HCIactive Launches VIRA Audit Bot to Modernize TPA and Carrier Remittance Audits

HCIactive announced the official launch of the VIRA Audit Bot, a breakthrough AI-driven audit engine purpose-built to modernize vendor and broker remittance audits across the insurance ecosystem. Des...

COLUMBIA, Md.: HCIactive announced the official launch of the VIRA Audit Bot, a breakthrough AI-driven audit engine purpose-built to modernize vendor and broker remittance audits across the insurance ecosystem.

Designed within HCIactive’s AI First and AI Everywhere architecture, the VIRA Audit Bot eliminates manual processes, improves audit accuracy, and delivers real-time validation across TPA, carrier, payroll, and remittance pipelines.

Key capabilities of the VIRA Audit Bot include:

Automated Rule Generation & Validation
AI evaluates benefit rules, policy rules, eligibility data, and remittance statements to build precise audit criteria.
Exception Detection & Root-Cause Analysis
Identifies mismatches in transactions, vendor files, premium flows, eligibility changes, and commission structures.
On-Demand Modification Code Generation
The engine provides proposed fixes and remediation logic for each error category, reducing human intervention.
Real-Time Streamlit Visualizations
Secure dashboards allow carriers, brokers, auditors, and administrators to see discrepancies instantly.
AI-Driven Compliance Tracking
Ensures alignment with carrier-approved processes, state regulatory frameworks, HIPAA, SOC 2 controls, and ERISA requirements.
Multi-Role Expert System Architecture
Includes Configuration Expert, Data Validation Expert, Analytics Expert, Remediation Expert, Modification Code Expert, and more.

The VIRA Audit Bot utilizes Azure OpenAI for secure, compliant analysis while remaining fully traceable and governed by HCIactive’s AI Governance Program.

“Remittance audits have historically been slow, manual, and error-prone,” said Henry Cha, CEO of HCIactive. “With VIRA Audit, we’ve automated the entire lifecycle-from rule creation to detection to correction. This is the next generation of administrative AI.”

The solution will roll out across all vendor, broker, and carrier remittance programs, with extensibility to claims, benefits, and compliance audits in upcoming releases.

For more information, visit HCIactive.com/virai-suite

Fonte: Business Wire