Simplifying the way forward
We’re streamlining payment integrity to be frictionless and future-ready. Combining cutting-edge AI with best-in-class expertise, our configurable solutions cut through complexity and deliver unprecedented results.
We’re The Healthcare Intelligence Company
At Machinify, we create disruptively simple, powerfully clear ways to maximize your financial outcomes and drive down healthcare costs for everyone.
Sharing unrivaled expertise
With over 40 years of experience, from developing subrogation law to codifying medical policy, we’re trusted leaders with a track record of excellence driven by a commitment to accuracy and transparency.
Stewarding client success
The trust we create with you is just as important as the results we deliver. We’re your partner, committed to maximizing accuracy, reducing provider abrasion, and improving financial outcomes.
Driving AI innovation
We’re transporting payment integrity into the future with AI that is safe and transparent. With cutting-edge AI models to detect anomalies, review claims and medical records, and identify errors, our products deliver game-changing efficiency.
Delivering full-suite flexibility
Our flexible, hybrid delivery model is as revolutionary as our technology, enabling you to configure our solutions to achieve the results you need. With solutions that span the payment continuum, our offerings can be insourced, hybrid, and outsourced to align with your preferences and overall strategy.
OUR APPROACH
Where passion meets precision
When complexities in healthcare stand in the way of performance and affordability, we know there’s a better way forward. We’re revolutionizing payment integrity by combining our deep expertise with an AI-forward approach to make it smarter, faster, and more transparent. And that leads to meaningful results for everyone.
OUR RESULTS
Our momentum by the numbers
WHAT WE DO
Your solutions on your terms
We don’t believe in one-size-fits-all. With a focus on shifting left, we offer pre- and post-pay solutions across a range of operational models—insourced, out-sourced, and hybrid—to help you take more control of your payment operations.
OUR IMPACT
Amplifying value for payers, reducing costs for everyone
With innovative tech and extensive healthcare experience, we’ve delivered billions in total savings and cost avoidance. Our AI approach turns petabytes of data into smarter decisions with a continuous feedback loop that grows with your business to deliver continuously greater accuracy and insights at scale.
Streamlining the payment process
Today, payment integrity processes are marked by complexity and redundancy. We use large-scale data mining capabilities to dig deeper and find meaningful efficiencies, eliminating technical debt from legacy software and processes.
Improving provider relationships
We work closely with you to address challenges in your provider workstream—improving communications, lowering administrative burdens, streamlining reimbursements, optimizing DRG code management, preventing cash flow disruption, and more. Our approach increases accuracy, resulting in fewer false positives, helping to build credibility with providers.
Understanding your business—invested in your success
Business success starts with shared understanding and transparency. We take the time to get to know your business on a deeper level to understand how you work, what you need, and how we can support you. That’s what makes us the right partner for over 60 payers—including many of the top 20 plans—no matter their size, requirements, or preferences.
We have realized considerable cost containment and avoidance without increasing our time-to-payment, which keeps provider abrasion low.
Payment Integrity Manager
Health Plan
Their flexible services and transparent platform allow us to have control of the process, while still enjoying their expert team’s support.
Payment Integrity Manager
Health Plan
Machinify is highly focused on outcomes and making sure they deliver on their commitments. They do what it takes to get the best outcome the right way.
Vice President
Health Plan
WHO WE ARE
Proven innovators
When administrative complexity costs payers $267+ billion annually, we know there must be a better way forward. As a team of industry pioneers, we set the standards for payment integrity—from developing processes for Medicaid subrogation, to representing 80% of the private health insurance industry in mass tort cases, to revolutionizing bill review and data mining for claims auditing.
With technical expertise and perspectives from across a diverse range of industries, we’re taking a fresh look to solve age-old problems in healthcare.
