STRUCTURE Trademark

Healthcare financial advisory services for providing payment integrity solutions; healthcare insurance case and utilization review and insurance claims adjustment services for healthcare purchasers and payers and providers and Medicare beneficiaries to ensure payment accuracy; healthcare insurance claims review services in the nature of assessing insurance claims to ensure payment accuracy; healthcare insurance administration services, namely, processing, review, analysis, submission, and adjudication support of healthcare insurance claims for payment accuracy on behalf of health insurance companies and managed care organizations; insurance claims auditing services in the field of healthcare, namely, pre-payment and post-payment review and analysis of health insurance claims for payment errors, coding inaccuracies, and contractual non-compliance.

Providing fraud and abuse support in the healthcare industry, namely, fraud and abuse surveillance and investigation services related to healthcare insurance claims and physical security of patients; providing fraud and abuse support in the healthcare industry, namely, regulatory compliance auditing and consulting services and tracking and monitoring regulatory requirements in the field of healthcare fraud for regulatory compliance purposes; providing fraud and abuse support in the healthcare industry, namely, monitoring of computer systems in the nature of surveillance services relating to the physical safety of persons and security of tangible property; fraud detection services in the field of health care insurance, namely, analyzing data in computer databases for criminal activity related to healthcare fraud or identity theft; compiling and analyzing statistical health data in order to uncover and identify health care fraud and claims errors

IT platform and SaaS services featuring non-downloadable software and platforms for healthcare claims payment management, quality measurement, population analytics, operations, and member engagement; SaaS and PaaS services featuring non-downloadable software and platforms for healthcare patient data interchange and data interoperability and for using artificial intelligence and machine learning models to extract information from patient data and assist healthcare organizations with its management; providing online non-downloadable software to automate healthcare processes using artificial intelligence and intelligent automation software; providing online non-downloadable quality logic software for collecting, measuring, monitoring, evaluating, and reporting information in the field of healthcare cost containment; providing online non-downloadable software for monitoring, alerting, prioritizing, and resolving payment accuracy issues and for commercial and government health payers and at-risk providers to conduct population health and risk analytics, predictive member health modeling, and member engagement; providing online non-downloadable software for subrogation of insurance claims, coordination of benefits of state and federal healthcare programs, managing healthcare insurance member engagement and care, conducting population health and risk analytics, and improving health outcomes through data warehousing, analytics engines, predictive modeling, and machine learning; providing temporary use of cloud-based audit recovery software for monitoring and evaluating healthcare payment integrity; providing online non-downloadable software using artificial intelligence for machine learning to provide payment integrity; providing fraud and abuse support in the healthcare industry, namely, digital forensic investigations of healthcare fraud computer crimes; insurance fraud detection services, namely, computer security threat analysis for protecting healthcare data

Healthcare cost containment, assessment, and analyses services; business consulting and data analysis services in the fields of healthcare claims, healthcare billing, healthcare coding, healthcare payment integrity and compliance, healthcare claims payment accuracy, and healthcare member engagement; auditing of healthcare claims for payment accuracy, coding accuracy, and compliance with contractual and regulatory requirements; recovery audit services in the nature of reviewing medical claims billing systems to detect overpayments and payment errors for business purposes; business auditing support services pertaining to the Medicare Recovery Audit Contractor program and other federal healthcare programs, namely, the preparation, organization and presentation of the documents and data requested by a government body, and advice on government audit processes, policies and strategy; providing an online internet website portal featuring cost containment performance data in the areas of healthcare insurance claim fraud, waste and abuse for use by health care providers, administrators and health professionals.