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.
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.
Hold the CMS contracts. Services-and-investigations heavy. Decades of fraud taxonomy. Detection stacks built on legacy rules engines.
Sell to commercial payers and managed care. Mostly post-pay recovery. Contingency-fee pricing. Mature analytics, limited proof infrastructure.
Newer entrants leading with machine learning and pre-pay claims. Strong on detection accuracy. Weak or absent on cryptographic attestation.
The incumbents of state Medicaid and federal program integrity. Trusted, deeply embedded, technically aging. Procurement advantage, innovation deficit.
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 detectionclaims caught before payment leaves the account | ● | ○ | ● | ◐ | ◐ | ◐ |
| Post-settlement attestationCREB evidence package, FRE 902(14) admissible | ● | ○ | ○ | ○ | ○ | ○ |
| Cryptographic evidence chainimmutable per-claim hash anchored on distributed ledger | ● | ○ | ○ | ○ | ○ | ○ |
| Flat-fee pricingno contingency, no percentage of recovery | ● | ○ | ● | ○ | ◐ | ● |
| Post-quantum cryptographyEd25519 + Dilithium-III hybrid, ML-DSA-65, Kyber KEM | ● | ○ | ○ | ○ | ○ | ○ |
| Bi-directional integrityreal-time prevention plus retroactive forensic attestation | ● | ◐ | ◐ | ◐ | ◐ | ○ |
| Production deploymentat scale, today, not in pilot or roadmap | ● | ● | ● | ● | ● | ● |
| Federal CMS contract relationshipdirect or prime contractor with CMS | ○ | ● | ○ | ● | ● | ● |
| Decades of fraud taxonomyaccumulated investigative case library | ◐ | ● | ◐ | ● | ● | ● |
Each of these exists in some form somewhere in the market. None of our competitors combine all four in a single platform.
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.
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.
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.
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.
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.
Anomaly flagging across the customer's claims book. Findings report, risk scoring, methodology documentation, executive readout.
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.
Full forensic investigation including blockchain tracing, sanctions and OFAC screening, beneficial ownership analysis, and cross-jurisdictional asset tracing.
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.
Credibility comes from honesty about gaps. Two areas where the incumbents have meaningful advantages JIL is actively closing.
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.
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.
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.