Integrity MTX
Advancing Healthcare Fraud Risk Identification with AI-Powered Integrity Management Technologies.
Integrity MTX
Advancing Healthcare Fraud Risk Identification with AI-Powered Integrity Management Technologies.
About Us
Our Mission
Integrity Management Technologies (Integrity MTX) delivers affordable, AI-driven integrity solutions and fraud risk assessment tools for health plans of all sizes, with a specialized focus on small to mid-sized, rural, and tribal health plans that often face limited resources. Our mission is to expand access to advanced health equity analytics traditionally reserved for large organizations while improving the accuracy and fairness of Fraud, Waste, and Abuse (FWA) detection.
Aligned with CMS’s equity-based approach to FWA identification, we integrate social determinants of health (SDOH), demographic data, and local care realities into program integrity decisions—helping health plans identify true risk red flags, reduce improper payments, and minimize false positives that can undermine access to care.
By integrating health equity into payment integrity, Integrity MTX drives proactive risk management, enhances compliance, and fosters lasting trust across community health plans.
Our Team
Our team of technology professionals, corporate ethics experts, healthcare investigators, and former federal law enforcement agents brings decades of experience in resolving sensitive and confidential misconduct, abuse, and ethics reports. We leverage our deep subject-matter expertise, including fraud risk assessment and health equity analytics, alongside proven investigative methodologies. This ensures that every case is handled with discretion, accuracy, and fairness, while also integrating payment integrity solutions into our processes.
Our Solutions
Investigative Case Management Software for Healthcare
We specialize in empowering small to mid-sized health plan SIUs with the industry’s most advanced investigative case management system—delivered at a cost that fits your budget. Our CaseX360 solution equips your health plan investigations team with everything needed to intake, track, investigate, and resolve even the most complex integrity focused cases, without straining your financial resources.
Whistleblower and Hotline Report Management
Our Smart Tip IQ platform is an affordable, secure, and technology-driven whistleblower and hotline reporting platform designed to meet the compliance and accountability needs of your health plan or non-profit.
For healthcare facilities regulated by CMS and state oversight agencies, Smart Tip IQ-Healthcare supports confidential reporting of complaints, misconduct, and elder abuse or neglect while safeguarding whistleblower identity and reinforcing quality of care.
For nonprofits and NGOs, Smart Tip IQ - Non-Proft provides a cost-effective solution to meet OMB Uniform Guidance and state reporting requirements by enabling secure reporting of fraud, waste, abuse, and internal misconduct.
Across all sectors, Smart Tip IQ delivers the highest level of data protection and anonymity, including GDPR compliance, ISO 27001 certification, end-to-end encryption (E2EE), and two-factor authentication (2FA), empowering organizations to demonstrate transparency, protect vulnerable populations, and uphold ethical governance.
Fraud Risk Assessment Technology
Launching soon, Fraud Risk Navigator 360 provides small to mid-sized health plan SIUs with advanced fraud risk assessment technology designed to support compliance and proactive risk management.
Health Care Provider Education Technology
Our upcoming Smart Provider solution is a Performance Remediation Intelligence (PRI) platform that uses AI to deliver targeted, topic-specific education to the providers in your network who need it most—increasing payment accuracy, identifying trends, generating measurable cost savings, and minimizing provider abrasion.
By analyzing claims data, denial patterns, and policy requirements, Smart Provider identifies the root causes of payment errors while accounting for local care realities. The platform delivers precise micro-education to the right provider in your network, closing knowledge gaps in claims, disputes, and compliance—helping prevent civil or criminal risk and protecting against future litigation.
Smart Provider tracks performance, provider engagement, and key social determinants of health (SDOH)—including poverty, transportation barriers, workforce shortages, housing instability, and limited broadband access—supporting standardized data collection and analysis that advance measurable, equity-focused insights, stabilize provider revenue, and strengthen network sustainability in alignment with CMS’s Framework for Health Equity 2022–2032.
Designed for affordability and accessibility, Smart Provider is a cloud-based, lightweight platform that requires minimal IT support—making advanced payment integrity capabilities attainable for small and mid-sized health plans, while remaining fully scalable to support organizations of any size.