# Falcon Health

> Falcon Health provides healthcare intelligence software for care management, payment integrity, provider performance, and Medicare operations. Falcon serves health plans, ACOs, PACE organizations, and risk-bearing providers.

## Core pages

- [Home](https://falconhealth.ai/): Overview of Falcon Health and its healthcare intelligence platform.
- [Products](https://falconhealth.ai/products): Pulse, Sentinel, Scope, and Helm.
- [Library](https://falconhealth.ai/publications): Articles, original research, practical guides, product briefs, and presentations.
- [Health plans](https://falconhealth.ai/solutions/health-plans): Medical-cost and payment-integrity investigations.
- [Risk-bearing providers and ACOs](https://falconhealth.ai/solutions/risk-bearing-providers): Contract performance, utilization, quality, and care-gap workflows.
- [ACO shared savings](https://falconhealth.ai/solutions/aco-shared-savings): ACO alignment, benchmarks, and shared-savings analysis.
- [About Falcon Health](https://falconhealth.ai/aboutus): Company and team information.
- [Contact](https://falconhealth.ai/contact): Contact Falcon Health.

## Products

- [Pulse](https://falconhealth.ai/products#pulse): Traditional Medicare claims, provider and ACO benchmarks, price transparency data, alignment simulations, bundled episodes, and custom extracts.
- [Sentinel](https://falconhealth.ai/products#sentinel): Claims intelligence, provider research, Medicare policy evidence, and payment-integrity investigations.
- [Scope](https://falconhealth.ai/products#scope): Medicare Advantage and PACE encounter, enrollment, risk-adjustment, and payment reconciliation.
- [Helm](https://falconhealth.ai/products#helm): ACO operations, attribution, care gaps, quality performance, and follow-up workflows.

## Publications and resources

- [Pulse: Medicare Data, Benchmarks, and Market Intelligence](https://falconhealth.ai/resources/pulse-medicare-market-intelligence-one-pager): A one-page overview of how Pulse turns Traditional Medicare claims, price transparency data, and public CMS datasets into benchmarks, simulations, and custom data products.
- [Scope for Medicare Advantage and MAPD Plans](https://falconhealth.ai/resources/scope-medicare-advantage-one-pager): A one-page overview of member-level risk-adjustment payment reconciliation across CMS files, encounter responses, clinical evidence, and plan data.
- [Scope for PACE Programs](https://falconhealth.ai/resources/scope-pace-one-pager): A one-page overview of participant-level Medicare and Medicaid payment reconciliation for PACE programs.
- [Scope for Special Needs Plans](https://falconhealth.ai/resources/scope-special-needs-plans-one-pager): A one-page overview of risk-adjustment payment reconciliation for D-SNPs, C-SNPs, I-SNPs, and other Special Needs Plans.
- [Every Risk Score. Fully Reconciled.](https://falconhealth.ai/resources/risk-adjustment-reconciliation-brochure): A concise, three-page look at how Falcon connects contract-aware risk-score calculation, payer and CMS reconciliation, recapture, and AI-supported suspect review.
- [Targeted Outreach. Measurable Correction.](https://falconhealth.ai/resources/targeted-provider-outreach-effectiveness-brochure): A concise four-page summary of how human-reviewed, client-sent provider outreach was followed by measurable claim corrections and promising—but exploratory—changes in future payment.
- [Effectiveness of Targeted Provider Outreach Letters: A Retrospective Comparison of Client Test Sent Letters and Client Control Drafted-but-Unsent Letters](https://falconhealth.ai/resources/targeted-provider-outreach-effectiveness-report): A 16-page retrospective study comparing sent provider outreach letters with drafted-but-unsent controls across earlier-claim reversals and subsequent payment.
- [What “Right” Looks Like: Diagnoses & Procedure Codes for PACE Center MA Encounters](https://falconhealth.ai/resources/pace-ma-encounter-coding-guide): A practical, four-page guide to the procedure codes, encounter data, and documentation practices that help PACE risk-adjustment diagnoses count.
- [From Prediction to Explainable Provider Behavior Profiles for Fraud, Waste, and Abuse Review](https://falconhealth.ai/resources/explainable-provider-behavior-profiles): A practical framework for turning claims data into interpretable provider behavior profiles that help fraud, waste, and abuse teams understand what changed and where to investigate.
- [Anomalous Urinary Catheter DME Billing Patterns in Medicare: ACO-Affiliated Beneficiaries at Disproportionate Risk](https://falconhealth.ai/resources/anomalous-urinary-catheter-dme-billing): An analysis of the rapid growth in urinary catheter billing, the suppliers driving the increase, and the disproportionate financial exposure borne by ACO-affiliated beneficiaries.

## Articles



## Presentations

- [Falcon Health company overview](https://falconhealth.ai/deck/index.html)
- [Pulse presentation](https://falconhealth.ai/deck/pulse.html)
- [Sentinel presentation](https://falconhealth.ai/deck/sentinel.html)
- [Scope presentation](https://falconhealth.ai/deck/scope.html)
- [Helm presentation](https://falconhealth.ai/deck/helm.html)