Built on OnyxOS — surfacing care gaps, missed codes, and audit-ready evidence buried in your clinical data, automatically.
The clinical evidence needed to close gaps and capture risk already exists. It's just not visible.
Healthcare payers face critical data fragmentation challenges that limit quality reporting, risk adjustment accuracy, and audit readiness. The evidence is there — buried in PDFs, scanned records, and unstructured clinical notes — inaccessible to the systems and teams that need it most.
Onyx Intelligence ingests multi-format clinical documents, processes them through AI and NLP, and surfaces HEDIS gaps, HCC suspects, and RAF scores — all with source evidence pre-attached. Built on Onyx IDR's longitudinal clinical record, the data it works from is already unified, structured, and continuously updated.
Intelligent Data Ingestion & Normalization PDFs, scanned images, C-CDA/XML, clinical notes — automatically ingested and linked to member records. Configurable data source management with no custom code required.
AI/NLP Clinical Processing Engine Natural language processing extracts conditions, HCC codes, medications, and clinical findings from unstructured text. Every document OCR-processed with completeness and accuracy scores.
RAF Scoring & HCC Suspect Detection AI identifies missed and unsupported HCC codes with configurable confidence thresholds — coders review only high-confidence suspects, not raw noise. CMS-HCC V28 RAF scoring with Very High-Risk member flagging
Semantic Search & Document Repository Natural language search across all member data. Real-time gap dashboards. Evidence pre-attached to every finding for immediate coder review and RADV defense.
AI semantic search across your entire member population — by name, MRN, insurer, condition, or free text. Instantly see confirmed vs. AI-suspected conditions per member, flagged for coder review. Filter by Market Segment, Insurance Plan, or Program — HEDIS, RA, Care Gaps — in real time.
What are you looking for?
All documents across all sources unified per member — searchable by condition, date of service, or program. Every document OCR-processed with completeness and accuracy scores for audit confidence. Instant AI-generated plain-language summaries of complex clinical records — no manual review required.
What are you looking for?
Open HEDIS gaps ranked by clinical urgency — retinopathy, foot exams, A1c, and more. Open, Closed, and High Priority buckets with real-time gap analysis per member. One-click detection triggers AI analysis against all linked clinical documents instantly. Supports Stars, HEDIS, and value-based care program targets simultaneously. Our customers see a 2× improvement in HEDIS gap closure rate compared to manual chart chase workflows.
What are you looking for?
AI/ML identifies missed and unsupported HCC codes from unstructured clinical notes — evidence pre-attached to every suspect. Configurable accuracy thresholds mean coders review only high-confidence findings. CMS-HCC V28 RAF scoring with Very High-Risk member flagging. Every accepted HCC backed by a complete audit trail — RADV preparation is continuous, not a crisis. Our customers see 35%+ more HCC suspects detected, 100% of accepted codes with pre-attached clinical evidence, and an 80% reduction in manual chart review time.
What are you looking for?
Every Onyx Intelligence deployment is backed by our expert services team — specialists in clinical AI, HEDIS, risk adjustment, and payer operations who scope, implement, and support alongside your team.
Request a demo or bring your team to an ROI Workshop — we model your expected RAF uplift, gap closure improvement, and audit defense posture using your own member population data. Most pilots are live with real results within 30 days.
