Built for payers

The Intelligence Layer for High-Impact Care

Powering smarter claims and clinical decisions that improve care and lower MLR.

MLRisrising.Carequalityisnot.

Payershaverichclinicalandfinancialdata,butfragmentedsystemslimithoweffectivelyitshapesdecisionsatscale.Theresultisamodelcenteredonreactivereimbursementinsteadofproactivecaremanagement.

Akitashiftsthebalancebyconnectingclinicalandfinancialsignalsinrealtime,enablingpreciseclaimsandcareinterventionsthatreduceunnecessaryspendandimprovepatientoutcomes.

ThisishowpayersregaincontrolofMLRandraisethestandardofcare.
MLRisrising.Carequalityisnot.

Payershaverichclinicalandfinancialdata,butfragmentedsystemslimithoweffectivelyitshapesdecisionsatscale.Theresultisamodelcenteredonreactivereimbursementinsteadofproactivecaremanagement.

Akitashiftsthebalancebyconnectingclinicalandfinancialsignalsinrealtime,enablingpreciseclaimsandcareinterventionsthatreduceunnecessaryspendandimprovepatientoutcomes.

ThisishowpayersregaincontrolofMLRandraisethestandardofcare.

Platform Overview

We are building the key capabilities health plans need to thrive in an Al world

We are building the key capabilities health plans need to thrive in an Al world

Healthcare Superintelligence

Identify the best interventions and the correct way to bill, code, and pay for them.

Healthcare Superintelligence

Identify the best interventions and the correct way to bill, code, and pay for them.

Living Model of Each Member

Maintain a comprehensive understanding from claims, clinical, and behavioral data.

Living Model of Each Member

Maintain a comprehensive understanding from claims, clinical, and behavioral data.

Insight to Agentic Action

Integrate agentic execution across claims, EMR, pharmacy, and consumer systems.

Insight to Agentic Action

Integrate agentic execution across claims, EMR, pharmacy, and consumer systems.

Natural-Language Interface

Enable a system that is explainable to and navigable for all stakeholders.

Natural-Language Interface

Enable a system that is explainable to and navigable for all stakeholders.

Product

Supercharged Workflows

Agents embedded in claims and UM systems to define, enforce, and explain how care is authorized and paid

Agents embedded in claims and UM systems to define, enforce, and explain how care is authorized and paid

Signal Intelligence

Rule Redesign

Embedded Execution

End-to-End Transparency

Identifies performance gaps and improvement opportunities

Continuously analyzes claims, clinical, and operational data to surface anomalous trends, coordinated billing patterns, and weaknesses in policy and contract design.

Identifies performance gaps and improvement opportunities

Continuously analyzes claims, clinical, and operational data to surface anomalous trends, coordinated billing patterns, and weaknesses in policy and contract design.

Re-architects the policies and contracts governing spend

Strengthens and modernizes medical policies, payment policies, and provider contracts by bringing them up to date with best practices and addressing incongruities.

Applies rules directly within core systems

Retrieves required documentation, evaluates requests against policy and contract criteria, and updates artifacts directly inside claims and UM systems.

Clarifies every rule and determination

Generates stakeholder-ready explanations that cite specific policy language and clinical evidence to enable review, auditability, and real-time feedback.

Product

Member Experiences

Secure, agentic workflows to handle members’complex cost and care issues end-to-end

Secure, agentic workflows to handle members’complex cost and care issues end-to-end

Agentic Patient Concierge

Agentic Patient Concierge

Cross-Platform Availability

Cross-Platform Availability

Context-Aware Actions

Context-Aware Actions

System Guardrails

System Guardrails

Autonomously executes administrative work

Instantly track and analyze your financial habits with precision.

Easily organize and manage your daily expenses in one place.

Take full control of your budget with smart tracking tools.

Autonomously completes member admin work from start to finish, including scheduling care, following up with providers and pharmacies, and resolving billing issues.

Autonomously executes administrative work

Autonomously completes member admin work from start to finish, including scheduling care, following up with providers and pharmacies, and resolving billing issues.

Meets the member where they’re at

Supports members in the channels they already use and keeps the full case context intact across all of them.

Assembles a complete picture of plan, provider, and patient

Uses plan details, provider information, and member history & preferences to decide what actions to take, reducing back-and-forth and avoiding incorrect or unnecessary work.

Checks and secures every action, bringing a human in the loop for critical decisions and sensitive actions

Applies automated checks before and after every action and routes sensitive, uncertain, or high-impact situations to highly-qualified human reviewers to protect member data, prevent errors, and ensure work is completed appropriately when interacting with members and providers.

Built by experts in
healthcare, tech, and finance

Built by experts in
healthcare, tech, and finance

If you’re excited about solving complex healthcare problems,
we’d love to hear from you at talent@akitahealth.com.

If you’re excited about solving complex healthcare problems, we’d love to hear from you at talent@akitahealth.com.

Backed by Thrive Capital and BoxGroup.

Backed by Thrive Capital and BoxGroup.

Right care, right time

Right care,
right time

Partner with Akita to make smarter clinical, financial, and administrative decisions.

Partner with Akita to make smarter clinical, financial, and administrative decisions.