For Small SIUs (Under 5 Investigators)

Managed FWA Detection & Triage Services: We Find It, Rank It, Deliver It

Your Challenge: You're stretched too thin to hunt for new FWA patterns. Your existing queue is a mix of high-value cases and noise, but you don't have time to figure out which is which.

How Lucor Helps: We run detection and triage for you. On a recurring basis, you receive:

• Net new FWA leads your current systems missed—ranked according to your criteria

• Your existing queue, re-triaged—so you know exactly which cases to work first

• Plain language explanations for every flag and ranking decision

• Investigation-ready packages with exposure estimates, supporting evidence, and case summaries

• Compliance validation and data quality checks before delivery
   

Think of it as adding 2–3 full-time senior analysts who only work high-value cases

Outcome: Recover $3–8M in the first year without expanding headcount. Your team focuses on investigation and recovery, not hunting and sorting.

For Mid-Sized SIUs (5–20 Investigators)

LucorScout (Our AI Copilot): Your Team Finds More, Triages Faster

Your Challenge: Your investigators are skilled, but they're spending too much time on data work—looking for new patterns, researching leads, figuring out what to work next. Triage that should take minutes takes hours or days.

How Lucor Helps: LucorScout, our AI copilot, plugs into your workflow, so investigators can:

• Discover net new, explainable FWA leads hiding in claims and provider data

• Quickly deep-dive on leads with follow-up analysis

• Re-rank and prioritize your existing queue based on true impact

• Generate audit-ready case summaries in minutes

• Automatically apply plan-specific compliance and policy rules

• Validate data upstream to prevent wasted reviews

Every recommendation is explainable, so your team can review, challenge, or use it immediately in case management.
 

Outcome: 50% faster triage and case throughput. Fewer false positives. Stronger documentation and defensibility.

For Large SIUs (20+ Investigators)

Enterprise Integration: AI Detection & Triage at Scale

Your Challenge: You have mature processes and multiple teams (SIU, Payment Integrity, Compliance), but your detection is siloed and your triage is manual. Cases stall between departments. You're missing cross-program patterns.
 

How Lucor Helps: We integrate directly into your systems via secure API or private-cloud deployment. Detection and triage happen automatically across teams—surfacing new FWA and re-ranking every queue in real time.

• Configurable AI components for detection, documentation, and compliance

• API integration with case management, claims, and analytics systems

• Custom logic based on your plan policies and regulatory requirements

• Cross-team visibility: everyone works from the same intelligence

• Role-based access and audit trails for every AI-supported decision

Outcome: 25-35% reduction in time from detection to recovery. Fewer audit surprises. Stronger cross-team coordination and evidence traceability.

For Plan Partners (Advisory, Audit & Consulting Firms)

Embedded AI Partnership: Enhance Your Client Offerings

Your Challenge: You work with multiple health plans to deliver FWA detection, compliance, and recovery services—but scaling impact across clients is difficult. Your analysts face the same data complexity and manual triage challenges as internal SIUs, often relying on time-intensive spreadsheets, sampling, and human judgment.
 

How Lucor Helps: Lucor embeds directly into your firm’s processes as an AI-powered investigation and operations partner—helping your analysts detect, prioritize, and document FWA across all your client engagements.

• Centralized AI infrastructure that scales across client datasets

• Configurable detection, triage, and case summarization capabilities

• Shared analytics and exposure reporting to enhance ROI proof points

• Secure, compliant data handling across engagements (HIPAA)
   

Outcome: Deliver 2–3x more FWA insights per client with the same analyst headcount. Faster turnaround. Differentiate with AI capabilities competitors can't match.