Galaxy Risk Suite
AI-powered risk adjustment for accurate coding, greater efficiency, and audit-ready compliance.
Enhance risk documentation, reduce administrative effort, and save costs with AI that unifies data, automates validation, and drives compliant, efficient workflows across the risk lifecycle.
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Comprehensive Risk Adjustment Solutions
AI-powered capabilities to streamline risk reviews, enhance data quality, and strengthen audit defensibility.
Analytics & Performance
Get the visibility you need to make accurate and confident decisions
Real-time dashboards track risk trends, coding precision, and provider performance across all lines of business with drill-downs by member, condition, or provider.
Predictive suspecting identifies members with potential unreported or miscoded conditions.
Intelligent chase lists prioritize outreach and reviews by documentation gaps and coding opportunities.
Chart Retrieval & Coding
Automate chart chase and improve coding precision with AI Agents
AI Agents automate chart identification, retrieval, and validation across provider networks to minimize redundant requests and reduce operational costs.
Embed real-time compliance and accuracy checks directly within coder workflows.
Maintain complete visibility from retrieval to submission to support RADV and internal audits.
Prospective, Concurrent, and Retrospective Reviews
Capture risk accurately before it becomes an audit risk
Surface suspect conditions and documentation gaps before, during, and after encounters with predictive analytics.
Equip payers with intelligence to support compliant documentation and accurate risk capture at the point of care.
Validate and reconcile post encounter diagnoses across claims, clinical, and chart data to ensure completeness and compliance.
Multipoint Gap Closure
Close every gap, across every channel
Point-of-Care: Prompt providers to capture and validate open HCCs during encounters
Pharmacy: Identify medication adherence issues and therapy patterns that support risk validation and chronic condition detection.
At-Home Assessments: Support in-home evaluations to capture conditions and improve coding accuracy.
Member Outreach: Engage members with targeted scheduling, reminders, and education to complete AWVs, HRAs, and follow-ups, supporting accurate risk documentation.
Encounter Data, Risk Reporting & Compliance Readiness
Ensure complaint, audit-ready submissions every time
Aggregate, reconcile, and validate encounter and risk data across RAPS, EDPS, 837 submissions, and internal systems for completeness and compliance.
Automate submission workflows with built-in validation, error resolution, and status tracking to ensure timely, compliant reporting.
Generate CMS-aligned RADV evidence packs with full source documentation and clinical traceability.
Conduct mock audits and checks to validate diagnoses with explainable AI, workflows, and human oversight.
Maintain continuous audit readiness with full transparency and defensible documentation from source to CMS submission.
Delivers Measurable Outcomes
0.5 ↑
Point in
STAR Ratings
Medicare Advantage Plans
34% ↑
Care Gap 
Closure Rate
Payer partner enabling VBC for senior populations
14% ↑
HCC Gap Closure 
MA Plans
Payer partner enabling VBC for senior populations
11% ↑
Coding Gap 
Closure for MA
Large PLHP with VBC focus operating in 6+ states
The Intelligence Behind Accurate, Defensible Risk Capture
Unified Risk Intelligence
Integrate claims, clinical, pharmacy, lab, and other data into a single interoperable source of truth for complete visibility across risk operations.
Automated Coding Workflows
Streamline chart retrieval, coding, and validation with full transparency and traceability across the entire risk-coding workflow.
AI-Driven Validation & Explainability
Detect missed HCCs, flag suspect codes, and validate documentation for completeness and audit readiness to reduce manual review effort and operational cost.
Real-Time Risk Analytics
Monitor documentation completeness and coding performance with predictive insights that enable proactive, compliant risk adjustment.
Built on the Galaxy Core
Empowering payers to automate manual work, ensure compliance, and scale performance with confidence.

One Data Model

Integrates clinical, claims, lab, pharmacy, and supplemental data into a single, governed source of truth, eliminating silos and improving data consistency across programs.

AI Agent Enablement

Build and deploy AI agents with full transparency and oversight to automate retrieval, coding, validation, and reporting workflows.

Configurable
workflows

Adapt quickly to plan policies, benefit structures, and compliance requirements with drag and drop configuration, and get access to a library full of pre-built agents

Built-In Intelligence

Surface actionable insights, coding prompts, quality alerts, and compliance checks directly within user workflows to accelerate decisions and reduce rework.

Interoperability by design

FHIR+, NCQA-certified, and CMS compliance-certified for secure, bidirectional data exchange standards to ensure seamless, bidirectional connectivity and audit-ready traceability.
Experience a unified AI platform built to make risk operations accurate, efficient, and audit-ready.
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