Coordinate
Machinify Coordinate combines large-scale data, advanced matching algorithms, and a comprehensive policy map to identify hidden coverage overlaps and drive cost avoidance with a post-payment recovery backstop.
one intelligent platform
The future of payment integrity.
Our products interoperate seamlessly to find and fix potential payment errors as early in the cycle as possible. Powered by our AI operating system, our products capture policy at scale and enforce it in real time across claims, charts, contracts, and eligibility data.
Bring your own expert
AI where it works. Experts where it matters.
We combine autonomous actions with human expert oversight to deliver safe, compliant, precise insights with efficiency. Our products are designed as modular interconnected blocks that attack payment errors in sequence, from eligibility and benefits to coding to pricing. Launch in fully-managed mode with our team of experts, or pair with your own expert analysts and reviewers.
Subrogate
Machinify Subrogate identifies potential third-party liability pre- and post-payment, and it manages the complex end-to-end recovery process while maximizing savings and ensuring compliance.
Audit
Machinify Audit flags claims with potential coding errors and reviews medical records and itemized bills to fix those errors across DRG, inpatient, outpatient, and other claim types, before or after payment.
Pay
Machinify Pay edits and reprices claims in real time to ensure accurate upfront payment against a wide range of coding rules, payment policies, and contracts. And it includes post-pay enforcement for exceptions.
Pharmacy
Pharmacy COB, audit, and compliance tools identify overpayments, maintain CMS compliance, and streamline audit readiness with AI-driven insights and expert oversight.
Our difference
Innovation that transforms. Quality you can trust.
For decades, we’ve been recognized for accuracy and exceptional customer service in payment integrity. Now, we combine that trusted foundation with transformative AI innovation to deliver reliable, frictionless, fast results your teams can trust.
Intelligence that improves constantly
Intelligence that improves constantly
Our self-learning, adaptive systems improve with every claim processed. Every missed opportunity is a learning opportunity. Our systems don't just detect problems, they fix them.
Deep human expertise
Deep human expertise
Our work is grounded in decades of experience solving payment integrity problems. Our products reflect deep insight into the intricacies of the underlying processes, and our solutions reflect our dedication to service excellence.
Seamless, fast deployment
Seamless, fast deployment
Our platform integrates seamlessly with your core systems and is built for fast, modular deployment. This helps to enable flexible launch mechanisms, strong ROI, and a consistent positive experience for all stakeholders.
What our partners say.
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
Leading Medicare health plan
We have realized considerable cost containment and avoidance without increasing our time-to-payment, which keeps provider abrasion low.
Payment Integrity Manager
Health Plan
For our organization, Machinify has improved their recovery numbers year over year at a pretty good clip. Machinify’s key strengths are effective delivery of savings and responsiveness.
Executive
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
Machinify’s key strength is definitely their people. Those people seem to have an edge when it comes to creating the solutions we use, and they can change things overnight. When I say overnight, I mean overnight. Machinify’s people are just faster and more advanced than others. A lot of that comes down to their expertise.
Executive
Health Plan
Let’s see what we can solve together.
Discover how our proven accuracy, exceptional service, and advanced AI help you recover more, reduce friction, and transform payment integrity.
Insights start here
Explore news, perspectives, case studies, and best practices that help navigate healthcare’s evolving landscape.
Learn more about what Machinify does and how healthcare leaders rate Machinify’s products, service, and innovation in this First Look report by KLAS.
Behind every real healthcare AI success story are six essential elements—skip one, and you’re not building a solution, you’re staging a performance.
With artificial intelligence (AI) top of mind for healthcare payers, they are beginning to search for ways to incorporate this novel technology into different areas of their workflow.
To better understand the state of AI applications and adoption amongst payers, Machinify surveyed 100 executives from U.S. health plans.