Software and Data
San Mateo, CA
Overall Rank: 67
Category: Software & Data
Category Rank: 20
- Top HealthTech Company of 2023
Apixio is the Connected Care platform at the intersection of health plans and providers. Its AI technology and flexible services power risk adjustment, payment integrity, and care delivery programs using centralized patient health profiles, data-driven insights, and seamless workflows. Healthcare organizations can streamline operations, ensure accurate payment, and uncover critical patient insights—building a resilient foundation for success as the industry moves toward value-based reimbursement models.
Apixio’s Connected Care Platform supports healthcare organizations with a robust suite of AI-powered solutions and services:
- Risk Adjustment: AI-powered risk adjustment coding and auditing solutions help teams scale across retrospective, prospective, and concurrent programs so they can capture a complete, consistent picture of patient health conditions. In addition to Apixio’s market-leading coding, audit, and point-of-care workflow solutions, the company now also provides AI-as-a-Service offerings that deliver actionable condition insights in any workflow via flexible APIs.
- Payment Integrity: Automated, AI-powered workflows increase health plan efficiency, accuracy, and transparency during claims and clinical chart reviews. The company’s flexible SaaS, service, and hybrid offerings support a wide range of payment integrity programs, including itemized bill reviews, DRG validation, and more.
- Health Data Management: Secure medical chart retrieval and intelligent chart management solutions bring together patient data, customized reporting, and AI-powered patient insights in one secure, centralized location for use across value-based care programs. These solutions empower organizations to extract maximum value from their medical charts, enterprise-wide, driving efficiencies and cost savings across teams and departments.
- AI-as-a-Service: Apixio’s AI-as-a-Service (AIaaS) offerings deliver actionable insights derived from industry-leading AI models within clinical and administrative workflows. These services provide additional flexibility for healthcare organizations that want to retain their existing infrastructure and processes while getting more value out of their data with proven AI.
Within two years, Capital Blue Cross increased RAF scores by 5%, and had a significant turnaround in risk revenue due to more accurate coding submissions for both Medicare Advantage and ACA programs. Their team is able to perform QA reviews more efficiently using HCC Identifier and feel confident that their coding decisions are well-supported.
- “I can sleep at night because I’m confident in the quality of coding reviews that have been performed with Apixio,” says Senior Medical Director, Government Programs.
Working with a large provider group, our AI-powered pre-visit solution enables their team to prepare charts before a patient visit 5 times faster from 4 charts per hour to 20 charts per hour. By surfacing insights alongside the evidence across structured and unstructured data, reviewers can quickly have a complete, accurate view of the patient’s current and suspected conditions.
With Apixio’s Connected Care Platform, health plans and providers can:
- Reduce coding workloads by 80%
- Review charts 5X faster with AI-driven pre-visit workflows
- Complete itemized bill reviews in less than 15 minutes
- Complete chart reviews for DRG with a turnaround time of 15 minutes
- Achieve 98+% DRG and itemized bill review accuracy
- Identify errors quickly with an average 40-50% change rate
Sachin Patel, CEO
Sachin brings broad experience across both healthcare and technology, spanning a variety of leadership roles, including operations, finance, and development. Sachin joined Apixio in 2017 as Chief Financial Officer and later served as President and Chief Financial Officer before taking his current role. Sachin has extensive experience working with value-based care provider groups including Vantage Oncology, a national leader in community oncology, where he served as Vice President, Finance, and Chief Financial Officer of Vantage Cancer Care Network, an innovative model for managing cancer populations.
Tom Magnotta, President and COO
Tom is a results-oriented, versatile, and hands-on executive whose nearly 25-year career has been shaped by his drive to lead transformative change, growth, and innovation within the health tech space. He has a proven track record of success in leading business growth, expanding enterprise value, and navigating companies through PE, M&A, and IPO activities. Tom most recently served as ClaimLogiq’s CEO to position the company for growth and scale and successfully steered the company to its merger with Apixio. Prior to ClaimLogiq, Tom managed DataLink Software’s core business operations as COO following an impactful tenure at HMS. Tom’s previous positions with WellCare Health Plans, Cotiviti, Health Net and his provider experience allowed him to experience various points of care. His unique perspective of the system is valuable as he leads efforts to solve challenges within the healthcare technology space. Tom holds a Bachelor of Science degree in Healthcare Administration from Springfield College and an MPA in Health Policy and Financial Management from New York University.
Sam Diederich, Chief Product Officer
Sam has more than a decade of strategic management experience within the healthcare industry across a variety of leadership roles, including corporate strategy, product, and growth. Prior to joining Apixio, Sam was the Senior Vice President at Optum, where he led large-scale businesses driving strategy, sustainable growth, product innovation, and industry differentiating partnerships. Sam has dedicated his career to improving the quality of care delivered to members, increasing healthcare affordability, and reducing costs for payers and providers. Using a collaborative and solution-oriented approach, Sam excels at developing new business models to solve meaningful challenges throughout the healthcare ecosystem. Prior to Optum, Sam has held roles at technology start-up TierMed Systems and at IBM. Sam holds degrees in Finance and Economics from the University of St. Thomas’ Opus College of Business in St. Paul, Minnesota.
Brian Moore, Chief Financial Officer
Brian has over 18 years of experience leading various levels of finance teams inside high-growth companies or as an advisor to larger organizations. As the CFO of Apixio, Brian is responsible for all accounting and finance-related matters throughout the organization. In his prior role as CFO for ClaimLogiq, Brian was tasked with integrating the back-office operations of three acquired companies and played a large role in the company’s 2023 merger with Apixio. He previously served as CFO of CertaSite, a private equity-owned company whose key growth strategy was through multiple acquisitions per year and held senior executive leadership positions at Equian and Deloitte. In preceding roles throughout his career, Brian has been involved in numerous acquisitions, led exponential growth in revenue/EBITDA, scaled finance/accounting and back-office operations, and managed various finance and acquisition-focused teams. Brian attended Indiana University, where he earned both his BS in Accounting and MBA in Accounting and Finance through the Kelley School of Business.
At Apixio, we strive for excellence in everything we do and understand that success is not built overnight but is the collective effort of smart people asking the right questions, taking calculated risks, and delivering innovative industry-leading solutions. Apixion’s are motivated, resourceful, intelligent, and scrappy trouble-shooters who work hard, play hard, and are committed to making an impact in our industry and in our communities. Our team is dedicated to hiring quality candidates of diverse backgrounds who can share their ideas and experience to create a holistic client and employee experience that is respectful of our company mission, and reflective of the individual talents that each Apixion brings with them. With Apixio you can expect the best because we are passionate and committed to delivering the best. We celebrate each success, big or small, and aim to help each Apixion reach their full potential.
Board member information is publicly not available.
Investor information is publicly not available.
- Apixio recently announced a new brand and strategic vision for delivering its leading Connected Care platform following its merger with technology-enabled payment integrity business, ClaimLogiq. Apixio’s proven AI-driven platform now expands across risk adjustment, payment integrity, health data management, and AI-as-a-service to optimize patient outcomes and outcomes-based reimbursement at scale.
- Apixio Earns 2022 Technology Innovation Leadership Award from Frost & Sullivan for Healthcare Data Unification Platform that Advances Value-based Care (Read)
News and Press Releases
- Apixio and Claimlogiq Merge To Create A Leading Connected Care Platform (Read)
- Apixio’s New Apicare Post-visit Solution Ensures Comprehensive, Accurate Risk Capture & Clinical Documentation Immediately After Patient Encounters (Read)
- Healthcare May Be The Ultimate Proving Ground for Artificial Intelligence (Read)