The Missing Piece for AI in Healthcare.The Connective Tissue of Healthcare Operations.
AI doesn’t fail in healthcare for lack of intelligence — it fails for lack of connected data. Falcon’s core technology links a vast, unmatched web of public and private healthcare data into a single platform, applied across every domain we touch. Trusted by ACOs, health plans, provider groups, and healthcare technology companies, reviewing millions of members every month across market intelligence, FWA investigation, population health research, and MAPD risk adjustment.
One Platform. Every Healthcare Domain.
Falcon isn’t just an FWA app or a risk-adjustment app. It’s a platform that connects thousands of public datasets, our own proprietary benchmark data, and your data and reports — all contextualized with real healthcare expertise — into one engine. That same engine powers every app we ship, curated with a different toolset for each domain.
Public Healthcare Data
Thousands of public datasets, contextualized so they’re actually usable
Proprietary Benchmark Data
National claims benchmark data, built and maintained in-house
Your Data & Reports
Files and reports, contextualized with our healthcare domain expertise
The Falcon Engine
The connective tissue platform — one engine, applied everywhere we work, curated with a different toolset for each domain.
NOT AN APP — THE PLATFORM UNDERNEATH ALL OF THEM
Pulse
Market Intelligence
Sentinel
Claims Intelligence
Scope
MAPD Financial Intelligence
Helm
ACO Care Management & Operations
Our platform in action - Where We're Proving Our Approach
We're applying the Falcon Engine to healthcare one domain at a time. These are the areas where we're demonstrating our expertise — with more to come:
Pulse - Market Intelligence
Falcon for healthcare market intelligence and provider network analysis. Map the competitive landscape across providers, ACOs, and six facility types — SNF, FQHC, RHC, HHA, Hospice, and ACO landscapes nationwide. Run custom SAS and SQL queries against our proprietary claims, benchmark with actuary-grade methodology (full SAS and SQL scripts published for review), and surface the network and contract decisions that move the needle.
Sentinel - Claims Intelligence
Falcon for FWA, overpayment, and contestation analysis — compliance on how claims should get paid. Two connected workflows — analyze member cohorts, HCC risk trajectories, and care gaps across your population; or follow a suspicious provider through claims networks to a complete CMS-compliant referral package. Generate AI-drafted overpayment and documentation request letters with certified-mail tracking, search Medicare LCD/NCD coverage and OIG enforcement history, and tap collective intelligence aggregated across the Falcon network.
Scope - MAPD Financial Intelligence
Falcon for Medicare Advantage Prescription Drug (MAPD) financial intelligence, risk adjustment, and CMS compliance. As a certified CMS encounter data submission vendor, we manage the full pipeline — from 837 claims and paper-to-clearinghouse conversion through encounter data submission — closing the loop so nothing gets missed. Auto-ingest and urgency-score every CMS communication, surface payment discrepancies and enrollment mismatches before reconciliation windows close, and use raInference — statistical HCC Condition Category documentation-gap analysis — to prioritize RADV audit preparation. Track Transaction Monitor and EDPS submissions across the risk adjustment lifecycle.
Helm - ACO Operations
Falcon for ACO member alignment, quality measure calculation, and provider relationship management. Implements the complex logic behind member attribution and quality scoring, and connects the dots between esoteric CMS reports — Monthly Expenditure Reports, Benchmark Reports, Quarterly Alignment Reports — and your underlying data. No more reading them report by report: Falcon connects them all and surfaces the bigger story and the opportunities hiding in between.
Why Work with Falcon
We built Falcon to be the analytics partner we wished we had — AI that truly understands healthcare:
- From Weeks to Hours. What used to take your team days or weeks of manual analysis now takes hours. Falcon handles the heavy lifting — researching, cross-referencing, and synthesizing data — so your experts can focus on decisions, not data wrangling.
- AI That Speaks Healthcare. Generic AI tools don't understand Medicare policies, CMS data formats, or healthcare operations. Falcon does. Our AI is built by a team that's worked at CMS, built healthcare companies, and holds PhDs in AI — and it shows you exactly which tools and data sources it used, so you can trust and verify every insight.
- Professional Reports for Leadership. Stop spending hours formatting spreadsheets for executives. Falcon delivers beautiful, presentation-ready analytics that stakeholders and business leaders can immediately understand and act on.
- Smart Monitoring & Anomaly Detection. Don't wait for problems to become crises. Our AI continuously monitors your data, detects anomalies early, and alerts you to patterns that need attention — whether it's utilization shifts, billing irregularities, or performance changes.
From Missing Piece to Intelligence Layer
Falcon starts by connecting your data and ours into a single platform, then evolves into the autonomous intelligence layer running your healthcare operations.
Start Here: Ask & Analyze
Ask questions in plain language. Get answers in minutes, not weeks. Beautiful reports ready for leadership.
Automated Intelligence
Save your best queries as reusable Skills, schedule recurring analyses, and let Topic Radar auto-group your team's chats, tickets, and reports — surfacing blockers and todos in one place.
Autonomous Intelligence
The intelligence layer that just runs. Insights surface before you ask. Your operations stay ahead, automatically.
See Our AI Co-Analysts in Action
Explore Pulse, Sentinel, and Scope — the first applications of our AI co-analyst framework, with more healthcare domains coming soon.
View Our SolutionsReady to put an AI co-analyst to work for your team? Let's talk.
Our offices
- Palo Alto, CA
Corporate HQ - Atlanta, GA
Technology Branch