AI in Healthcare

Redefining Healthcare Quality with AI

Improve clinical and operational performance to maximize care quality, patient safety, and financial outcomes.

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Problem

Managing care
quality at scale is hard

Health systems want to deliver excellent care, but without continuous oversight, quality improvements remain out of sight, until it's too late.

Untapped Revenue Potential

CMS awards over $12.7 billion annually in Star Rating bonus payments, representing substantial untapped revenue potential for quality improvements.

Quality Related Penalties

In 2025, 34.1 million people were enrolled in Medicare Advantage plans,2 however the number of 4 and 5-Star rated plans fell.

Communication Failures

Communication failures drive more than 49% of malpractice claims and significantly impact patient satisfaction scores, creating both legal and reputational risks.

solution

Complete visibility into care quality and compliance

Monitor every clinical interaction. Identify care gaps as they occur, predict compliance risks before they become violations, and track performance.

Monitor

Track clinical interactions, documentation, administrative workflows, and claims processes

Measure

Generate HEDIS scores, Medication Adherence rates, eCQMs, TEAM and other quality KPIs

Analyze

Produce interactive dashboards with actionable insights from call and EHR data to identify and anticipate care gaps

Improve

Proactive care gap closure, and deliver targeted training to improve quality scores and financial outcomes

Use cases

The problems we solve for our customers

Quality andRisk Management

Ensure call quality and completeness by auditing 100% of calls, rather than sampling just 5%.

Telehealth Communication Audit

Provider calls are evaluated in multiple languages to screen for appropriate patient evaluation and empathy, resulting in improved care quality, higher patient satisfaction scores, and reduced institutional risk.

Pre-appointment Intake Analysis

Interaction analysis of intake calls between administrators and patients highlights incomplete or missing information to prevent appointment cancellations and optimize scheduling.

Clinical Guideline Adherence Monitoring

AI evaluation of clinical practice against local or national guidelines, enabling targeted workforce training for quality improvement.

Star Ratings and Performance Improvement

Automatically identify care gaps, monitor guideline adherence, and track provider performance on value-based care measures.

HEDIS Effectiveness of Care Measures

Continuous oversight of performance for effectiveness of care measures, enabling timely, automated interventions to improve overall scores and payments.

Medication Adherence Measures

The platform supports quality leaders in improving the proportion of days patients are covered with medications, leading to improved CMS Star ratings and bonus payments.

TEAM Quality Measures

Track and improve performance in TEAM measures for patients having surgery, reduce avoidable hospital readmissions and emergency department use.

Customer Stories

Proven results across healthcare

Telehealth Communication Quality Improvement

A Nationwide Telehealth Provider

Challenge

Manual auditing of provider-patient telehealth calls was catching only a small fraction of quality issues, leaving gaps in care delivery and potential risks undetected.

Solution

Deployed our multi-agent AI system to evaluate 100% of telehealth consultations for clinical completeness, empathy, and adherence to communication protocols.

Results
Reduced percentage of calls with omissions
Achieved significant labor cost savings from AI vs manual audit
Decreased number of complaints in the case period
Reduced percentage of calls with omissions

Billing & Claims Audit

Healthcare Revenue Cycle Management Company

ChAllenge

Manual claims processing created accuracy issues affecting speed of reimbursement.

Solution

Manual claims processing created accuracy issues affecting speed of reimbursement.

Results
Audited a high volume of claims through automated processing
Generated a measurable delta in revenue due to improved accuracy
Achieved significant labor cost savings for AI vs manual claims audit
Accelerated reimbursement timelines and reduced processing delays

Prior-Authorization Audit

A Florida based Health System

Challenge

Prior-authorization documents were audited manually to address an increase in denial rates, leading to heavy administrative burden.

Solution

Our AI engine audited eligibility and benefits verification, and reviewed clinical documentation for completeness and procedure necessity.

Results
Reduced documentation omissions to prevent claim denials
Reduced provider frustration
Decreased number of complaints in the case period
Saved labor costs from AI audit vs manual audit
about us

Building better healthcare outcomes through lived experience

We experienced firsthand how healthcare quality gaps, from missed screenings to documentation errors, impact patient care. We saw that health systems need comprehensive tools to monitor and improve quality at scale.

So we built one. Drawing on our expertise from healthcare delivery, enterprise software, and AI, we created a platform that monitors every clinical interaction to identify care gaps before they impact patient outcomes.

Team with experience from

+ 24 others

Backed by advisors from

+ 4 others
Secure Security & Integrations

Your data, your control

Privacy and security

SOC 2 Type II, GDPR, and HIPAA certified with end-to-end encryption

Flexible deployment

Self-hosted in your VPC or private cloud, your data never leaves secure environment

Audit-ready

Complete evidence trails with tamper-proof logs for regulatory reviews

Role-based access

Granular permissions aligned with your organizational requirements

Integration Ready

Integration with health records, CRMs, cloud telephony, and cloud providers.

We make sure your data and privacy is in your control

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Start your journey

Use AI to achieve comprehensive quality oversight, improve patient outcomes, and reduce administrative burden.

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