Pilot Information System helps health plans, TPAs, and employers eliminate claim errors, reduce overpayments, and maximize cost savings.
Claim Editing & Overpayment DetectionComprehensive Payment Integrity — Prospective and Retrospective Prospective payment integrity solutions are becoming increasingly important for health plans seeking to increase payment integrity and strengthen provider relationships. Pilot Information Systems makes this possible with lightning-fast processing — returning claims files in under 20 minutes to enable true prospective payment review. But prepay solutions are just one part of the equation. Retrospective analysis remains a cornerstone of a complete payment integrity strategy, providing the insight needed to identify patterns, prevent future errors, and recover missed savings. With Pilot, you can run retrospective reviews on any set of claims, for any time period, backed by unlimited claims history for greater accuracy and deeper analysis. The result: a balanced, end-to-end payment integrity program that delivers confidence, control, and measurable savings.
Cloud-Based SaaS PlatformAt Pilot Information Systems, our commitment to automation, speed, and client satisfaction gives us the agility to adapt quickly to new industry trends — and deliver results faster than anyone else. While most competitors take a year or more to add new edits, Pilot can design, develop, test, and implement them in just weeks. Even better, we create custom claim edits tailored to your state and local requirements — a level of service no competitor can match. Our clients rely on over 60 years of combined managed care and IT experience, backed by responsive, expert support that’s handled quickly and always to their satisfaction. The difference: with Pilot, you don’t wait for innovation — you lead it.
On-Premise LicensingUnlock the Hidden Savings in Your Claims Data Pilot’s Overpayment and Recovery System (OaRS) uncovers overpayments by mining your database with 25+ industry-standard edits—delivering the same powerful results as competitors, but at a fraction of the cost. In today’s crowded marketplace, many vendors claim to stand out through how they “apply” their edits. But here’s the reality: industry-standard edits are just that — standard. Whether it’s NCCI, MUE, Add-on Procedures, Global Surgical Period, or MPPR edits, they’re all based on the same underlying data sources. That’s why Pilot focuses on what truly makes a difference — cost efficiency, speed, customization, and accuracy. With OaRS, you get the same trusted edits used across the industry, enhanced by Pilot’s automation, intelligent data processing, and unmatched value.
Custom Edits & ReportsPilot offers flexible deployment options designed to fit your organization’s operational and security requirements. Our primary delivery method is Software as a Service (SaaS), which provides fast, secure, and scalable access to Pilot’s full suite of payment integrity tools. Through a secure VPN connection to our SSAE 18 Type II (SOC 2) certified servers, clients can transmit claims data with complete confidence in its security and privacy. This model allows claims to be processed in large batches or incrementally throughout the day, giving you total flexibility in how and when data is submitted. The result is a seamless integration with your existing systems—no on-premise hardware, no software maintenance, and instant access to the latest code and edit updates. For clients with specialized environments or additional regulatory requirements, Pilot also offers on-premise or hybrid deployment options, ensuring our solutions adapt to your infrastructure—not the other way around.
