payer-technology
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1upHealth built the pipes. Now comes the hard part: getting healthcare to use them.
A health-data company discovers that connecting computers is only half the job. The other half involves insurers, clinical records, and the surprisingly persuasive power of a letter.
MHK and the Hidden Cost of a Handoff
A health plan can have capable people and still leave thousands of disputes waiting. MHK’s wager is that better care begins with fixing the work between the people.
Onos Health and the Notes Nobody Read
Health plans can count visits and claims. Onos Health wants them to read the clinical story hidden behind those numbers - and act before a poor care path hardens into a costly one.
Machinify’s $670 Million Bet: Fix America’s Medical Bills Before They’re Paid
Machinify started with a broad promise to turn enterprise data into decisions. A decade later, it is making a narrower, harder wager: teach machines the rules of American healthcare, then catch costly claims errors before the money leaves the building.
HealthEdge Is Building the Operating System Health Plans Were Too Scared to Replace
The dullest machinery in American healthcare may be the most expensive to leave untouched. HealthEdge spent 20 years turning claims rules, care workflows and provider records into one payer platform - then merged with the operator that knew how to move insurers onto it.
Zelis Wants to Fix the Part of Healthcare Nobody Sees - the Money Moving Underneath It
Most patients will never know its name. Yet Zelis helps decide what a claim should cost, how a provider gets paid and whether a confusing bill becomes a three-month ordeal - or a solvable problem.
CitiusTech Bet Everything on Healthcare. Now It Has to Make AI Behave.
For two decades, CitiusTech refused to become a general-purpose IT shop. That stubborn focus built a valuable healthcare specialist - and now gives it a credible shot at making enterprise AI survive contact with clinical reality.
HealthAxis Wants to Make Health Insurance’s Boring Back Office Actually Work
HealthAxis runs the machinery most members never see: claims, eligibility, provider data and the audit trail behind them. Its bet is that health plans will buy software and operational help together - if the savings arrive without a compliance hangover.
InteropX Sold the Plumbing: How a Five-Person Health-Data Company Made Stale Records Useful
Health plans had APIs, repositories and a stubborn problem: the records still arrived stale, duplicated or trapped in documents. InteropX built the virtual pipe between payers and providers, priced retrieval as low as $1 a chart, and eventually sold the system to Onyx.