For Auditor, Manager and ExecutiveLeader in the Unimed system · 40+ cooperatives

Audit that relies only on the human eye does not scale, and fraud knows it.

Nous prioritizes the highest-impact claims, 450+ AI models sweep the whole base and the auditor only decides where it makes a difference.

Your medical claims audit at its best.

+0%
cost avoidance
0%
operational effort
+0%
routine automation
0,000+
automated checks
// see it in action

Live operations

What changes for you

Choose your perspective

Situation

Situation

As a manager, you answer for loss ratio, medical cost and the audit team's productivity.

Problem

Problem

Sampling is blind to the whole. And when you adjust a rule in one place, another one goes off.

Implication

Implication

Medical cost out of control, exhausted team and difficulty explaining the number.

Need, payoff

Need, payoff

Full coverage, +30% in cost avoidance and a team focused on high-impact clinical and financial decisions.

Agents in your routine

Intelligent Agents act, humans in command.

Nous is UpFlux's operational AI. It prioritizes the day, executes the routine with Intelligent Agents and gives back the result in hard currency, with humans deciding where it matters.

Claims prioritizer450+ clinical modelsDynamic knowledge baseRisk triage
See the full agent catalog
Nous cockpit · today
+30%
cost avoidance
live
Claims prioritizer
42 actions
450+ clinical models
28 actions
Dynamic knowledge base
17 actions
Risk triage
11 actions
Integrations

Native where the process already runs.

Plugs into the ERP in production, reads the real process and writes actions back into the same system. Without replacing what already works.

TASYMVSolusUnimed system

Process Intelligence of the full audit cycle, from claim intake to leakage flag, with root cause by provider.

Gartner + Everest PEAK Matrix, the only Latin American vendor listedR$ 780M+ in results generated
// frequently asked questions

Frequently asked questions

Direct answers for teams evaluating operational AI in enterprise settings.

How do you automate medical claims audit?

UpFlux automates medical claims audit with more than 450 clinical AI models that analyze 100% of incoming claims, not a sample. Low-risk claims are released without human touch; high-impact ones reach the auditor with the discrepancy already flagged and the patient's clinical context attached.

How do you reduce medical claim leakage with AI?

UpFlux's AI cuts leakage by identifying improper payments, duplicate charges and protocol mismatches before payment. Payers running UpFlux capture more than 30% in cost avoidance on the audited base, with an audit trail that stands up in legal and regulatory proceedings. UpFlux has generated more than R$ 500M in savings for payers, over R$ 100B+ in medical claims processed.

Can you audit 100% of medical claims instead of a sample?

Yes. With UpFlux, 100% of the claims run through the 450+ clinical models automatically. The human auditor no longer draws samples and only decides on the highest-impact cases, with the patient's history and the rule that triggered the alert already in view.

How does the AI integrate with TASY, MV and the Unimed system?

UpFlux integrates natively with TASY, MV, TOTVS and the Unimed system. The rollout is plug and play, no long project, no system swap, and 40+ Unimed cooperatives are already running intelligent audit with UpFlux in production.

Does AI-driven claims audit stand up to regulatory and legal scrutiny?

Yes. Every UpFlux finding carries the full trail: the clinical rule that fired, the evidence in the claim and in the patient history, and the final decision, which always stays with the human auditor. That traceability is what defends the payer's position in disputed claims and regulatory reviews.

Does AI replace the medical claims auditor?

No. UpFlux's AI does the sweep no human team could do manually, 100% of claims against 450+ models, and hands the auditor the highest-impact cases with the discrepancy and clinical context already flagged. The auditor stops drawing samples and decides where human judgment matters most.

Your operation is leaving money on the table. Let's measure how much.

In 30 minutes we show how Nous connects your data, acts inside daily operations and proves the return in hard numbers.