Improper payment and program integrity review

Too many payments to review, too few reviewers

Your program integrity office is measured on the improper payment rate your agency reports and on what it recovers. Most of that work still happens after the money has gone out, one package at a time.

The evidence sits in several places: the payment system, the vendor or beneficiary record, the contract, and a file of receipts, hotel folios and timesheets. Your reviewer opens each one by hand before writing a finding.

Review capacity is the ceiling. Every false flag costs a reviewer an hour, so the queue grows faster than the team that works it.

How improper payment and program integrity review works

H2O Driverless AI builds the risk models, and Enterprise h2oGPTe reads the documents and runs the agents.

Step 1: score before the payment goes out

Driverless AI trains models on your past payments and review outcomes. Each score carries reason codes, so your reviewer sees why a payment was flagged.

Step 2: find the unusual

Anomaly detection surfaces duplicate invoices, split purchases, changed bank details and billing patterns that no rule describes yet.

Step 3: connect records across programs

Models can link the same vendor, provider or beneficiary across program systems, so a pattern that looks small in one program shows up across all of them.

Step 4: read the package

Document AI in Enterprise h2oGPTe reads receipts, folios, timesheets and invoices, and returns structured fields. Each line is checked against contract terms, GSA per diem rates and 2 CFR 200.

Step 5: assemble the case and let a person decide

Agents in H2O AI Super Agent gather the records behind a flag and draft a review memo, and every finding cites the rule or document line behind it. Your reviewer accepts, edits or rejects each finding, and the decision and its evidence are logged.

Waste and abuse detection

Waste and abuse rarely break a rule outright. They show up as patterns: a provider who bills more units per visit than peers, a vendor whose invoices cluster just under an approval threshold, or travel that sits at the top of the rate every time. Models trained on your reviewed cases rank those patterns by risk, so your team works the top of the list first.

Invoice and travel audit

For contractor invoices and travel vouchers, the check runs line by line. Document AI reads the package and validates each charge against the contract, the GSA per diem rate for the place and date, and the cost principles in 2 CFR 200. An agent drafts the audit memo with the rule cited next to each exception, and your auditor signs it.