01Sense
Continuously ingests claims, ADT feeds, EHR documents, pharmacy fills and SDoH into one longitudinal member record.
FHIR R4 · HL7v2 · X12Unstructured-note NLP
02Decide
Predictive models and policy-grounded reasoning rank risk, match criteria and recommend the next best action — with citations.
Explainable scoresPolicy & criteria grounding
03Act
Agents execute: draft determinations, place outreach calls, build care plans, schedule CMRs — within guardrails you set.
Configurable autonomyClinician sign-off gates
04Learn
Every outcome, override and appeal feeds back into monitoring — so models improve and drift is caught before it matters.
Bias & drift monitoringFull audit trail