Apixio

Apixio | Healthcare AI Solutions for Plans and Providers is a healthcare AI platform focused on unifying health data and delivering AI-powered insights to health plans, providers, and ACOs. It combines risk adjustment, payment integrity, health data management, and AI-as-a-Service to enhance coding accuracy, pre-visit risk capture, chart reviews, and interoperability. Following the acquisition and restructuring, Apixio's offerings emphasize actionable insights, streamlined workflows, and data-driven decisions to improve reimbursements, reduce costs, and elevate care quality across payer-provider ecosystems.

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What it does

• Unifies health data and analyzes it with AI to surface targeted insights for risk adjustment, payment integrity, and utilization management.
• Provides AI-powered retrospective, prospective, and concurrent risk adjustment to improve documentation, coding accuracy, and QA.
• Delivers itemized bill review, automated IBR workflows, and clinical chart review support.
• Offers interoperability and centralized chart management to streamline data retrieval and sharing across systems.
• Extends capabilities through AI-as-a-Service for flexible integration into existing workflows and tech stacks.
• Targets health plans, providers, and ACOs with tailored solutions to optimize value-based care programs.

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Key Solutions Overview

• Risk Adjustment
• Retrospective Risk Adjustment: AI-powered coding and auditing to improve retrospective accuracy.
• Prospective & Concurrent Risk Adjustment: AI-powered insights at the point of care for complete, accurate risk capture.
• Payment Integrity
• AI-powered insights for pre-pay and post-pay reviews, supporting clinical chart reviews and complex claims analyses.
• Health Data Management
• Unify and analyze health data to streamline care efficiency and outcomes across organizations.
• AI-as-a-Service (AIaaS)
• AI-powered clinical diagnosis insights that can be embedded into payer and provider workflows for risk adjustment, payment integrity, and utilization management.

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How it Works (High-Level)

• Integrates health data from multiple sources to build a unified data platform.
• Applies AI-driven diagnosis insights to support risk adjustment, payment integrity, and utilization management.
• Delivers actionable recommendations and workflow automation to accelerate chart reviews, coding, and decision-making.
• Enables easy integration into current systems via AI-as-a-Service and interoperable data sharing.

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Who We Serve

• Health Plans
• Providers
• ACOs

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Why Apixio

• Industry-leading AI-powered risk adjustment, payment integrity, and health data management.
• Scalable ML models designed to handle large patient populations and complex healthcare data.
• Emphasis on interoperability, centralized chart management, and seamless workflow integration.
• Trusted by health plans and providers to improve operational accuracy, efficiency, and care quality.

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Resources & Education

• Industry blogs, articles, guides, white papers, brochures, webinars, and case studies exploring AI in healthcare.
• eBooks and insights on prospective risk adjustment and payer-provider collaboration.

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How to Get Started

• Explore AI-powered Risk Adjustment, Payment Integrity, Health Data Management, and AI-as-a-Service solutions.
• Contact for a demonstration to see how Apixio can fit into your health plan, provider, or ACO program.

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Core Features

• Unified health data platform combining Risk Adjustment, Payment Integrity, Health Data Management, and AI-as-a-Service
• Retrospective, Prospective, and Concurrent Risk Adjustment with AI-powered coding insights
• Itemized Bill Review (IBR) and automated IBR workflows
• AI-powered clinical chart review support
• Centralized Chart Management and interoperability services
• AI-powered insights for Utilization Management (UM)
• Flexible AI-as-a-Service for easy integration into existing workflows
• Scalable ML models capable of handling large patient populations
• Tools and resources to support health plans, providers, and ACOs