Pre-built agentic Solutions for utilization management, RCM, Patient 360, and HCC retrospective, plus Gwen for the workflows your team wants to ship itself. Running on the Data Layer, governed by the Context Layer, and routed through your humans where judgment lives.
Our take on agentic
The Ai Workforce runs on the Data Layer, reasons through the Context Layer, and hands off to humans where judgment lives. Workers handle whole workflows. Your team handles the calls only people should make.
The Chatbot
The Ai Workforce
Pre-built Agentic Solutions
For the workflows we have already built and proven, the Solutions are ready. Each one is composed of multiple Ai Workers, governed by the Context Layer, working over the Data Layer.
Intake to determination. Payer policy lookup, clinical criteria matching, evidence assembly, and confidence-gated review. The nurse stays in the loop on every edge case.
Claims, coding, denials, appeals. Multiple Ai Workers running across the revenue cycle, surfacing risk before submission and drafting appeals after denial.
A member or patient profile assembled from every system that touches them. Always current. Always traceable. The view your team always wished they had.
V24 and V28 fluent. Reviews charts, surfaces missed conditions, attaches supporting documentation, and routes for coder sign-off. End-to-end, on the cadence your team operates.
Gwen, the builder
Inside the Workforce
Operations and clinical leads build their own Ai Workers without code and stay in command of where review happens. Same Data Layer underneath. Same Context Layer governing every output. Same humans in every loop.
Learn about GwenGwen · the no-code Ai Worker builder
Gwen
Composable by design
01
Atomic skills that handle a specific task. Versioned, eval'd, ready to call.
02
Workers composed into end-to-end workflows. Live for UM, RCM, Patient 360, HCC.
03
Solutions stacked across your organization. The compounding system underneath every operation.
Reuse callout · ICD-10 Extractor
The same Worker that powers HCC Coding & Risk Adjustment also runs in your real-time documentation flow. Build once. Use everywhere.
The rule we do not break
Every workflow has explicit human review checkpoints, configurable to how your team operates. Configure once. Adjust anytime.
Review checkpoint options · choose any, mix freely
Every case
Every Ai Worker recommendation is reviewed by a human before action is taken.
Edge cases
Only outputs flagged as edge cases route to human review. The rest run through.
By dollar
Outputs above a configurable dollar threshold route to human review.
Sample
A representative sample of outputs is routed to human review for ongoing audit and quality assurance.
By risk
Outputs scored as high-risk by the Ai Worker route to human review.
You decide
Compose your own gating rules. Mix any of the above, by workflow, by line of business.
Healthcare administration at the speed of patient need.