Agentic AI Applications for Health Plans

20+ AI-native applications. 250+ integrations. skyAgent™ gets real work done, powered by skyBrain™, your organization’s unified intelligence layer.

Trusted by leading health plans and value-based care organizations

Proven Business Impact

Real outcomes from health plans using Skypoint – lower admin costs, better member satisfaction, and improved operational efficiency within the first year.

25%

Reduction In administrative costs

20%

Improvement In member experience

25%

Improvement in utilization management

20+ AI Apps. Start with one App.
Start with one use case. Expand when ready.

skyAgent executes the real work – not suggestions. It coordinates across every application so automations in utilization management, member experience, prior auth, claims, risk adjustment, and compliance work together – not in silos.

We run Skypoint on skyMSP™ — a HITRUST r2-certified layer on Azure, Google, and AWS. Now offered to our clients. Build and deploy with Claude Code. Run and operate agents and apps securely.

Unifies data, memory, and context through bidirectional integration with 250+ systems — powering analytics, AI agents, and applications.

Match, merge, and dedupe patient, resident, and member records into a unified, real-time 360° view — the ground truth your AI agents run on.

Your organizational brain. Without it, every agent works in isolation, every insight disappears, and your team starts from zero, every time. Knowledge should compound, not evaporate.

The AI engine inside every Skypoint application. Executes tasks, triggers workflows, delivers finished outputs – not recommendations.

Converts web visitors to members via AI chat, forms, SMS, phone and email. Includes sales team training, coaching and human-in-the-loop support.

Human-like AI that manages inbound and outbound calls instantly.

Automates SEO, AEO and reputation management with intelligent review generation, aggregation, responses and patient surveys.

eSignature and contract life cycle management (CLM) for health plan workflows.

Automates and tracks prior authorizations for faster patient access and improved utilization management.

Automates referral tracking with timely follow-up to reduce patient leakage and improve care coordination across all providers.

Automated referral intake, scoring, eligibility checks, and reimbursement optimization for SNFs.

An AI-native care management application that integrates into EHR workflows to close care gaps, reduce readmissions, and drive value-based care performance.

AI-powered ticketing, staff service and helpdesk automation.

Transcribe, summarize, search, and analyze every team conversation. Never miss a decision, action item, or key insight again, skyNote captures it all and turns talk into searchable knowledge.

Automated recruiting, hiring and applicant tracking system.

AI-powered background checks, credentialing and license monitoring.

AI-powered learning that develops your workforce, ensures regulatory compliance, and accelerates onboarding.

AI-powered scheduling and labor cost optimization.

The operational command center built for every role, with 350+ KPIs, predictive analytics, and prescriptive actions that accelerate decisions.

Real-time clinical, financial and operational reports and dashboards integrated seamlessly into any BI tools or applications.

A private, AI assistant for secure, instant answers and deep reasoning on your own data.

skyAgent™ Use Cases for Health Plans

Risk Adjustment

Improves coding accuracy and documentation to ensure proper risk scoring and optimized revenue under value-based care models.

Quality Measurement

Monitors and improves STAR ratings, HEDIS, and ACO metrics-automating compliance tracking and driving quality performance.

Utilization Management

Automate prior authorizations, accelerate reviews, and improve care decision accuracy with intelligent, real-time insights.

Member Engagement

Personalizes outreach based on demographics, claims, and past interactions to drive preventive care and satisfaction.

Resource Allocation

Improves care team efficiency by aligning staffing and services to member risk, utilization, and predicted needs.

Outcome Forecasting

Predicts outcomes for member cohorts using historical and real-time data to guide care strategy and benefits design.

Integrated to 250+ claims systems, EHRs and data sources

Forward Deployed Engineering
 Your Team, Scaled

Skypoint’s FDE model places our engineers alongside your clinical, actuarial, and operations teams — solving payer-specific problems directly within your existing systems and workflows.

Embedded Expertise

FDEs become an extension of your team, delivering new AI capabilities in weeks, not months.

Continuous Delivery

Every two weeks, you get product updates tuned to your workflows – from prior authorization automation to population health analytics.

Adaptability at Scale

As regulations, payer requirements, and patient needs evolve, our engineers evolve your AI agents in real time.

Trusted Partnership

FDEs build long-term relationships, aligning with your culture and compliance standards.

Proven Outcomes
Real Customers

AI has enabled Livmor to level the playing field by digesting millions of data points and structuring them in record time. The Skypoint AI Platform has proven invaluable for solving these data challenges. Without the Skypoint AIP, Livmor would not exist.

We struggled with billing reconciliation for 10 years. Other partners couldn't solve it. With Skypoint AI, a process that used to involve more than a hundred people is now done by one person.

I interviewed other companies and went through our own RFP process. What tipped the scale for me was that 1) Skypoint could improve on the analytics we had, and 2) Skypoint takes advantage of generative AI capabilities. We ended up choosing Skypoint, and I’m glad I did. It’s working out well.

With Skypoint AI, our business partners who have been involved are ecstatic about what’s available now, compared to what they couldn’t do before. It’s a success story that we can build on as we grow and expand into other areas.

Skypoint’s AI Platform has made a tremendous difference in our business and positioned us in a way that has surprised many in our business. If we look at where we were seven months ago and where we are now, our business will tell you it’s night and day.

Skypoint AI made us a different company. We use sophisticated metrics now, proactively managing care hours and boosting staff satisfaction. I don’t even want to guess how much time we’ve saved, an hour a day of pulling reports, times 50 employees - it’s been a crazy value-add.

Customer Stories

See how health plans and value-based care organizations are driving measurable results with Skypoint.

How an Emergency Services Provider Improved Data Visibility

Learn how Northwest Acute Care Specialists (NACS) used a data warehouse and Power BI to greatly improve data visibility and generate more actionable insights.

Simplifying Medicare Enrollment With the Skypoint AI Platform

Central City Concern: Building a Future-Ready Data Infrastructure with Skypoint

Central City Concern (CCC) is a nonprofit, Portland-based FQHC dedicated to providing comprehensive solutions for individuals experiencing homelessness, poverty, and addiction. With integrated services spanning housing, employment, and healthcare, CCC serves thousands of vulnerable individuals annually.

Your 24/7 AI Workforce for Health Plan Operations

20+ agentic AI applications working alongside your utilization, member services, and compliance teams. Start with one use case. Expand when ready.

Industries We Serve