Detection is crowded. Proof is empty.
Payment integrity is one of the older categories in healthcare technology. What makes JIL different is not that we detect fraud. It is that we attest to every claim we touch on a court-ready evidence chain. This page is an honest accounting of the field and where we sit in it.
What this page is for.
If you're a BD prospect, an investor, or a customer comparing JIL to incumbents, this is the short answer for where JIL sits in the field. The full competitive matrix and capability comparison sit below.
If you're a BD prospect
JIL is not a like-for-like replacement for any single incumbent. We replace pieces of: a fraud-screen vendor (Pre-Settlement attestation), a transaction-monitoring vendor (Money API), and an outside investigator + e-discovery vendor (Retroactive CREB(TM)). The cost line is consolidated; the audit posture is upgraded.
If you're an investor
The defensible moat is the multi-jurisdictional validator quorum + the cryptographic evidence bundle, not the individual checks. Competitors can build any one check; replicating 14-of-20 BFT consensus across 13 jurisdictions with FRE 902(14) admissibility is a 3-5 year project.
If you're already using a fraud-screen vendor
JIL doesn't displace fraud detection - it adds the cryptographic + audit + evidence layer on top. Many customers run JIL alongside their existing fraud-screen for the first 6-12 months; once the JIL signal is calibrated, the legacy vendor is consolidated out.
If you're already using Chainalysis / TRM / Elliptic
Those tools are address intelligence layers; JIL consumes their feeds (and several others) and adds the verdict-signing + evidence-bundle layer. Complementary, not competing - though the per-event economics let customers shift more of their spend to JIL over time.
If you're already using a recovery / dispute-resolution vendor
JIL's CREB(TM) bundle replaces the per-case investigator workup with a per-bundle deterministic deliverable. State MFCUs and outside counsel accept it under FRE 902(14). Your recovery vendor still does the human judgment work; JIL does the evidence assembly.
What this is NOT
Not a fraud-screen. Not an address intelligence vendor. Not a recovery vendor. JIL is the verification + evidence + audit layer that sits underneath all three. The cost-benefit case is consolidation + audit posture, not displacement.
Four kinds of companies compete for the same dollar.
The payment integrity market is not a single category. It is four overlapping categories with different business models, different data access, and different relationships to the regulator. JIL sits at the intersection of all four.
Federal Contractors
UPICs: Qlarant, SafeGuard, CoventBridge, IntegriGuard. RACs: Cotiviti, Performant, HMS.
Hold the CMS contracts. Services-and-investigations heavy. Decades of fraud taxonomy. Detection stacks built on legacy rules engines.
Payer-Side PI Vendors
Cotiviti, Optum Payment Integrity, Change Healthcare PI, EXL, Multiplan.
Sell to commercial payers and managed care. Mostly post-pay recovery. Contingency-fee pricing. Mature analytics, limited proof infrastructure.
AI Detection Startups
Codoxo, Pareo / ClarisHealth, HealthEdge Source, Smart Data Solutions.
Newer entrants leading with machine learning and pre-pay claims. Strong on detection accuracy. Weak or absent on cryptographic attestation.
Legacy Analytics & State MMIS
SAS, LexisNexis Risk, Gainwell, Conduent.
The incumbents of state Medicaid and federal program integrity. Trusted, deeply embedded, technically aging. Procurement advantage, innovation deficit.
Where each actually plays.
Capabilities matter more than logos. Below, nine capabilities mapped across the field. Where a vendor partially supports a capability, the mark reflects that. Sources: vendor documentation, public filings, analyst briefings.
| Capability | JIL Sovereign | Cotiviti | Codoxo | UPICs | Optum PI | SAS / Legacy |
|---|---|---|---|---|---|---|
| Pre-settlement detection claims caught before payment leaves the account | Yes | No | Yes | Partial | Partial | Partial |
| Post-settlement attestation CREB evidence package, FRE 902(14) admissible | Yes | No | No | No | No | No |
| Cryptographic evidence chain immutable per-claim hash anchored on distributed ledger | Yes | No | No | No | No | No |
| Flat-fee pricing no contingency, no percentage of recovery | Yes | No | Yes | No | Partial | Yes |
| Post-quantum cryptography Ed25519 + Dilithium-III hybrid, ML-DSA-65, Kyber KEM | Yes | No | No | No | No | No |
| Bi-directional integrity real-time prevention plus retroactive forensic attestation | Yes | Partial | Partial | Partial | Partial | No |
| Production deployment at scale, today, not in pilot or roadmap | Yes | Yes | Yes | Yes | Yes | Yes |
| Federal CMS contract relationship direct or prime contractor with CMS | No | Yes | No | Yes | Yes | Yes |
| Decades of fraud taxonomy accumulated investigative case library | Partial | Yes | Partial | Yes | Yes | Yes |
Legend: Yes = capability native to platform. Partial = partial or via integration. No = not offered. This comparison reflects publicly disclosed capabilities as of April 2026. Vendor capabilities evolve; JIL revises this matrix quarterly. We are happy to discuss specific scenarios where the comparison would render differently.
Four capabilities, combined for the first time.
Each of these exists in some form somewhere in the market. None of our competitors combine all four in a single platform.
Pre-settlement detection at production scale
Stops improper payments before they leave the account. Most incumbents operate post-pay and chase recoveries. The economics of prevention are fundamentally better than the economics of chase, for the payer and for the regulator.
Court-ready evidence under FRE 902(14)
CREB is a per-case, cryptographically attested evidence package anchored on CourtChain. Admissible without further authentication. Available on the cases the customer chooses to escalate from detection findings. No competitor offers this layer at any price.
Flat-fee economics, no contingency
Detection should not be priced on the volume of fraud found. That creates the wrong incentives. JIL prices on detection capacity, not on recovery share. Engagement scope and fee are set in writing before work begins.
A live Layer 1 anchoring every attestation
Ten production validators across thirteen jurisdictions. 14-of-20 BFT quorum. Hybrid Ed25519 plus Dilithium-III signatures. The chain is the evidence layer, not a marketing claim. It is in production today.
Three tiers, each priced to scope.
JIL does not run free trials. Every engagement begins with a written scope and a fixed fee. Customers escalate from one tier to the next based on the value of the cases worth pursuing, not the cost of the detection run.
Detection
Anomaly flagging across the customer's claims book. Findings report, risk scoring, methodology documentation, executive readout.
- Flat-fee engagement scaled to portfolio size
- Bounded delivery window per scope
- Methodology documentation included
- Output: ranked findings inventory
Fee set in writing per scope.
CREB Validation
Court-ready evidence packages under FRE 902(14), anchored on CourtChain. Per case or per validated block. Customer selects which Tier 1 findings to escalate.
- Per-case or block pricing
- Cryptographic chain of custody
- FRE 902(14) admissibility
- Output: CREB evidence library
Fee set in writing per case or block.
Deep Forensics
Full forensic investigation including blockchain tracing, sanctions and OFAC screening, beneficial ownership analysis, and cross-jurisdictional asset tracing.
- Per-case engagement, scope-driven
- Senior forensic investigator-led
- Multi-source intelligence correlation
- Output: investigative dossier
Engagement scope and fee negotiated per case.
Tiers are sequential by design. Most customers begin with Tier 1 detection and escalate selectively to Tier 2 and Tier 3 on the cases that warrant the deeper investment. JIL does not bundle tiers. Customers pay only for the tier of work they actually need.
What the incumbents do better.
Credibility comes from honesty about gaps. Two areas where the incumbents have meaningful advantages JIL is actively closing.
Federal Footprint
Cotiviti, the UPICs, and Gainwell have CMS contracts measured in decades.
Those contracts are worth billions and they took 10 to 20 years to build. We are not going to acquire that history overnight, and we do not pretend we will. Our path is subcontracting under existing UPIC primes who need differentiated technology in their CMS bids, while we build direct CMS pilots over the longer horizon.
Investigative Case Library
SAS, Cotiviti, and Optum have decades of fraud taxonomy embedded in their rules.
Twenty years of investigators feeding cases back into models is a real moat. Our answer is not to claim parity. It is to integrate where possible, license where appropriate, and lean on architectural advantages where it matters most: prevention rather than recovery, and proof rather than probability.
Bring your real claims data.
A scoped Tier 1 detection engagement against your book. Findings delivered under DUA with full methodology documentation. From there, Tier 2 and Tier 3 are available on the cases that justify them. Engagement scope and fee set in writing before work begins.
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