AI-Powered Insurance Policy Compliance

Automatically validate insurance policies, detect compliance issues, and mitigate risks with our advanced AI platform.

Policy Validation

Automatically cross-check claims against policy terms

Compliance Checks

HIPAA, CMS, and ACA compliance verification

Risk Detection

Identify policy gaps and contradictions

Key Features

AI-Powered Insurance Compliance

Our platform uses advanced AI to streamline insurance policy validation and compliance checks

Policy vs Claim Validation

Extract coverage terms and cross-check medical codes for claim validity

Compliance Checklist

HIPAA, CMS, and ACA compliance verification with detailed reports

Risk Flagging

Identify incomplete clauses, contradictions, and risky exclusions

Multi-Doc Comparison

Compare contracts or policy versions to detect changes and risks

Document Ingestion

Intelligent Document Processing

Our platform processes PDF, Word, EOBs, claims, and policy documents using OCR and entity extraction to convert unstructured data into actionable insights.

AI Layer

Advanced LLM Processing

Powered by state-of-the-art language models fine-tuned on insurance and HIPAA corpus, our system provides accurate clause validation and compliance detection.

Rule Engine

Compliance Rule Engine

Our platform includes codified HIPAA/CMS/ACA rules and enterprise-specific guidelines with JSON-based rule definitions for modular updates.

Analytics

Comprehensive Reporting

Generate detailed audit reports with explainable AI highlights for mismatches and export to PDF/Excel or integrate with ticketing systems.

Success Stories

See PolicyGuard.AI in Action

Discover how leading insurance companies are using PolicyGuard.AI to streamline compliance

National Health Insurance

85% reduction in compliance review time and $1.2M annual savings

Read case study →

Midwest Health Partners

32% fewer claim denials with automated validation process

Read case study →

BrightSmile Coverage

Streamlined policy updates across 50 states with $850K savings

Read case study →

Our Team

Meet Our Founders

The visionaries behind PolicyGuard.AI bringing expertise in insurance, compliance, and AI

Shankar

Co-Founder

Bangalore, USA

Mahendra

Co-Founder

Surat, India

Mohan

Co-Founder

Bangalore, USA

Pricing

Choose the Right Plan for Your Needs

Flexible pricing options for businesses of all sizes

Free Trial

$0/month

Perfect for compliance teams to evaluate our platform

3 audits per month
Basic claim-policy matching
Standard compliance reports
Email support

Popular

Pro

$499/month

Ideal for mid-sized insurers with regular compliance needs

50 audits per month
PDF export functionality
Standard HIPAA checks
Advanced policy validation
Priority email support

Enterprise

Custom

For large health insurers and TPAs with advanced needs

API access
Custom rule training
On-premise deployment option
Advanced integrations
Dedicated account manager
24/7 priority support

Not sure which plan is right for you?

Use our ROI calculator to see how much your organization could save with PolicyGuard.AI

Comparison

How PolicyGuard.AI Compares

See how our solution stacks up against traditional methods and other tools

Feature	PolicyGuard.AI	Manual Audits	Other LLM Tools
HIPAA/CMS prompt library
Red teaming audit layer
SOC2-ready logs
Claims vs. Policy comparison
Plug-and-play API

Why PolicyGuard.AI Stands Out

PolicyGuard.AI combines specialized insurance compliance knowledge with advanced AI capabilities to offer a solution that traditional methods and generic AI tools simply cannot match.

Purpose-built for insurance compliance with HIPAA/CMS expertise
Advanced security with red teaming audit layer and SOC2-ready logs
Seamless integration with existing systems via our API