Omega by ByteVox – Your End-to-End Insurance Fraud Intelligence Hub

Detect fraud, validate claims, and gain complete visibility across policyholders, hospitals, and claim pipelines – all in one powerful voice + data intelligence system.

Why Insurance Fraud Remains Unsolved

Traditional methods fail to address the complex, evolving nature of insurance fraud in today's digital landscape.

Manual Process Bottlenecks

Slow, human-dependent verification leads to delays and missed fraud patterns.

Impact Analysis

  • 5–7 day claim processing time
  • 30% fraud cases missed
  • ₹4,000 Crore average annual losses
  • 3x manual review workload

Lack of ICD Mapping

No automated correlation between claims and medical diagnosis codes.

ICD Impact

  • No ICD validation = unchecked fraud
  • Frequent mismatches with procedures
  • Zero diagnosis-code traceability

No Voice-Hospital Correlation

Call center data exists in silos, disconnected from claim verification.

Disconnected Data

  • Voice logs not linked to hospital
  • No NLP matching with ICD
  • Poor voice-data traceability

Language Complexity

Multi-lingual claims create verification challenges and fraud opportunities.

Multilingual Risk

  • Miscommunication leads to fraud gaps
  • 11+ Indian languages complicate review
  • No AI translation checks

Introducing Omega – Intelligence at Every Step

Our comprehensive solution addresses fraud detection from every angle.

AI Voice Verification

Advanced voice analysis detects stress patterns and verifies claimant identity against historical data.

AI Voice Verification Details

  • 98.7% accuracy in voice matching
  • Detects 15+ vocal stress indicators
  • Cross-references with 3+ years of call history
  • Real-time analysis during calls
  • Supports all major Indian languages

Real-Time Risk Scoring

Dynamic scoring algorithm evaluates each claim against 200+ fraud indicators in milliseconds.

Risk Scoring Highlights

  • Evaluates 200+ risk parameters
  • Scores in under 500ms
  • Considers historical patterns
  • Integrates with pre-auth & post-claim flows

Hospital Fraud Mapping

Proprietary database tracks provider fraud patterns across geographic regions.

Mapping Capabilities

  • 30,000+ hospital profiles tracked
  • Regional pattern clustering
  • Blacklist & watchlist integration
  • Geo-risk intelligence overlays

ICD Code Pattern Detection

Automated analysis of diagnosis codes against treatment claims and historical patterns.

ICD Logic Insights

  • Matches diagnosis to treatment norms
  • Flags upcoding and mismatched codes
  • Aligns with WHO & IRDA frameworks
  • Detects misuse in chronic & acute illness tags

Audit Trails & Escalation Logs

Complete documentation of every verification step for compliance and review.

Audit Features

  • Timestamped record of each step
  • Reviewer & escalation metadata
  • Integrated with policy audit trails
  • Compliant with IRDAI & insurer SOPs

Automated Workflows

Smart routing of claims based on risk level, reducing manual review workload by 40%.

Workflow Capabilities

  • Risk-based triaging
  • Auto-escalation for high-risk claims
  • 40%+ reduction in manual workload
  • Smart handoff to medical review teams

21 Modules. One Unified Fraud Defense Grid.

Comprehensive coverage across the entire claims lifecycle.

Data Onboarding

TPA Ingestion

Policy Mapping

Hospital Registry

Data Specifications

  • CSV/Excel/JSON formats
  • API integration support
  • AES-256 encryption
  • Real-time sync
  • 99.99% uptime SLA

Voice Intelligence

Aarav Agent

Call Logs

Voice Biometrics

Voice Capabilities

  • Multilingual Support
  • Real-Time Transcription
  • Embedded AI Signal Detection

Risk & Detection

Risk Engine

Threat Correlation

Anomaly Detection

Detection Details

  • Real-Time Scoring
  • Fraud Signal Heatmaps
  • Layered Intelligence System

Escalation

Case Management

Action Tracker

Investigator Portal

Escalation Tools

  • SLA Based Escalation
  • Role-Based Access
  • Auto-Notifiers

Compliance

Rules Engine

ICD/Hospital Matrix

Regulatory Digest

Compliance Insights

  • Pre-Built & Customizable Rules
  • Regulatory Norm Mapping
  • Secure Rule Editing Interface

Support

Multilingual UI

Help Center

Interactive Walkthrough

Support Features

  • 11 Indian Languages
  • Guided Screens
  • Live Chat + FAQ System

How Omega Works

A seamless flow from claim intake to resolution with intelligent fraud detection at every step.

Claim Intake

Automated ingestion from TPAs, hospitals, and policyholders

Data Mapping

Correlation across policies, providers, and historical claims

Voice Verification

AI-powered call analysis and claimant authentication

Risk Assessment

Real-time scoring against 200+ fraud indicators

Resolution

Automated approval or flagged for investigation

Fraud triggers identified at each stage

Built for India. Built for Everyone.

Native support for all major Indian languages with regional dialects.

🇮🇳 Hindi
🇮🇳 Bengali
🇮🇳 Tamil
🇮🇳 Telugu
🇮🇳 Marathi
🇮🇳 Gujarati
🇮🇳 Malayalam
🇮🇳 Kannada
🇮🇳 Odia
🇮🇳 Punjabi
🇬🇧 English

Proven Results from Early Deployments

Quantifiable impact across insurance providers and TPAs.

600ms

Faster Detection

Reduction in time to identify fraudulent claims

40%

Faster Claim Closure

Improvement in legitimate claim processing time

50,000

Fraud Detected

Of fraud cases identified through voice + data correlation

91%

Rejection Accuracy

Accuracy rate in identifying fraudulent claim patterns

Enterprise-Grade Deployment Plan

Comprehensive support throughout implementation and beyond.

On-site Resource

Dedicated implementation specialist for first 90 days

Senior Client Manager

Strategic account oversight and quarterly reviews

Tech Lead Oversight

Direct access to technical leadership for critical issues

Webinars

Monthly training sessions

Dashboards

Custom analytics views

Agent Costs

Included in base package

Language Packs

All regional languages

Transparent, Scalable Pricing

Pay-per-claim model with volume discounts.

Starter

₹100 /claim
  • Up to 50K claims/year
  • Basic fraud detection
  • Email support
POPULAR

Professional

₹90 /claim
  • Up to 100K claims/year
  • Advanced fraud detection
  • Phone & email support
  • Monthly analytics reports

Enterprise

₹80 /claim
  • 200K+ claims/year
  • Premium fraud detection
  • 24/7 dedicated support
  • Custom integrations
  • Quarterly strategy sessions

Setup Fee: ₹2 Crore

One-time implementation cost includes tech stack, licenses, AI models, and onboarding for your team.