Proven Solutions to Increase Revenue, Cut Costs, and Save Time Across 8 Healthcare Segments
Choose your segment to see solutions designed specifically for your organization. From provider rate negotiations to home health optimization, we have the right tools for you.
Our Products
Market Data Insights
Maximize revenue, reduce unit costs, and save teams 15+ hours per week with price transparency and benchmarking that pays for itself.
Key Benefits:
- ✓Increase reimbursement rates 10-30% with market benchmarks by geography, specialty, payer, and billing code
- ✓Reduce unit costs 15-25% with competitor rate analysis and outlier detection for network decisions
- ✓Save teams time with decision-ready exports and insights that eliminate manual research and reduce stakeholder friction
- ✓Identify revenue leakage and cost-reduction opportunities 80% faster with automated variance analysis
Managed Care Workflow Optimization
Maximize contract value and save contracting teams 15+ hours per week with workflow automation that reduces friction and shortens cycle times.
Key Benefits:
- ✓Save time with centralized contract repository, tracking, and automated renewal alerts
- ✓Maximize revenue with automated monitoring for rate escalations, term changes, and missed opportunities
- ✓Prioritize high-value renegotiations with market benchmarks and financial impact analysis
- ✓Reduce cash flow risk with pro forma modeling to forecast revenue, margin impact, and downside scenarios
Payer Contract Management
Automate contract ingestion and analysis with AI-powered extraction that saves teams 20+ hours per week on manual contract review and data entry.
Key Benefits:
- ✓Save time with AI-powered extraction of contract terms, fee schedules, and administrative details from PDF contracts
- ✓Centralize contract repository with structured data storage for efficient search, comparison, and analysis
- ✓Compare contracts side-by-side to identify rate differences, term variations, and negotiation opportunities
- ✓Track contract status, expiration dates, and renewal alerts to reduce revenue risk and improve compliance
Value-Based Care Operations
Protect margin and reduce total cost of care with operational intelligence that improves outcomes and reduces avoidable utilization.
Key Benefits:
- ✓Improve quality scores and protect revenue with performance tracking and actionable improvement insights
- ✓Reduce total cost of care by 10-20% with utilization and variation analysis that eliminates waste
- ✓Save clinical teams time with predictive care planning that targets the right interventions faster
- ✓Protect margin with risk-adjusted modeling to understand performance and payment implications
Provider Revenue Integrity
Recover cash faster and reduce manual work by 70% with automated underpayment detection and standardized appeals workflows. Zero upfront costs, zero risk — you only pay when we recover revenue for you.
Key Benefits:
- ✓Recover 2-4% of net revenue from underpayments automatically with contract-to-payment matching
- ✓Zero financial risk — performance-based pricing means you only pay when we recover cash
- ✓Works alongside existing RCM systems as a quality control layer — zero disruption
- ✓Forensic analysis of aged claims (12-24 months) no longer being actively worked
- ✓Prioritize recoveries by ROI with underpayment quantification and value-based ranking
- ✓Save teams 20+ hours per week with automated appeals package generation and tracking
Employer Benefits Optimization
Reduce healthcare costs by 15-25% and save benefits teams 10+ hours per week with transparent pricing and performance signals.
Key Benefits:
- ✓Reduce total cost of care by 15-25% with carrier and network performance analysis to identify high-value options
- ✓Save teams time with cost and quality benchmarking for steerage and reference pricing strategies
- ✓Optimize plan design to reduce waste by 10-15% while protecting member satisfaction and outcomes
- ✓Prove measurable ROI with year-over-year trend tracking and variance reports stakeholders trust
Home Health Care Orchestration
Protect margin under CY 2026 and save clinical teams time with predictive insights that reduce LUPAs and improve HHVBP performance.
Key Benefits:
- ✓Save $200-400 per episode with LUPA avoidance predictions and visit mix optimization
- ✓Increase revenue up to +5% with HHVBP score optimization and quality outcome tracking
- ✓Save clinical teams time with care orchestration recommendations for visit scheduling and resource allocation
- ✓Protect margin with real-time dashboards to track episode performance, cost variance, and focus improvements
APIs for Data Integration
Save engineering time by 80% and ship pricing intelligence faster with reliable APIs that eliminate data headaches.
Key Benefits:
- ✓Ship faster with RESTful APIs, comprehensive documentation, and pre-built integration libraries
- ✓Reduce downtime risk with real-time data feeds and 99.9% uptime SLA guarantee
- ✓Save engineering time with flexible data formats (JSON, CSV, XML) and normalized, analysis-ready outputs
- ✓Reduce implementation friction with dedicated technical support and integration assistance
Customized & White-Labeled Portals
Save internal teams 20+ hours per week by delivering pricing and quality intelligence through self-serve portals tailored to your workflows.
Key Benefits:
- ✓Reduce internal support burden with fully branded, self-serve portals matching your company identity
- ✓Save teams time with custom dashboards and workflows aligned to your KPIs and decision paths
- ✓Control access efficiently with multi-user support and role-based permissions
- ✓Reduce maintenance costs with ongoing enhancements, updates, and support included
Personal Injury Defense Benchmarks
Challenge inflated medical bills with defensible market-based pricing benchmarks. Reduce claim costs by 30-50% and strengthen negotiation positions with CMS-validated pricing data.
Key Benefits:
- ✓Reduce claim costs by 30-50% with defensible market-based pricing benchmarks
- ✓Save time on bill review with standardized evidence and comparison workflows
- ✓Strengthen negotiation positions with transparent, explainable methodology
- ✓Support expert testimony with CMS-validated pricing data that's admissible in court
Solutions by Customer Segment
Click on your segment to see tailored solutions and free resources
Healthcare Providers
Maximize revenue and cash flow without working more hours or fighting payers. Cut contracting time in half with negotiation-ready market benchmarks.
Recommended Solutions:
- • Market Data Insights
- • Managed Care Workflow
- • Payer Contract Management
- • Revenue Integrity
Health Insurers
Reduce healthcare costs and identify lowest-cost, highest-quality providers. Save analyst time with decision-ready market intelligence and outlier detection.
Recommended Solutions:
- • Market Data Insights
- • Value-Based Care Operations
- • APIs for Data Integration
Home Healthcare Agencies
Protect margin and increase cash under CY 2026: avoid $200-400 per LUPA, improve HHVBP performance, and reduce operational burden on clinical teams.
Recommended Solutions:
- • Home Health Care Orchestration
Revenue Cycle Management Teams
Recover 2-4% of net revenue from underpayments with zero financial risk. Performance-based pricing means you only pay when we recover cash. Works alongside your existing RCM systems as a forensic quality control layer.
Recommended Solutions:
- • Revenue Integrity
- • Market Data Insights
- • APIs for Data Integration
Employers & Benefits Teams
Reduce total healthcare costs by 15-25% while improving quality. Save benefits team time with transparent pricing, quality signals, and decision-ready analytics.
Recommended Solutions:
- • Employer Benefits Optimization
- • Market Data Insights
Benefits Brokers
Win and retain accounts by delivering measurable cost savings to employer clients. Save time on plan analysis with decision-ready benchmarks and network insights.
Recommended Solutions:
- • Employer Benefits Optimization
- • Market Data Insights
- • Customized Portals
WC & PI Legal Advisors
Reduce claim costs by 30-50% with defensible market benchmarks. Save time on bill review, strengthen negotiation positions, and speed case resolution.
Recommended Solutions:
- • Market Data Insights
- • APIs for Data Integration
Healthcare IT Companies
Ship pricing and quality intelligence faster with APIs and white-labeled portals. Save engineering time and reduce data headaches for your customers.
Recommended Solutions:
- • APIs for Data Integration
- • Customized Portals
- • Market Data Insights
Testimonials
“Before working with Medlyze, we were struggling through payer negotiations with no visibility in market rates and little leverage to improve our low reimbursement rates. Medlyze provided the exact support we needed by exposing competitor rates and delivering a clear contract negotiation strategy, finally giving us the data to align our approach. Now, we are positioned to increase our rates with our current payer and have a replicable strategy for future contracts with companies like Cigna.”
Urology Practice Owner
Owner, Colorado Urology Practice
“This is Gold!”
Actuary
Actuary, BCBS Plan
“We thought our RCM team was doing a great job, and they were. But Medlyze found $1.8M in underpayments we'd completely missed. It's like having a forensic auditor who only gets paid when they find money. Zero risk for us, pure upside.”
CFO
Chief Financial Officer, Regional Hospital System
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