AI for Healthcare That Actually Works

Building a frictionless foundation for healthcare payments
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65M
Members covered by our platform
$1B+
Annual financial benefit to customers
$200B
Medical claims reviewed annually
15%
Reduction in admin costs

Products

Machinify Audit

Machinify Audit is a medical AI system that identifies erroneous claims and performs record review for clinical, coding, and billing errors.
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Machinify Pay

Machinify Pay processes claims at wire speed, ensuring accurate coding and pricing aligned with payment policies and contracts.
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Machinify Audit

Machinify Audit leverages medically trained AI to identify erroneous claims and accelerate complex audits of all types
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Machinify Pay

Machinify Pay automates the review of medical bill's coding and pricing errors at wire speed and prevents unnecessary or invalid billing
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A different approach

Unique AI purpose-built for healthcare

  • Trained on billions of claims to understand medical coding and patient care trajectories
  • Interprets medical records to evaluate fine-grained clinical and coding criteria
  • Digests healthcare rules as reflected in coding manual, payment policies, and contracts

Your Partner, not your vendor

  • Safe: Use AI to digest and unify your policies, contracts, and admin rules, consistently applied to your payment integrity program to deliver predictable results
  • Transparent: Full operational and policy visibility to know how your program is performing 24/7
  • Control: Implement your own policies tailored to your health plan’s needs

Real-world results

  • $500M+ annual incremental value delivered for single health plan
  • 30% increase in findings per case
  • 57% reduction in false positive findings
  • 15% reduction in administrative costs
  • Transparency: A "glass-box" approach to AI—we don't keep our rules under wraps, transferring knowledge to eliminate misalignment
  • Control: Our AI isn't a one-size-fits-all solution, but tailored and updated to the health plan's needs
  • Safety: AI drives efficient and consistent data and document digestion; final decisions confirmed by experts
  • $500M+ annual incremental value delivered for single health plan
  • 30% increase in findings per case
  • 57% reduction in false positive findings
  • 15% reduction in administrative costs
  • Trained on billions of claims to understand medical coding and patient care trajectories
  • Interprets medical records to evaluate fine-grained clinical and coding criteria
  • Digests healthcare rules as reflected in coding manual, payment policies, and contracts
Feature article

Using Three Levels of AI to Distinguish Reality from Fiction

There are three “levels” of AI that you could test a product for, specifically in the context of claims processing use cases. Asking the right questions can not only help you determine what level of AI a product uses, but can also help you determine if a product even uses AI at all. Discover the three "levels" in the article here.

Feature ARTICLE

4 Times to Never Use AI in Healthcare 

We have a saying in the operating room, “just because you can, doesn't mean you should.” We have microscopic graspers, robots, and laser-guided navigation at our disposal, yet there’s still a doctor behind those tools, making sure everything is running smoothly.

Feature article

What is Payment Integrity?

There is a saying in the operating room, “just because you can, doesn't mean you should.” The same principle works for the use of AI in healthcare. Learn about the scenarios where AI is significantly better than the current state.

Learn from our customers

My team loves Machinify! Their AI capabilities have increased recoveries by over 30% and reduced our dependence on PI vendors. Even more, as a leader of a large PI organization, Machinify multiplied reviewer productivity while eliminating false positives.

VP of Payment Integrity at Leading Medicare Health Plan

Working with Machinify has been a uniquely positive experience. Machinify helped us identify opportunities that were previously missing and continues to serve as valuable thought partners.

AVP of Claims Operations at Leading US Health Plan

Machinify is very flexible and has clearly demonstrated a track record with our payment integrity team. We couldn't ask for better partners. Internally, there is a high level of respect and trust in Machinify and when you say something, you do it.

AVP of Data Science at Leading US Health Plan