Filing-ready network analytics. Member-ready directory. Both on the same data.
Three live MA plans. About 90,000 providers. No directory-accuracy audit findings reported across our live tenants. We're the layer that turns network adequacy, the CMS directory API, and member experience into one problem with one answer.
Network adequacy filing.
County × specialty × disease coverage scoring with care-pathway weighting and Medicare-aged denominators. HSD table export for HPMS upload — same numbers as the operations dashboard.
Member-facing provider directory.
Faceted, geo-aware search across providers, facilities, pharmacies, and formulary. White-labeled per plan, EN/ES localized, accessibility-conformant.
CMS-0057-F Provider Directory API.
DaVinci PDex Plan-Net R4. Seven resources, $export, SMART Backend Services. Hosted under your branded subdomain — your surface, our conformance.
Directory accuracy attestation.
90-day attestation cadence, monthly accuracy report, change-log of NPI-keyed diffs. The artifact you hand the CMS reviewer when they ask.
From provider refresh to filing, one pipeline.
- 1
Provider data refresh
CSV upload, AI-assisted schema validation, atomic UUID-tagged batch.
- 2
Coverage scoring
County × specialty × disease, care-pathway weighted, Medicare-aged denominators.
- 3
Directory live
Member-facing search and FHIR Plan-Net API update under your subdomain.
- 4
Adequacy filing
HSD table export ready for HPMS — same numbers as the dashboard.
Network adequacy · live
Endocrinology · Diabetes · Sample service area
Counties
6
in service area
Adequate
2
≤ 10 patients/provider
Critical
1
action required
County coverage · patients per provider
- County 017.2
- County 029.4
- County 0314.1
- County 0422.6
- County 0517.8
- County 0611.3
Running a D-SNP too?
Dual-eligible members run in the same workspace as your general MA line — Medicaid-acceptance and language filters, plus care pathways that account for Medicaid wraparound services. The full picture lives on the D-SNP page.
Three commercial paths, one platform.
01
Pilot
Pick one of your insurance customers. Deploy together. The deployment becomes the case study that opens the next ten conversations.
Recommended starting point.
02
Co-sell
Sell InsureLytix as a named line in your existing payer engagements. Joint pipeline, rev-share commercials, no channel conflict.
Fastest path to first joint revenue.
03
White-label
InsureLytix becomes part of your healthcare offering, under your branding. Long-term, deepest integration.
Where the partnership compounds over time.
Network adequacy, plainly answered.
Yes. The same county × specialty × disease coverage scoring that drives the executive dashboard exports as the HSD table CMS expects in HPMS. The numbers don't drift between the dashboard the CFO sees and the file the regulator sees.
Ready when you are
Bring this platform to your plan.
If your provider data is ready, a new white-labeled tenant goes live in about a week. Compliance certification runs alongside it, not as a later phase.