The only Connected AI Platform for Payer Operations. Benefits, provider, claims, customer experience, and insights — unified on one platform where every model, automation, and decision compounds in value. Trusted by 70+ health plans.
Faster product build
CS10 80% faster product build (CS10)Quality scores
98% quality scoresCost reduction via intelligent automation
30%+ cost reduction via intelligent automationIDC MarketScape Leader positions
2 IDC MarketScape Leader positionsThe average health plan operates 15 to 25 disconnected systems, each integrated point-to-point, each generating its own version of the truth. These are architecture problems, not technology problems.
Disconnected systems per average health plan
15 to 25 disconnected systems per average health planIntegration cost per point solution added
$500,000 to $2,000,000 integration cost per point solution addedOf IT budget consumed by maintenance
80% of IT budget consumed by maintenanceOf first-touch claims pend — costing 20× more than auto-adjudicated claims
15%+ of first-touch claims pend, costing 20 times more than auto-adjudicated claimsEvery point solution a health plan adds costs $500K to $2M to integrate and fragments decision-making across yet another silo. Simplify Healthcare eliminates this tax. Every solution shares the same connected AI layer, the same payer ontology, and the same source of truth, so each capability you add makes every other one smarter. One activation layer eliminates rule duplication and ensures consistent interpretation across the enterprise.
Foundry1™ lets payers build and run solutions using their own rules, data, and workflows. Eight capabilities spanning agentic AI, app building, analytics, documents, integration, and security. Payer context — Low code, no code. Payer intelligence delivered through AI, not generic AI applied to healthcare.
Context1 is the payer ontology and data activation engine at the core of the platform. It maps the full complexity of payer operations into a structured, computable knowledge layer, then activates every data asset against it, so every AI model, every automation, and every insight across Simplify compounds from a single, continuously enriched source of truth.
Every AI action is traceable, auditable, and governed. Exception-based automation ensures human review where it matters. HITRUST, SOC 2, HIPAA compliant by design.
Every solution operates on a shared payer ontology and data activation engine. Every domain you activate makes the AI across all others more powerful. No integration tax. No data silos. One compounding platform.
Connected sales enablement and plan configuration, automated compliance validation and mandated material generation, and machine-learning models that reveal hidden portfolio patterns across every line of business. From product strategy to market in days, not months.
Automated provider onboarding and data management, contract discovery across thousands of agreements in seconds, continuous roster processing, and real-time directory accuracy monitoring. Fewer provider data errors upstream means fewer claims pends and denials downstream.
AI-powered claims configuration, first-touch pend automation, automated functional and regression testing, and smart payment orchestration across all 49 state prompt-pay regimes. Agentic automation with human governance: the platform acts, your team decides.
Every member, provider, broker, and employer interaction draws from connected plan data, enriched by the payer ontology. The Health Literacy Model adjusts every response by audience, channel, and comprehension level: fewer call center escalations, fewer grievances, faster resolution.
The payer ontology and five-stage data activation engine that ingests, normalizes, enriches, and activates every data asset across your payer operations. Not a data warehouse; the structured knowledge layer that connects to your core systems of record and gives every AI model across the platform domain intelligence.
Industry Recognition
Three ways to experience the Connected AI Platform. Choose the one that fits where you are in your evaluation.
Your data. Working AI on your claims. No commitment. See measurable results before you commit to anything.
Start a Conversation about a Payer AI Sprint →Tailored to your operational priorities. See Benefits1™, Provider1™, Claims1™, or any platform in action with your use cases.
See It In Action with a Platform Walkthrough →Case studies from 70+ health plan engagements. Real stats, documented outcomes, verified customer impact.
View Case Studies from health plan engagements →Recognized by industry leaders for innovation in healthcare technology, security, and operational excellence.
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