Exciting News: Machinify Spins Out Auth App to Evolent >> Read more

OUR MISSION
We develop software that helps people get the right medical care, at the right time, at the right price.

The Healthcare Industry

The $4 trillion healthcare industry is the largest and most complex sector of the U.S. economy. It involves maze-like processes, arcane rules, a multi-party payment system . . . and the yearly processing of 7 billion health claims.
Healthcare data is fragmented across industry players, stored in legacy systems, and is often unstructured and not machine-readable (think faxes).
WE STARTED MACHINIFY TO LEVERAGE HEALTHCARE DATA AT SCALE TO DRIVE DOWN COSTS AND IMPROVE OUTCOMES.
OUR PRODUCTS
Our software platform leverages the latest advances in machine learning, large language models, data analytics, and cloud processing to solve previously intractable problems.
MACHINIFY PRECISION AUTH

Machinify Precision Auth automates the review of proposed medical treatments for appropriateness and provides the authorizations that ensure proper reimbursement. In most cases Machinify Precision Auth can provide an answer in real-time. And when human intervention is required it can increase reviewer productivity by up to 800%.

FOR PATIENTS
FOR PAYER
Protect against delayed or abandoned care, reported as high as 40%
Protect against over/under treatment
Faster time to care
Reduce uncertainty and fear of rejection
Easier access to what is covered and what is not
Reduce cost of preauthorization by 10X
Increase speed, accuracy and consistency of decisions
Steer care to the right setting and provider
Improve Patient experience
Enhance Provider relationships by reducing turnaround and cost overhead and by eliminating appeals
Reduce uncertainty and fear of rejection
MACHINIFY PRECISION AUDIT

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FOR PATIENTS
FOR PAYER
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Steer care to the right setting and provider
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MACHINIFY PRECISION PAYMENTS

Machinify Precision Payments automates the review at wire speed of medical bills to prevent unnecessary or invalid billing. Machinify Precision Payments accurately determines the right amount to pay for a given treatment or procedure by automating multiple processes from coding, to error detection, to line item analysis, to clinical review of appropriateness.

FOR PATIENTS
FOR PAYER
Protect against medical overbilling and fraud
Reduce out of pocket expenses and surprise billing
Improve privacy
Replace payment integrity vendors with technology driven automation
Take control by running the process in house
Flag and fix errors in pre-pay with realtime, advanced models
Expand clinical reviews with AI-powered medical record and bill analysis
Reduce provider abrasion with precision claim selection,  fewer roundtrips, and faster payment
MACHINIFY AUTH

Machinify Auth automates the review of proposed medical treatments for appropriateness and provides the authorizations that ensure proper reimbursement. In most cases, Machinify Auth can provide an answer in real-time. And when human intervention is required it can increase reviewer productivity by up to 800%.

FOR PATIENTS
FOR PAYER
Protect against delayed or abandoned care, reported as high as 40%
Protect against over-/under-treatment
Faster time to care
Reduce uncertainty and fear of rejection
Easier access to what is covered and what is not
Reduce cost of preauthorization by 10X
Increase speed, accuracy and consistency of decisions
Steer care to the right setting and provider
Improve Patient experience
Enhance Provider relationships by reducing turnaround and cost overhead and by eliminating appeals
Reduce uncertainty and fear of rejection
Machinify Audit

Machinify Audit leverages medically trained AI to automate the clinical review of medical claims, prevent unnecessary treatments or procedures, and discover undiagnosed underlying conditions.

FOR PATIENTS
FOR PAYER
Protects against unnecessary medical procedures
Save out-of-pocket expenses by catching providers who perform unnecessary procedures or misrepresent patient services.
AI-driven discovery of undiagnosed conditions can lead to more effective early interventions and to better outcomes
Substantial increases in audit productivity though AI-driven claim selection and assistance
Better leveraging of scarce audit resources
Improved audit consistency and accuracy though live integration with medical policy
Improved regulatory compliance
Lower maintenance costs through automated model updates following policies and coding evolution
Automated discovery of latent undiagnosed conditions leading to more accurate risk scores and accurate premiums per patient
Improved Provider education and communication by sharing audit discoveries
MACHINIFY PAY

Machinify Pay automates the review of medical bills at wire speed to prevent unnecessary or invalid billing.

FOR PATIENTS
FOR PAYER
Protect against medical overbilling and fraud
Reduce out of pocket expenses and surprise billing
Improve privacy
Replace payment integrity vendors with technology-driven automation
Take control by running the process in-house
Flag and fix errors in pre-pay with real-time, advanced models
Expand clinical reviews with AI-powered medical record and bill analysis
Reduce provider abrasion with precision claim selection,  fewer roundtrips, and faster payment
MACHINIFY BY THE
NUMBERS
52
M
Number of people
covered by our
platform in the U.S.
4
OUT
OF
TOP
10
Leading U.S. health
insurance companies
under contract
$
200
B
Medical claims
reviewed annually
200
%
Year over year
growth
Transparent, real-time care and
payment decisions.
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