Transform Healthcare Payment Integrity with AI-Powered Precision

Leading healthcare payers save $4.5B+ annually with Machinify's AI operating system. Customers reduce administrative waste, ensure compliance, and reclaim lost dollars with Machinify.

McKinsey 2024 Report Findings:

AI could save payers $530M - $1.27B per $10B revenue.

But only if you stop thinking like an auditor and start thinking like an operating system.

Our AI OS embeds 45 years of subrogation expertise, 30+ years of coding knowledge, and real-time policy intelligence into every payment decision.

The transformation imperative is here.

78% of payers now have active AI initiatives
Early adopters report 6.2% margins vs 2.8% traditional PI
Digital leaders achieve 50% faster claim processing
AI-powered payers show 23% lower provider turnover

Connect with a PI Expert

We don't just find errors - we prevent them.

Machinify's AI Operating System revolutionizes healthcare by interpreting policy autonomously, eliminating manual processes, and delivering continuous improvement.

99%+ sustain rates minimize provider disputes
Under 15-minute reviews maintain payment velocity
Transparent platform gives you control while delivering results

Machinify is the industry's most integrated payment integrity partner, built to scale across all claim types and payer lines of business.

While legacy vendors rely on static rules and retrospective audits, Machinify operationalizes AI as an operating system for payment accuracy — fast, explainable, and continuously improving.

We are the next-generation PI partner, providing faster ROI, flexible engagement, and scalable outcomes that meet the highest clinical and legal standards, easily outperforming legacy vendors.

The shift from "detect and recover" to "prevent and pay correctly" is here.

The numbers speak for themselves

45+

years expertise embedded in AI

95%

accuracy with 99%+ sustain rates

$4.5B+

in annual cost avoidance and recoveries

Solutions that Scale with Your Organization

Pay

Ensure payment accuracy in real time, preventing costly errors before payment .

Audit

Surface errors others miss with AI- driven precision and a continuously expanding library of audit types.

Coordinate

Eliminate coverage overlaps with advanced matching and self-learning models.

Subrogate

Maximize recoveries from third-party responsibility with AI precision and decades of expertise.

Pharmacy

Stop pharmacy overpayments, maintain CMS compliance, and streamline audit readiness.

Useful Payment Integrity Resources

Case Study: 378% Gain in Pharmacy Recoveries with Machinify Retro Term

See how a national health plan achieved 378% pharmacy overpayment recovery growth with Machinify's retro term solution.

Download Case Study

Blog: How Agentic AI is Accelerating Engineering Excellence at Machinify

See how Machinify uses agentic AI to accelerate software development while improving quality and outcomes.

Read Blog

MedCity News | Payment Integrity is a Systems Problem, not a Data Glitch

Payment integrity challenges run deeper than isolated data errors—they stem from fragmented, outdated systems. This article explores why true financial accuracy requires a holistic approach, not just patchwork fixes. Discover how health plans can reduce leakage and strengthen compliance through systemic transformation.

Read Article

Asking the Important AI Questions: Q&A With Chief Data Scientist, Vijay Bharadwaj

Machinify’s Chief Data Scientist, Vijay Bharadwaj, explains how agentic AI is driving smarter, more reliable solutions for healthcare payment integrity.

Read Q&A

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