Every team that touches a claim
gets their time back.

The problem

The majority of claims that come through your door are routine — the same procedure codes, the same benefit categories, the same straightforward decisions. Yet they still land in someone's inbox, wait their turn, and consume reviewer capacity that should be going to complex or suspicious cases.

How Qubiclo helps

Qubiclo adjudicates routine claims automatically, the moment they arrive. Your rules run on every claim — coverage limits, exclusion lists, benefit schedules — and a decision is produced in under 3 seconds. Your reviewers only see the claims that actually need a human.

The problem

By the time a suspicious claim is spotted — if it's spotted at all — the payment has usually already gone out. Manual review teams can't check every claim for overbilling, duplicate submissions, or abnormal billing patterns. The ones that slip through add up fast.

How Qubiclo helps

Qubiclo screens every claim for fraud before a decision is made. It checks for duplicate submissions, billing amounts above contracted rates, treatment combinations that aren't clinically possible, and unusual patterns in how providers are billing. Anything suspicious is flagged and held for human review — before the payment.

The problem

Running a TPA means maintaining a different rulebook for every client — different benefit schedules, different exclusions, different approval thresholds. Keeping all of that straight manually, across dozens of clients, creates errors and makes scaling nearly impossible.

How Qubiclo helps

Qubiclo is built for multi-payer environments. Each client gets their own isolated rulebook, their own provider network, and their own audit trail. You manage all of them from one platform — without any client's rules affecting another's.

The problem

Life and general insurers expanding into health face a hard choice: build a claims adjudication capability from scratch (expensive, slow) or buy an enterprise system built for large incumbents (overbuilt, inflexible, multi-year implementation). Neither fits.

How Qubiclo helps

Qubiclo is API-first and designed to be running in days, not months. You configure your benefit schedule, connect your provider network, and go live. No massive IT project. No dedicated adjudication team to hire.

The problem

Large employers running self-insured benefit plans have to verify every provider claim before paying out — but they typically don't have the systems or the staff to do it well. Claims get rubber-stamped, fraud goes unchecked, and provider disputes take weeks to resolve.

How Qubiclo helps

Qubiclo gives self-insured employers the same adjudication infrastructure that insurers use. Upload your benefit schedule, connect your provider contracts, and every claim gets checked against your rules before you approve it.

The problem

Government and mandatory health insurance programmes are held to the highest standard of accountability. Every approval and every rejection must be justifiable. When an auditor asks why a claim was approved three years ago, you need to be able to produce a complete record.

How Qubiclo helps

Qubiclo logs every action taken on every claim — who reviewed it, what rule applied, what the outcome was, and when. Records are immutable and exportable. Your team is always audit-ready without any preparation.