Stop incorrect payments before funds are released.
JIL Sovereign adds a pre-settlement attestation layer between payment approval and payment release so health plans can reduce improper payments, strengthen compliance, and create a cleaner audit trail without replacing existing payment rails.
Claims, reimbursement, or vendor payment instructions originate from current systems.
Provider identity, exclusions, sanctions, routing integrity, and policy rules are checked before approval to pay.
Clean transactions proceed. Exceptions are held, scored, and routed for review.
ACH, RTP, or current bank-controlled processes still move the money. JIL verifies the release decision.
The problem
Health plans validate claims, but many still do not apply the same rigor to the final payment instruction. That is where leakage, documentation gaps, routing errors, and avoidable compliance exposure can persist.
What JIL does
JIL is a pre-settlement attestation and authorization layer. It checks who is being paid, whether the payment meets policy, whether routing details are valid, and whether the transaction should proceed.
What you gain
Lower payment leakage, stronger payment integrity, cleaner exception workflows, and audit evidence attached to every approved payment event.
$87.1B in improper payments. 79% caused by a documentation gap.
CMS reported $87.1B in improper payments in FY2024 across Medicare, Medicaid, CHIP, and ACA programs. The data is clear: these are not detection failures -- they are structural gaps where the payment cleared before documentation was verified.
~100% attributable to absent pre-payment gate
- 79% of Medicaid improper payments: insufficient documentation (CMS FY2024)
- Medicare Fee-for-Service: $31.7B improper -- 7.66% rate for eighth consecutive year
- Remaining 21%: unenrolled providers, wrong amounts -- also attestation-preventable
- GAO: 100+ CMS recommendations unimplemented including pre-payment review
The payment cleared without verification -- not because fraud was cleverly concealed, but because the documentation gate does not exist before settlement. JIL adds that gate: SDV documentation binding, provider enrollment checks, and claim corridor enforcement before any payment is released.
Sources: CMS HHS Agency Financial Report FY2024; GAO FY2024 ($162B federal improper payments); AFP 2025 Payments Fraud and Control Survey.
What JIL Verifies Before Payment Release
- Provider identity and enrollment: verify the provider is enrolled, licensed, and not excluded before the payment instruction is approved
- Documentation tokenization: bind supporting documentation to the payment via the Secure Document Vault -- no document, no payment
- Claim corridor enforcement: flag out-of-pattern amounts, duplicate claims, and claims that exceed policy thresholds before release
- Sanctions and exclusions: real-time screening against OIG exclusion lists, OFAC, and state-level debarment databases
- Routing and account integrity: confirm payment routing matches the attested provider record -- block substituted or modified bank accounts
Use the Calculator Below
Enter your institution's payment volume and leakage rate to see the financial case for adding a pre-settlement attestation layer. The industry baseline above suggests that the vast majority of healthcare improper payments are structurally preventable.
Estimate the financial case in under a minute.
Use your own assumptions. This model focuses on payment leakage reduction and labor savings from exception handling. Adjust the inputs below to fit your environment.
This illustrative model does not include secondary value from stronger CMS audit readiness, faster exception resolution, reduced provider abrasion, or avoided downstream recovery efforts.
Start with a narrow proof of concept.
Duration: 2-4 weeks
Scope: one payment class, one provider segment, or one regional payment workflow
Outputs: exception rate, routing mismatches, documentation gaps, policy violations, and estimated savings
Integration: API-based, low disruption, current payment rails remain in place
What we verify before release
- Provider identity and entity matching
- Exclusion and sanctions checks
- Routing and account integrity validation
- Policy and threshold enforcement
- Verification receipt for every approved payment
Request a Payment Integrity Evaluation
Pre-settlement verification for healthcare payment flows. Reduce leakage, strengthen compliance, and create audit-ready evidence.