Payer intelligence that closes the loop.
One member. One longitudinal truth. From clinical evidence to financial outcome.
Connect fragmented payer data. Find where value is lost. Act before it becomes revenue leakage.
- 6M+ Member Lives
- MA • Medicaid • ACA • Duals
- Top-20 MA Plan Deployment
- SOC 2 Type II • HIPAA
One member. One longitudinal truth.
Your systems can all be working, and the plan can still be losing money.
Risk, coding, encounters, quality and claims often see the same member differently. Invent Health finds where those views diverge.
See. Reconcile. Act.
Purpose-built intelligence for the workflows that matter most.
Risk Adjustment Intelligence
Explain why RAF moved and where value is being lost.
ExploreCoder Workbench + Clinical NLP
AI finds the evidence. Coders make the final call.
Encounter Intelligence
Prove every coded diagnosis reached CMS.
ExploreQuality + Provider Intelligence
Close the right gaps at the point of care.
ExploreBuilt with payers. Proven with payers.
“We see Invent Health thinking ahead and anticipating what our needs might be. They've been very responsive to customizing, as new policies come out from CMS.”
“I'm blown away. The amount of data we are getting from the dashboards is incredible. I couldn't have asked for a better partner. Beyond excellent.”
“The team is very flexible. Constantly supporting us above and beyond, specially during submissions timelines.”
“The depth of details is amazing. We are getting so much more data with IH than any other vendor previously. The team is very supportive.”
Three questions payers are asking.
“Why did RAF move?”
Trace opportunity → coding → encounter → CMS acceptance.
“Where are we still losing dollars?”
Find discrepancies across clinical, operational and financial data.
“Why don't our systems agree on this member?”
Create one longitudinal member truth.
AI that works inside payer workflows, not another chatbot.
Evidence cited • Rules applied • Humans remain in control.
Built beyond traditional payer silos.
The same member-level intelligence foundation can support workflows where clinical, operational and financial data must agree.
The cost of disconnected data is getting higher.
RADV
Every diagnosis needs defensible evidence.
Encounter Linkage
Coding alone is not enough: submissions must trace to accepted encounters.
ACA / HHS-RADV
Changing models make reconciliation and traceability more important.
Deployment proof
Coder Workbench 2.0 + EHR Integration
Live August 2026 Read the announcementBring the question your teams can't agree on.
We'll show you where the story breaks, what it costs, and what to do next.
