Better Outcomes Start With the Right Playbook.

A playbook is a pre-built AI workflow designed for a specific healthcare challenge. Connect your data, run the playbook, and get actionable insights and recommendations. No data team, no setup, no waiting.

How It Works
Playbooks

Explore the Full Playbook Library.

Risk

Pharmacy

Quality

RISK ADJUSTMENT & CODING

HCC Coding Accuracy & Provider Education

Analyzes provider HCC documentation accuracy and identifies revenue opportunities through improved risk adjustment coding. Generates targeted education plans to close documentation gaps.
RISK ADJUSTMENT & CODING

HCC Recapture Campaign Optimization

Optimizes HCC recapture campaigns to ensure prior-year conditions are re-documented. Identifies high-value recapture opportunities and provider gaps.
RISK ADJUSTMENT & CODING

Member Risk Stratification & Care Management

Stratifies members by clinical and financial risk to surface the highest-priority care intervention opportunities. Generates prioritized outreach plans to optimize care management resources and improve health outcomes.
RISK ADJUSTMENT & CODING

Provider Performance Risk Quality Scorecard

Evaluates provider performance across risk adjustment, quality measures, cost efficiency, and engagement. Generates provider-specific communication plans to drive improvement.
PHARMACY & CLAIMS

Pharmacy Claim Denial Reduction

Analyzes denied pharmacy claims to identify patterns and root causes. Provides actionable recommendations to reduce denial rates and improve revenue cycle efficiency.
PHARMACY & CLAIMS

Medication Adherence & Stars Optimization

Monitors medication adherence patterns to identify members at risk of missing quality targets. Generates targeted pharmacy and provider interventions to protect Star Rating bonus revenue.
PHARMACY & CLAIMS

Formulary Coverage Analysis

Analyzes insurance plan coverage across payers to identify gaps and restrictions. Maps therapeutic alternatives and quantifies the financial impact of coverage issues.
PHARMACY & CLAIMS

CA Pharmacy Subsidy Eligibility

Calculates eligibility probability for California medication subsidy programs. Analyzes income, coverage, and health factors to generate personalized enrollment recommendations.
PHARMACY & CLAIMS

Pharmacy Trend Analysis

Identifies prescription volume trends, therapeutic shifts, and payer mix evolution. Delivers strategic insights for pharmacy business planning and operational optimization.
PHARMACY & CLAIMS

Prescription Fill Lag Time Analysis

Analyzes prescription turnaround time from receipt to dispensing. Identifies delays impacting adherence, member experience, and Stars performance.
PHARMACY & CLAIMS

Prescription Profitability Analysis

Analyzes prescription patterns and NDC alternatives to maximize profit margins. Evaluates formulary coverage and identifies cost-saving opportunities for pharmacy operations.
PHARMACY & CLAIMS

Pharmacy Inventory Optimization

Optimizes stock levels to reduce carrying costs and minimize waste. Calculates reorder points and identifies supplier consolidation opportunities for cost efficiency.
QUALITY & MARKET INTELLIGENCE

Integrated Risk Quality Market Dashboard

Integrates risk adjustment, Stars, provider performance, and market trends into a single executive view. Delivers strategic insights for VP-level program leadership.
QUALITY & MARKET INTELLIGENCE

US Chronic Disease Indicators

Analyzes CDC chronic disease data to identify population health trends and risk factors. Provides actionable prevention and resource allocation insights.
PLAYBOOK REPORTS

Every Insight Your Team Needs, on a Single Page

Each playbook generates a structured report with AI-driven findings, revenue impact, data quality scoring, and recommended actions ranked by priority and timeline. No dashboards to configure, no analysts to loop in.

DEEPER ANALYSIS

Every Finding Comes With the Full Story

Click into any insight to get root cause analysis, supporting evidence, prioritized recommendations, and risk assessments with mitigation strategies. Each deep dive includes a confidence score so you know how much to trust the results. Need to explore further? Ask the built-in AI assistant anything about the analysis.

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