Bluespine is an AI-powered payment integrity platform that identifies, recovers, and prevents medical and pharmacy overpayments. It enables self-insured employers to reduce healthcare spend by up to 10% while strengthening fiduciary compliance under ERISA.
The platform reviews up to 100% of claims across the lifecycle, validating payments against each employer’s specific plan terms, contracts, and pricing agreements. This approach uncovers billing errors that traditional audits and generic rules often miss.
Bluespine operates as an independent layer alongside carriers and ASO vendors, requiring no changes to workflows, vendors, or member experience. It introduces no administrative burden and does not disrupt member benefits.
Bluespine has experience working with more than 50 leading insurance carriers and ASO vendors, enabling integration into complex claims environments.
The platform delivers evidence-backed findings with precise policy citations and audit-grade documentation, enabling accurate recoveries and defensible oversight. Employers use Bluespine to enforce plan terms, reduce financial leakage, and protect plan assets from fraud, waste, and abuse.
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