Machinify builds AI-powered payment integrity solutions for health plans, using foundation models and task-specific agents to deliver cost avoidance and recoveries.
Machinify builds AI-powered payment integrity solutions for health plans. Its central product is an AI operating system that learns from billions of healthcare data points, using foundation models alongside task-specific agents to identify cost avoidance opportunities and recoveries. The company reports more than 85 customers, including 18 of the top 20 health plans in the United States, covering 270m member lives and generating over $6bn in annual cost avoidance and recoveries.
Beyond the platform, Machinify provides payment integrity services through three engagement models - insourced, hybrid and fully-managed - adapted to a client's own strategy, with an operating cadence that allows for overnight responsiveness. The company combines 40 or more years of healthcare industry experience with its technical work in machine learning, data engineering and healthcare data analytics.
The team spans data engineers, clinical experts and customer support professionals, working across disciplines on problems in healthcare payments and health insurance. Its stated approach to model development emphasises responsible AI with human oversight, transparent and safe models, and continuous feedback loops. Further information is available at machinify.com.
