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)
Adaptive Care Model for clinical and subclinical needs
Global provider network in 200+ countries
1:1 coaching with evidence-based guidance
Circles group support sessions
Pathways self-guided programs
Crisis care escalation for urgent needs
Self-assessment and personalized care plan
Ongoing check-ins to track well-being
Multi-lingual care in 80+ languages
Stepped Care methodology for triaging needs
Employer portal with admin analytics
Incident response support for employers
Integration with employee benefits ecosystem
PEPM or usage-based pricing options
Cultural-centered care across specialties
Integrations
PDE (Pharmacy Data Exchange)
MMR (Monthly Membership Report)
MAO-004 (Medicare Advantage Organization data)
MOR (Medical Office Record)
277CA (Claims Attachment)
