Simple and intuitive. Almost deceivingly so.
[Be] in your element
The sleek design includes a customizable dashboard dynamic fraud scoring and dashboard widgets.
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Core Elements: [Pay] in your element.
Fight fraud on two fronts. With Nucleus you get the world’s foremost payment integrity application and HCI’s signature clinical validation process. Working together in perfect harmony.
Ct
Clinical Touch
Ct Clinical Touch
Only HCI brings the power of clinical validation — medical, coding, and investigative expertise — to each of our payment integrity solutions. Our process delivers you greater savings and unmatched payment accuracy.
Tools: [Work] in your element.
Fight fraud on two fronts. With Nucleus you get the world’s foremost payment integrity application and HCI’s signature clinical validation process. Working together in perfect harmony.
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Sm
Social Messaging
Sm Social Messaging
Social media opens the possibilities of communicating. A first of its kind, the Nucleus Message Center allows you to group organizational contacts, post rich data to threads and even start real-time chats with customer service.
Pci
PhysicianClaim Insight®
Pci PhysicianClaim Insight®
Meet the ultimate professional claim solution. PCI was designed to help you maximize claims payment accuracy, prevent FWA and reduce professional claims costs. And because of our advanced software, experienced clinicians and seasoned investigators, it does just that.
Ps
Prepayment Solutions
Ps Prepayment Solutions
Each of HCI’s solutions help you detect and prevent fraud, waste and abuse before claims are paid. When you detect improper payments before the check gets cut, you eliminate the hassle and expense of pay and chase.
Gs
Great Service
Gs Great Service
Standing behind each HCI payment recommendation are experienced clinicians and account managers to help you navigate the challenges of claim reimbursement. Achieving payment, member and provider harmony is now a reality.
Uf
User Friendly
Uf User Friendly
Every aspect of the Nucleus user experience was designed with you in mind. With endless ways to customize your workflow, you’ll be fighting fraud, waste and abuse faster and more efficiently than you ever thought possible.
Br
Better Results
Br Better Results
Nucleus isn’t just another SaaS application, it’s a whole new way of paying claims. Now you have access to industry — first features that help you get better results. Realize improved claim margins and an ROI as high as 9 to 1.
Ws
Work Smarter
Ws Work Smarter
Sleek. Efficient. Intelligent. Nucleus is like no other payment integrity application. With a clean, intuitive interface that includes intelligent fraud scoring and color-coded indicators, it’s designed to help you stop fraud faster and work smarter.
Tc
Total Customization
Tc Total Customization
Nucleus is at your disposal. Nearly every element of the interface is totally customizable, from dashboard widgets and drag-and-drop data fields to user-defined shortcuts and searches; all the elements are there for you.
Id
Idea Driven
Id Idea Driven
Take part in the evolution of Nucleus. Mixing the latest in social media and crowd — sourcing technology, you can share feedback, brainstorm with other users and post ideas to improve Nucleus. You have a voice. We’re listening.
Dci
DentalClaim Insight®
Dci DentalClaim Insight®
Get the definitive dental claim solution that delivers definitive results. DCI helps you prevent dental FWA with cutting-edge technology and clinical validation. Get rapid, state-compliant professional review from Certified Dental Consultants and start saving.
Oci
OncologyClaim Insight®
Oci OncologyClaim Insight®
Experience the only oncology claim solution that reduces costs and elevates patient care. OCI combines targeted claim and case identification software. You’ll get evidenced-based treatment plans and support from Oncology Certified Nurses to help you save.
Aa
Advanced Analytics
Aa Advanced Analytics
HCI’s Nucleus platform deploys highly effective next-generation analytics you can’t find anywhere else. With millions of payment triggers in your arsenal, you’ll see a significant boost in your fraud detection rates.
Ti
Total Insight
Ti Total Insight
Health care reimbursement is a complex equation. The answers are in the data and Nucleus gives you the tools to find them. See results on the real-time dashboard and access leadership — level reports to stay ahead of the competition.
Ap
Accelerated Productivity
Ap Accelerated Productivity
Give your payment integrity program a shot in the arm. Nucleus helps accelerate user productivity with its powerful tools and advanced technology. You’ll measure gains in cases opened, claims impacted and dollars saved.
Cn
Claim Neutral
Cn Claim Neutral
It’s time to consolidate. Nucleus gives you all-in-one versatility on a scalable, claim neutral platform. Now you can stop fraud in physician, facility, dental, and pharmacy claims with a powerful integrated solution.
Hc
Help Center
Hc Help Center
You’ll never be left in the dark with the Nucleus Help Center. Providing new ways to navigate the user experience, you can chat online with our support team, watch video tutorials and visit HCI U. With Nucleus, help is only a click away
Rt
Real—time Processing
Rt Real—time Processing
Time is money, and Nucleus understands that. By processing results in real-time and returning clean claims in seconds, you’ll be in compliance with prompt — pay laws and detect suspect claims quicker.
Fci
FacilityClaim Insight®
Fci FacilityClaim Insight®
We built the most effective payment integrity application around, so you can avoid the trauma of facility bill overpayment. FCI offers bill negotiation, repricing and forensic analysis of high-dollar cases. You’ll see results unmatched in accuracy and savings.
Rxi
PharmaClaim Insight®
Rxi PharmaClaim Insight®
Get the latest pharmacy FWA detection solution that offers just the right dose of savings. RxI was created to isolate suspect patient and provider activity while strengthening payment precision. Cutting-edge software and Rx Coding Specialists help you get better results.
Core Elements: [Pay] in your element.
Fight fraud on two fronts. With Nucleus you get the world’s foremost payment integrity application and HCI’s signature clinical validation process. Working together in perfect harmony.
Hu
Happier Users
Hu Happier Users
The wrong payment integrity software wastes time and energy. Nucleus gives your team powerful views and a friendly, intuitive interface that will turn your claims processing and SIU staff into happier, more efficient users.
Sa
Software-as-a-Service
Sa Software-as-a-Service
Use what you want, when you want, and where you want. Nucleus’ SaaS model was developed to help you save time and reduce overhead. With no software installs, maintenance fees or upgrade costs, Nucleus makes life simple.
As
Absolute Security
As Absolute Security
Rest assured knowing HCI is URAC accredited, and has stood up to the stringent standards of a SAS 70 audit. Our commitment to security, quality and accountability allows you to focus on work, not worrying about your data.
Es
Easily Scalable
Es Easily Scalable
No growing pains here. Nucleus allows you to scale with ease by adding new users, lines of business and service modules. Payment integrity software should not only allow you to grow, but also grow with you.
Cti
CaseTracker Insight℠
Cti CaseTracker Insight℠
We’ve taken a complex problem and simplified it. CTI gives you feature rich case tracking that’s seamlessly integrated with the industry’s most advanced payment integrity platform. Easily follow cases from start to finish and simplify your case investigation workflow.
Technology: [Thrive] in your element.
Fight fraud on two fronts. With Nucleus you get the world’s foremost payment integrity application and HCI’s signature clinical validation process. Working together in perfect harmony.
Si
Seamless Integration
Si Seamless Integration
Working well with others is a Nucleus strong suit. Integrating seamlessly with your current payment processes, from legacy applications to the latest payment platforms, Nucleus is ready to fight fraud alongside all your vendors.
F
Fraud
F Fraud
For some, fraud is a four-letter word that involves false claims, kickbacks and identity theft. Perpetrated by complex criminal networks to individual providers, fraud robs our nation’s health care system. The result? Skyrocketing costs, higher premiums and more innocent victims.
W
Waste
W Waste
Waste (aka Overpayment) is a major contributor to the $300B lost to FWA annually. Many honest providers unknowingly facilitate waste in the form of administrative errors, duplicate claims and modifier misuse. Unfortunately, the patient gets stuck with the tab.
A
Abuse
A Abuse
Billing abuse is the precursor to fraud. It takes the face of upcoding, modifier manipulation, unbundling and excessive services. Citing sicker patients, superior care or unfair compensation, some providers feel justified in bending the truth. That doesn’t make it right.