Pulse
Choose the right provider partners
Benchmark ACOs, practices, and facilities on cost, utilization, and quality.
For health plans, PACE orgs, and risk-bearing providers, and the patients they serve.
Clinicians have
their EHR. Teams
carrying risk now
have falcon.
Hospitals run on one system. The organizations that pay for care and carry its risk still run on spreadsheets, vendor portals, and scores nobody can explain. Falcon brings your claims, contracts, members, and CMS rules into one platform, with AI that does the analysis. So your team can reach the patients who need help sooner, and put more of every dollar into care that works.
Built by a former CMS staff member, two PhD scientists, former Astrana Health executives, and a former Harvard researcher.
Falcon HealthProduct tour
One platform for every job that comes with carrying risk.
Every finding traces back to the data, the method, and the policy behind it.
Sentinel
Stop improper payments
Follow a billing signal to a documented case, backed by claims patterns and Medicare coverage policy.
Scope
Get Medicare Advantage revenue right
Reconcile enrollment, encounters, risk adjustment, and payments across 70+ CMS files, member by member.
Helm
Close care gaps and hit your contract
Attribution, quality measures, and prioritized worklists for ACO and risk-bearing teams.
You see the shortfall. Now find the cause.
More hospital visits? A billing problem? Patients missing follow-up? Falcon helps you follow the evidence across care, claims, and payments—then decide what needs attention.
The Falcon products
From the financial warning to the work that needs doing.
Population health, claims investigation, provider intelligence, and Medicare Advantage operations—with healthcare expertise, benchmarks, and repeatable workflows built in.
Pulse
Evaluate provider partners
Compare provider and ACO performance, investigate utilization patterns, and evaluate network partners with market and benchmark context.
Sentinel
Find preventable spend
Investigate suspicious billing and potential overpayments with claims patterns, provider research, and Medicare coverage evidence for your team to review.
Scope
Run Medicare Advantage data operations
Manage encounter submissions and reconcile enrollment, risk-adjustment, and payment data so your team can find discrepancies that put Medicare Advantage revenue at risk.
Helm
Manage population health
Identify care gaps in high-risk populations, track quality and utilization, and create follow-up lists with the member and provider context your team needs.
How it works
Find the cause. Act with evidence. Track what changes.
When spending rises, check whether the cause is incomplete data, changes in care, or unusual billing. Keep the supporting evidence with the investigation, then create reports, chase lists, and scheduled monitoring for your team.
01
Connect claims, payments, and CMS reports
Bring MA data, financial and claims context, and the business definitions your team already trusts into one foundation.
02
Investigate the cause with supporting evidence
Ask an urgent operational or savings question and trace it across the data, analysis, and supporting evidence.
03
Act on findings and monitor what changes
Turn findings into case files, reports, and follow-up lists. Reuse trusted methods and schedule monitoring so your team can track changes over time.
Client data
CMS + public
Benchmarks
Falcon foundation
Context, methods, Skills, memory, and governed AI
Helm
Sentinel
Pulse
Scope
↺Feedback and validated work improve the foundation
Talk to us
Bring the question your team needs to answer.
We’ll answer it with your data in a 30-minute call.