Apixio is a pioneering AI-driven Connected Care Platform designed to sit at the critical intersection of health plans and healthcare providers. Founded in 2009, its core mission is to leverage advanced data science, patented natural language processing (NLP), and machine learning to extract and analyze vast amounts of clinical data, especially the unstructured text and scanned documents that make up the majority of a patient's medical record. This process transforms previously 'trapped' data into real-time, actionable intelligence.
Key Benefits and Value Proposition
Apixio's platform empowers healthcare organizations to thrive in value-based care models by ensuring accurate payments and improving patient outcomes. The primary focus areas are:
- Financial Accuracy: Optimizing reimbursement revenue for Medicare Advantage members through accurate risk adjustment (HCC coding) and identifying billing errors via Payment Integrity solutions.
- Operational Efficiency: Streamlining resource-intensive processes like chart retrieval, review, and quality assurance through automation and intelligent work queues.
- Care Quality: Uncovering critical patient insights, identifying care gaps, and stratifying patient populations for better preventative and disease management programs.
Main Features and Capabilities
Apixio's solutions are built on the Health Data Nexus™, a centralized, searchable data repository that unifies disparate health data sources. Key product features include:
- Risk Adjustment Solutions: Retrospective, Prospective, and Concurrent solutions (e.g., Post-Visit Solution) that use AI-powered coding predictions and certified coder review to ensure complete and accurate risk capture.
- Payment Integrity: Tools for itemized bill review and denial management to reduce reimbursement inaccuracies.
- Health Data Management: Unified Chart Retrieval and Data Acquisition, advanced search capabilities, record linkage, and tokenization across datasets.
- AI-as-a-Service (AIaaS): Delivering immediate results by deploying AI models in existing workflows through APIs, such as Apicare AuthAdvisor for AI-powered prior authorization decisions.
- Analytics and Dashboards: Performance dashboards, peer benchmarking, and program analytics for ROI tracking and data-driven decision-making.
Apixio operates as a Software-as-a-Service (SaaS) solution deployed entirely in the cloud, offering a scalable and secure platform for its enterprise clients.