Accelerate & bring Real World Data for improved Member Experience, Risk Adjustment & Underwriting Decisions

200+ Integrations with wearables, med devices & health systems

HIPAA & SOC 2 Compliant

Solutions

100000 + API calls

average supported per customer

12000 + data elements curated from 200+ Health Systems & Wearables

Fraud, Waste & Abuse (FWA)

Billions are lost every year to subtle and undetected fraud. Taliun’s predictive models and anomaly detection engines surface unusual patterns in claims, while NLP uncovers inconsistencies in documentation, so you can intervene before losses escalate.

Risk Adjustment & Revenue Integrity

Missed or inaccurate HCC coding leads to serious revenue leakage. Our AI-driven retrospective chart review and coding analytics ensure every condition is captured, and your reimbursements are fully optimized

Member Churn & Retention

Not all churn is visible until it’s too late. Taliun uses multi-source data to predict at-risk members and uncover the root causes of dissatisfaction empowering you to personalize engagement and keep members in your plan.

Provider Network Leakage

When members go out-of-network, costs soar. Taliun maps referral patterns and identifies leakage hotspots enabling you to steer care, close network gaps, and reduce unnecessary spend.

Care Gaps & Rising-Risk Members

The costliest members are often the ones who fall through the cracks. Our risk stratification models identify rising-risk individuals early and surface care gaps helping your care teams act before conditions escalate.

Value-Based Contract Misalignment

Value-based care is only as good as the data behind it. Taliun builds real-time, contract-specific scorecards with risk-adjusted quality metrics, ensuring your value-based arrangements are aligned, fair, and outcomes-driven.

Specialty Pharmacy Overspend

Specialty drugs are a growing portion of your spend but are they delivering value? Taliun’s RWE analytics evaluate effectiveness, adherence, and ROI, giving you the data you need to manage specialty pharmacy with confidence.

Claims Processing & Administrative Waste

Administrative overhead adds up fast. Our platform surfaces denial trends, automates clean claim approvals, and flags disputes before they happen freeing up your teams and improving provider relationships.

Overall Claims analytics

Claims analytics turns complex healthcare data into actionable insights. From identifying cost drivers and fraud to predicting risk and improving outcomes, it empowers payers to make smarter, faster decisions that reduce waste and elevate the quality of care.