Payer AI apps
Each app targets one health plan workflow, runs on synthetic data, and has a case study covering the problem, architecture, evaluation and the path to production.
Prior Auth Copilot
Checks a prior authorization request against the coverage policy, one criterion at a time, and cites the evidence for a nurse reviewer.
LLM criteria review with verified citationsDenial & Appeals Assistant
Explains each denied line from its CARC/RARC codes, decides whether to appeal or correct it, and drafts the appeal from verified evidence.
Evidence-checked analysis and draftingBenefits Navigator
Answers coverage questions from the member's own plan documents, gets cost estimates from a calculator tool, and checks every citation and dollar figure.
Tool-using agent with checked answersPayment Integrity Radar
Finds providers whose billing stands out from risk-adjusted specialty peers, then writes a neutral, fact-checked brief for investigators.
Robust peer statistics with checked LLM briefsHCC Evidence Finder
Compares charts with submitted codes in both directions: missed conditions with MEAT evidence, and unsupported codes to review before a RADV audit.
MEAT evidence review with code-owned HCC rules