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BAE NetReveal for Insurance Fraud from BAE Systems Applied Intelligence
End-to-end fraud detection and investigation solution that uses advanced analytics and machine learning to identify potentially fraudulent insurance claims. Features include network analysis to detect fraud rings, real-time risk scoring, investigative tools, and case management capabilities.
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Product analysis by function
Fraud Detection Solutions for Claims Management
AI-powered tools that identify suspicious patterns, anomalies, and potential fraudulent activities in claims data. These solutions use advanced algorithms to flag high-risk claims for further investigation.
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Data Integration & Ingestion
(8 Yes /8 Known /10 Possible features)
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Multi-source Data Support Ability to connect, extract, and ingest data from multiple insurance systems (claims, policy admin, CRM, external data, etc.). |
NetReveal is marketed as ingesting data from multiple insurance systems (claims, policy admin, external data) per vendor site and industry reviews. | |
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Real-Time Data Ingestion Capability to onboard and process data as it is created or updated, enabling timely fraud detection. |
Vendor materials reference real-time risk scoring and alerting, indicating real-time data ingestion. | |
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Batch Data Processing Ability to import and process large datasets at scheduled intervals. |
Supports batch ingestion of claims data (data import and bulk processing) as part of insurance fraud analytics. | |
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Data Standardization & Enrichment Automatic transformation of diverse data formats into standardized formats, and enrichment with external sources (public records, watchlists, etc.). |
Data standardization and enrichment from 3rd parties (watchlists) is mentioned in product overviews. | |
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Data Quality Controls Automated checks for missing, inconsistent, or outlier data and the ability to flag or remediate issues. |
Automated data quality, anomaly, and outlier detection are fundamental to NetReveal's fraud analytics. | |
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Third-Party Integrations Integration with sources such as government databases, social networks, medical provider registries, etc. |
Platform integrates with external sources (govt databases, watchlists), per documentation. | |
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Unstructured Data Handling Support for textual, image, or PDF files for analysis (documents, photos, adjuster notes). |
Support for unstructured data (notes, documents) is mentioned in product capabilities. | |
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API Access APIs available for inbound and outbound data exchange. |
Open API for integration and data exchange listed in NetReveal integration documentation. | |
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Data Storage Capacity Maximum supported data storage for large and growing datasets. |
No information available | |
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Data Latency Average time lag between data ingestion and availability for analysis. |
No information available |
Detection Techniques & Algorithms
(9 Yes /9 Known /11 Possible features)
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Rule-Based Detection Ability to configure and run expert rules (red flags) to identify known fraud patterns. |
Rule-based detection (red flags, expert rules) is a standard NetReveal feature. | |
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Machine Learning Models Deployment of statistical and ML-based algorithms to discover new and evolving fraud patterns. |
Supports machine learning models for anomaly/fraud detection. | |
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Anomaly Detection Identifies outliers or abnormal behaviors in claims, entities, or transactions. |
Anomaly and outlier detection is explicitly mentioned in platform feature lists. | |
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Network/Link Analysis Visualization and scoring of relationships and connections among claimants, providers, vehicles, etc. |
Network/link analysis to surface fraud rings is a featured capability. | |
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Natural Language Processing (NLP) Processes and analyzes unstructured text (adjusters' notes, medical reports) for hidden clues. |
NLP of unstructured adjuster notes supported for additional fraud clues. | |
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Image/Document Analytics AI-based analysis of uploaded images/documents to detect tampering or inconsistencies. |
Includes analytics of uploaded documents/images for manipulation or tampering. | |
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Behavioral Analytics Analyzes claimants’ or providers’ behavior over time for suspicious changes. |
Behavioral analytics of claimants/providers is included in solution description. | |
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Custom Model Support Ability to import, build, or train custom fraud detection models. |
Custom and imported models for local business rules are supported. | |
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Adaptive Learning System updates and retrains itself based on newly detected fraud cases. |
Adaptive/self-learning capabilities noted in latest solution announcements. | |
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False Positive Rate Percentage of legitimate claims incorrectly flagged as fraudulent. |
No information available | |
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Detection Accuracy Overall accuracy of the fraud detection algorithms. |
No information available |
Alerting & Investigation Support
(8 Yes /8 Known /10 Possible features)
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Automated Alert Generation Automatic flagging of suspicious cases and routing to appropriate teams. |
Automated alerting and case routing is core to NetReveal's value. | |
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Alert Scoring & Prioritization Ranking alerts by risk/severity and potential financial impact. |
Alert prioritization by risk and potential impact is demonstrated in product demos. | |
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Case Management Workflow Integrated modules for tracking, documenting, and managing investigative cases. |
Case management workflow is called out as a primary feature. | |
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Audit Trails Comprehensive history of all investigation actions and decisions for compliance. |
Full audit trails of investigations and actions are included for compliance. | |
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Collaboration Tools Facilitates communication and sharing between adjusters, special investigation units, and external parties. |
Collaboration tools (sharing findings between teams) described in product documentation. | |
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Evidence Attachment Ability to attach files (documents, correspondence, images) to investigation records. |
Ability to attach and manage evidence files within cases is a listed capability. | |
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Automated Notifications Sends email/SMS alerts to investigators when high-risk activity is detected. |
Automated notifications (email/SMS) for high risk activities is supported. | |
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Investigation Cycle Time Average time to resolve a flagged claim from initial alert to closure. |
No information available | |
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Case Volume Supported Maximum number of concurrent investigations supported by the system. |
No information available | |
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Customizable Alert Thresholds Adjust criteria for triggering alerts to suit business policies or risk appetite. |
Customizable thresholds for triggering alerts is a standard feature for business policy alignment. |
Integration & Interoperability
(8 Yes /8 Known /10 Possible features)
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Core System Integration Native or API-based integration with policy administration systems, claims management systems, and payment platforms. |
Integrates with core insurance systems via API and native connectors. | |
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Third-Party Services Integration Support for integration with credit bureaus, watchlists, and public records databases. |
Integration with external services (credit bureaus, watchlists, etc.) is supported. | |
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Open API Availability Publicly documented APIs for custom integrations. |
Product documentation references open/public APIs for extensible integration. | |
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Batch Export Capabilities Ability to export alert, case, and analytics data for external analysis. |
Ability to export analytic results and case data in batch mode for external review. | |
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Custom Connector Support Ability to develop and deploy custom integrations to less common or in-house systems. |
Custom integration connectors can be supported per system integrator documentation. | |
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Bidirectional Sync Synchronization of investigation status and outcomes with other systems. |
Bi-directional sync with other systems (claims status, investigation result updates) is noted in product brochures. | |
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Integration Response Time Average latency for data exchange between the solution and integrated platforms. |
No information available | |
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Plug-and-Play Connectors Pre-built connectors to major core insurance systems and commercial data providers. |
Plug-and-play connectors to typical insurance data sources are advertised. | |
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Data Mapping Tools Visual tools for field mapping between systems. |
GUI mapping tools for systems integration mentioned by system integrators. | |
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Integration Scalability Number of concurrent integration endpoints supported. |
No information available |
User Experience & Accessibility
(7 Yes /7 Known /10 Possible features)
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Role-Based Access Control User access managed according to defined roles and permissions. |
Role-based user access and permission control is a standard requirement and supported. | |
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Intuitive User Interface User-friendly dashboards with easily navigable menus and customizable layouts. |
Web-based dashboards and customizable UI highlighted in marketing and user guides. | |
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Mobile Accessibility Optimized access or mobile app for use by investigators in the field. |
Mobile accessibility is mentioned in solutions brief and product sheets. | |
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Multi-language Support Availability of the interface in multiple languages for global teams. |
No information available | |
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Screen Reader Compatibility Accessibility support for visually impaired users. |
No information available | |
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Customizable Dashboards Personalized widgets, views, and alert preferences per user. |
Dashboards are customizable by user or role per UI demonstrations. | |
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Saved Searches and Filters Ability to create, save, and recall custom search queries and data views. |
Saved filters and searches are commonly available and highlighted in user guides. | |
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Bulk Processing Capabilities Actions on multiple records at once (e.g., closing several cases, bulk notifications). |
Bulk/batch actions on sets of cases or alerts referenced in workflow documentation. | |
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Notification Customization User-level control over which events trigger email, SMS, or in-app alerts. |
Users may select notification preferences at account/profile level. | |
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Concurrent User Support Maximum number of users who can work on the system simultaneously. |
No information available |
Reporting, Analytics & Insights
(9 Yes /9 Known /10 Possible features)
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Pre-built Reports Standard set of out-of-the-box reports (fraud trends, investigator productivity, savings etc.). |
Pre-built reports (fraud trends, productivity, savings) are available as part of the standard reporting suite. | |
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Ad Hoc Reporting Ability to build custom, on-demand reports with a visual builder or SQL. |
Ad hoc reporting and visual report designers are noted as supported. | |
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Visualization Tools Charts, graphs, heatmaps and other visualizations for rapid data understanding. |
Rich data visualizations are a highlight of the NetReveal product demo materials. | |
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Drill Down Capabilities Navigate from summary views to individual claim detail easily. |
Drill down from dashboards to individual claim/case level is supported. | |
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Scheduled Report Distribution Automatic scheduling and emailing/distribution of recurring reports. |
Report distribution by schedule (email, portal) described in user manual. | |
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KPI Dashboards Real-time dashboards with configurable key performance indicators (e.g., detection rates, financial impact saved). |
KPI dashboards and customizable metrics are core to executive reporting. | |
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Data Export Options Ability to export reports and data in various formats (CSV, PDF, Excel). |
Multiple export formats (CSV, Excel, PDF) supported for report/data extraction. | |
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Historical Data Analysis Review of past fraud cases, trends, and system effectiveness over time. |
Analysis of historical fraud data/cases and trend reporting is part of the analytics package. | |
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Predictive Analytics Forecasting future fraud risk based on data modeling. |
Predictive analytics and risk forecasting are supported with embedded models. | |
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Report Generation Speed Time required to generate a typical report. |
No information available |
Security & Privacy
(9 Yes /9 Known /10 Possible features)
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Data Encryption at Rest All stored data is encrypted on disk. |
Encryption at rest is a default requirement for regulated industries, and confirmed by BAE security documentation. | |
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Data Encryption in Transit All data transmitted between systems/users is encrypted. |
Encryption in transit (TLS/SSL) required and confirmed for NetReveal deployments. | |
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Multi-factor Authentication Users must verify identity with multiple factors at login. |
Multi-factor authentication is available per BAE's security suite documentation. | |
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Access Logging & Monitoring Comprehensive logs of all user access and critical actions. |
Comprehensive access logging available for audit and compliance; part of core platform. | |
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Granular Permission Controls Fine-grained control over user permissions to sensitive functions or data. |
Granular permission model (by team, user, data) is highlighted for compliance-driven clients. | |
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Automated Threat Detection Monitors for potential security threats or unusual access. |
Automated threat monitoring and detection part of security options. | |
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Compliance Certifications Product is certified for GDPR, SOC2, HIPAA, or other relevant standards. |
GDPR & SOC2 compliance certifications are claimed by the vendor. | |
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Data Retention Policy Management Configurable settings for data retention and secure disposal. |
Configurable data retention and disposal policy supported for compliance. | |
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Single Sign-On (SSO) Integration with upstream SSO/identity providers (Okta, Azure AD, etc.). |
Single sign-on integration with enterprise identity systems is supported. | |
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Security Incident Response Time Average time to detect and respond to security incidents. |
No information available |
Scalability & Performance
(5 Yes /5 Known /10 Possible features)
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Horizontal Scalability Capacity to add more processing nodes as data volumes grow. |
Horizontal scaling (processing nodes) supported for large deployments. | |
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Processing Throughput Maximum number of claims processed per hour. |
No information available | |
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System Uptime SLA Guaranteed minimum system uptime by the vendor. |
No information available | |
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Peak Concurrent User Support Highest number of users supported during peak loads. |
No information available | |
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Elastic Resource Allocation Automatic scaling of compute and storage resources as usage fluctuates. |
Elastic compute/storage scaling is available in cloud deployments. | |
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Load Balancing Distributes workloads automatically for consistent response times. |
Load balancing for processing and user traffic confirmed in architecture documentation. | |
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Response Time (Normal Load) Average expected user response time during typical volume. |
No information available | |
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Response Time (Peak Load) Average expected user response time during peak volume. |
No information available | |
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Geographic Redundancy Deployment in multiple geographic regions/data centers for business continuity. |
Geographic redundancy and disaster recovery are supported for high availability deployments. | |
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Disaster Recovery RTO Target Recovery Time Objective if a major outage occurs. |
undefined Disaster recovery targets (RTO) are specified in customer SLAs. |
Compliance & Regulatory Support
(10 Yes /10 Known /10 Possible features)
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Audit Logging Comprehensive and immutable records of all user and system actions. |
Immutable audit logging for user/system events included for compliance. | |
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Record Retention Scheduling Automated enforcement of record retention and deletion policies for compliance. |
Enforcement of record retention/deletion periods is included for regulated customers. | |
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Support for Regulatory Reporting Pre-built templates and workflows for mandatory reporting to authorities. |
Out-of-the-box regulatory reporting templates available for insurance and banking clients. | |
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Consent Management Mechanisms for tracking consent for data collection, use, or sharing. |
Consent management (opt-in/out, tracking) supported to address GDPR and similar laws. | |
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PII/PHI Masking Automatically masks or redacts sensitive information in UIs and reports. |
PII/PHI masking and redaction features for data privacy referenced in documentation. | |
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User Policy Acknowledgment Tracks user acceptance of compliance and use policies. |
Tracks policy acknowledgements/user compliance for regulated environments. | |
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Data Sovereignty Controls Options to ensure data is stored/processed in specific geographies. |
Deployment in specific geographies for data sovereignty compliance is supported. | |
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Legal Hold Management Support for restricting deletion/editing of data under legal hold. |
Legal hold features for litigation/regulatory purposes are available. | |
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Access Review Workflows Scheduled review and re-verification of user access rights. |
Workflow for regular access reviews and re-certification is available. | |
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Automated Compliance Alerts Notifies stakeholders of possible policy violations. |
Automated compliance alerts for policy violations are referenced in compliance modules. |
Deployment, Maintenance & Support
(9 Yes /9 Known /10 Possible features)
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Cloud Deployment Option Solution available as SaaS or hosted in a cloud environment. |
Cloud deployment (SaaS or hosted) is available, per product webpage. | |
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On-Premises Deployment Option Solution can be installed and operated in customer's data center. |
NetReveal can be deployed on-premises in customer data centers. | |
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Hybrid Deployment Support Supports mixed on-prem and cloud configurations. |
Hybrid on-prem/cloud deployments are available and described for large insurers. | |
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Automated Updates System and models updated automatically with new features and fixes. |
Automated model/system updates are available for SaaS/cloud clients. | |
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24/7 Support Availability Vendor provides round-the-clock technical support. |
24/7 technical support is a standard option per vendor materials. | |
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Technical Documentation Up-to-date user, integration, and admin documentation available. |
Extensive technical/user documentation is available. | |
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Sandbox/Test Environment Staging area for testing new features or integrations. |
Test/sandbox environments are provided for client integration and feature testing. | |
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Training & Knowledge Base Access to user training, video tutorials, and FAQ resources. |
Training (video, KB, documentation) is available to all customers. | |
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Upgrade Downtime Maximum expected system downtime for scheduled upgrades. |
No information available | |
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Dedicated Customer Success Manager Assigned vendor resource to support onboarding and ongoing engagement. |
Dedicated customer success managers are assigned for major deployments. |
Cost & Commercial Flexibility
(9 Yes /9 Known /10 Possible features)
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Transparent Pricing Model Clear, published pricing structure with no hidden costs. |
Transparent pricing models are referenced (no hidden costs, clear contracts). | |
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Pay-Per-Use/Volume Pricing Flexible pricing aligned with volume of claims processed or storage consumed. |
Pay-per-use or volume pricing is available for some clients/regions. | |
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Enterprise Licensing Option Available annual contracts with unlimited users or usage within an organization. |
Enterprise-wide licensing (annual contracts/unlimited usage) is available. | |
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Free Trial or Pilot Risk-free trial available for proof-of-concept evaluation. |
Free pilot or trial environments available for qualified prospects. | |
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Multi-year Discount Availability Discounts or incentives for multi-year commitments. |
Discounts for multi-year contracts have been cited in RFP reviews and vendor Q&A. | |
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No Lock-in/Exit Clauses Option to terminate contracts with minimal penalty or data migration support. |
Standard clauses allow client to exit/terminate contract with limited penalty and reasonable data migration support per contract terms. | |
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Implementation Fee Transparency All setup, onboarding, and integration charges disclosed up front. |
Transparent fee disclosure for implementation, onboarding, and integration is provided in proposals. | |
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Annual Maintenance Costs Annual percentage of license cost paid for maintenance and updates. |
No information available | |
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Scalable User Licensing Licenses can be flexibly allocated or re-assigned as business needs change. |
Licenses are scalable to cover different user groups or business units as needed. | |
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Flexible Payment Terms Ability to choose quarterly, annual, or custom payment schedules. |
Quarterly/annual/custom payment terms can be agreed during contracts according to customer preference. |
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