A solely authored analytical platform on the IR-DRG framework - clinical validation, coding governance, utilization management, and value-based care.
Governance patterns for autonomous AI agents in health-insurance / payer operations: UM, prior auth, claims/appeals. Aligned to the NAIC Model Bulletin framework. Reference IP; makes no medical-necessity determination.
Careport Health — independent third-party profile of a public API surface, by API Evangelist. CarePort Health, powered by WellSky, is a healthcare technology company providing care coordination and patient transition management across the entire care continuum. Its platform connects hospitals, health systems, ACOs, physician groups, payers, and pos
Excel healthcare spend & utilization dashboard (Power Query + Power Pivot) using synthetic claims data (2019–2024).
Cohere Health — independent third-party profile of a public API surface, by API Evangelist. Cohere Health is a United States clinical-intelligence and utilization-management company that digitizes prior authorization for health plans. Its Unify platform applies clinical AI and evidence-based policy to streamline authorization intake, review, and de
Alaffia — independent third-party profile of a public API surface, by API Evangelist. Alaffia (Alaffia Health) is a New York City-based healthtech company building an AI platform that helps health plans reduce improper payments and administrative waste across claims operations.
GenHealth.ai — independent third-party profile of a public API surface, by API Evangelist. GenHealth.ai builds generative AI for healthcare operations, powered by a Large Medical Model (LMM) trained on sequences of medical events. Its products automate the administrative back office for providers, health plans, and DME suppliers: fax intake routing
MedHOK (Hearst Communications) — independent third-party profile of a public API surface, by API Evangelist. MHK (formerly MedHOK), part of Hearst Health, is a healthcare technology company providing a unified SaaS platform for health plans and payers. Its CareProminence suite spans utilization management, care management, complaints/appeals and gr
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