packages, OIG report formats, and internal audit documentation with complete evidence trails.

Configurable Outlier Thresholds

Set your own thresholds for what constitutes an outlier. Specialty-specific parameters, regional adjustments, and plan-specific configurations.

Recovery Tracking

Track overpayment identification, recovery efforts, and ROI by detection category. Prove the value of your program integrity investment.

Ready to See What's Hiding in Your Claims?

Let us run a pilot on your data. If we don't find actionable FW&A, you don't pay.

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