For Health Plans

Amplify Your Plan’s Accuracy and Efficiency with High-Impact AI

Put health data to work for your members and your business with flexible solutions for risk adjustment, payment integrity, and utilization management.

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How We Support Health Plans

Health plan operations have become increasingly complex under different value-based payment models and performance programs that require a nuanced understanding of patient health and clinical treatment. AI-powered Risk Adjustment, Payment Integrity, Health Data Management, and AI-as-a-Service solutions help your plan reduce operational overhead while surfacing meaningful insights from administrative and clinical datasets.
Benefits for Health Plans

Operate More Efficiently

Help your team streamline workflows, quickly share data, and spend more time on high-value tasks.

Increase Accuracy and Transparency

Extract deep, trustworthy insights out of your clinical and administrative data.

Streamline Data Acquisition and Management

Reduce friction with providers and IT with centralized data acquisition, storage, and analytics.

Proactively Assess Population Health

Identify and address patient conditions early and often with reliable, AI-powered intelligence.
Solutions for Health Plans

Health Data Management

Centralized data acquisition, chart storage, and analytics solutions that promote internal data reuse and simplify data sharing with external partners.

Risk Adjustment

Proven AI technology and centralized review workflows for prospective, concurrent, and retrospective risk adjustment programs.

Payment Integrity

Intelligent, data-driven solutions and services that increase efficiency, accuracy, and transparency for Itemized Bill Review and Clinical Chart Review validation programs.

AI-as-a-Service

Actionable AI-powered insights, tailored to your member populations and delivered within your existing systems and workflows

The Impact

4X

Faster

4X faster coding time

96%

Accuracy

96% coding decision accuracy

3-5%

Net-New

3-5% incremental net-new HCCs per project

Streamline Health Plan Operations with Time-Saving Solutions

My team can review at least twice the number of charts on a daily basis to uncover more supported HCCs, surpassing expectations while minimizing coder burnout.
Risk Adjustment Leader,
Regional Health Plan

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Give Your Health Plan a Competitive Advantage with Apixio

Explore how Apixio can support your health plan’s unique administrative and care delivery program needs.