Zscore Technologies
AI-powered health insurance claims processing and data management platform
Overview
Zscore Technologies is a claims technology and data management platform for health insurers. Founded in 2016 and headquartered in Whitefield, Bengaluru, India, the company focuses on automating health insurance claims operations through machine learning, natural language processing, and contextual intelligence.
The platform delivers intelligent document processing, automated adjudication, and fraud detection capabilities delivered as an on-premises or private cloud solution. It digitizes unstructured claim documents, applies policy rules automatically, and flags anomalies in real time. A tariff digitization module benchmarks claims against hospital tariff schedules to identify overpayments.
The company participated in accelerator programs including Startupbootcamp FinTech Singapore, NetApp Excellerator, and NASSCOM DeepTech Club, and has clients in India and Australia. Reported customer outcomes include 40% efficiency improvement and up to 10% reduction in overpayments.
Products & Services
Intelligent Document Processing
Automated extraction and digitization of health insurance claim documents using NLP. Reduces manual data entry and processing errors by converting unstructured claim forms into structured data.
Key Features
- NLP-based extraction from unstructured claim forms
- Automated digitization reducing manual entry
- Structured data output for downstream processing
Target Users: Health insurance claims teams, TPAs
Error and Fraud Detection
ML-based detection of anomalies, forgeries, and suspicious patterns in claims data. Flags irregularities before payment to prevent fraudulent claims.
Key Features
- Real-time flagging of suspicious claim patterns
- ML-based anomaly and forgery detection
- Pre-payment fraud prevention workflow
Target Users: Claims auditors, fraud and compliance teams
Automated Adjudication
Algorithmic adjudication of health claims against policy guidelines, reducing overpayments through consistent rule application.
Key Features
- Policy-rule-based adjudication engine
- Up to 10% reduction in overpayments
- Consistent application across high claim volumes
Target Users: Health insurers, TPAs
Tariff Digitisation
Hospital data analytics module that digitizes tariff schedules and benchmarks claims against cost norms.
Key Features
- Tariff schedule digitization
- Claims-to-tariff benchmarking
- Potential 25-30% reduction in processing time
Target Users: Health insurance operations teams
Data-Driven Decisions
Real-time analytics dashboard providing claims trend analysis and operational metrics.
Key Features
- Claims trend analysis
- Operational KPIs and reporting
- Strategic decision support for insurers
Target Users: Health insurance executives, operations managers
At a Glance
- Founded
- 2016
- Headquarters
- Bengaluru, Karnataka, India
- Employees
- 1-10
- Funding
- Seed
Category & Focus
- Category
- Claims Technology
- Subcategories
- Claims Automation Fraud Detection Document Management Automated Adjudication
- Insurance Verticals
- Health
- Target Customers
- Carriers, TPAs
Customers
- Australian health insurer (unnamed)
- Indian health insurer (unnamed, CDO testimonial)
- Indian health insurer (unnamed, CEO testimonial)
- Indian health insurer (unnamed, GM testimonial)
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Last updated: 2026-06-08