The Palo Alto-based company’s software functions within a plan’s own security perimeter, meaning sensitive clinical and claims data never leaves the internal environment. This architecture bypasses the need for additional business associate agreements, allowing health plans to transition from contract to production in weeks. The system utilizes what the company calls Glassbox reasoning, providing a human-readable rationale for every decision to ensure audit readiness and compliance with CMS requirements.

For utilization management, the platform automates record review against specific medical policies, resolving up to 92 percent of cases without human intervention. In the realm of risk adjustment, the software supports HCC V24 and V28 models alongside over 72,000 ICD-10 codes. CEO Fawad Butt argues that current processing delays are a choice rather than a necessity, suggesting that embedding intelligence directly into the cloud infrastructure allows organizations to defend their accuracy while accelerating care decisions for members.