Features
Risk Adjustment Copilot with trumping logic and RADV audit trail
Quality & Stars Copilot with unified gap closure and glide-path forecasting
Pharmacy & Part D Copilot for triple-weighted PDC measures
Provider Network Copilot with auto-generated practice agendas (90→15 min)
Care Management Copilot with ADT-driven TOC and 5-day follow-up
AI Data Analyst for plain-English querying of canonical record
Live data ingestion from 147+ streams (claims, EHR, pharmacy, labs, ADT, payer SFTP)
TCPA-compliant outbound voice actions (multilingual)
EMR overlays via Epic SMART-on-FHIR and Athenahealth marketplace
Coder workspace with encounter-and-claim review
Pre-claim flagging for RAF lift before submission window closes
Cross-team coordination surfacing blind spots across departments
RADV-grade chain-of-custody and audit trail
Tenant-isolated, BAA-covered, encrypted in transit and at rest
ECDS-scale data volumes (35-75x hybrid sampling)
AI-generated pricing intelligence reports from transparency data
Benchmark rate trends and spot anomalies
Row-level visibility traceable to original MRFs
Spreadsheet-like interface for exploring data
Integrates with CRM, RCM, EMR via API
SOC 2 Type II compliant data security
Sample reports for quick evaluation
Processes 15+ trillion rates for deep insights
National coverage of healthcare price data
Utilization data analysis (allowed amount counts)
Physician assistant reimbursement analysis by state
Provider prospecting for network teams
Independent Dispute Resolution (IDR) support
Drug price transparency analysis (with noted gaps)
Integrations
PDE (Pharmacy Data Exchange)
MMR (Monthly Membership Report)
MAO-004 (Medicare Advantage Organization data)
MOR (Medical Office Record)
277CA (Claims Attachment)
