Performant Healthcare helps health insurance payers — both government and commercial — identify and recover improper payments in the healthcare system. Improper payments occur when claims are paid incorrectly due to billing errors, incorrect coding, lack of medical necessity, or situations where a different payer should have been responsible. Performant's two core services are claims auditing, where Performant screens claims using proprietary analytics and nurse/coder reviews to identify incorrectly paid claims, and Coordination of Benefits (COB) services, where Performant identifies situations where a payer should not have been the primary payer and recovers funds from the correct payer. Performant operates almost entirely on a contingency fee model, earning a percentage of the funds it recovers — if it finds nothing, it earns nothing. Performant serves federal government agencies (primarily CMS), state Medicaid agencies, and commercial health plans. On the federal side, Performant holds Recovery Audit Contractor (RAC) contracts with CMS to audit Medicare claims in specific regions, and holds the national exclusive Medicare Secondary Payer contract. Commercial clients have grown to roughly 60% of healthcare revenue, driven by a land-and-expand strategy targeting the top managed care organizations. Performant is also pursuing state Medicaid agencies as an emerging growth opportunity. The company's cost structure is predominantly labor and technology; Performant is investing in AI and NLP tools to automate parts of the claims review workflow and improve claim selection accuracy.