MSOs & networks

Every payer, every practice, one set of numbers — delivered at scale, priced at wholesale.

You coordinate and manage risk your affiliated practices cannot carry alone, and you promise them the analytic capability that makes it survivable and profitable. Then you assemble that capability from three payer portals, a settlement statement nobody can reproduce, and a spreadsheet somebody maintains by hand. The promise is right. The plumbing and the tech debt are the problem.

Use an AI that has no stake in your vendors and no side in your politics — one that cuts cost and delivers sharper insight faster, at a fraction of what that capability costs you today.

What it replaces the delegated-reconciliation and VBC-administration functionpopulation-health analytics bought per contractthe analyst headcount that grows with every new payerthe practice-support queue

Your whole portfolio, on one taxonomy

Each payer sends different files, on a different cadence, with a different definition of almost everything. So performance gets reported per contract, and nobody can answer the questions that actually run the business: which payer relationship is working, which practices are carrying the network, where the same member is being managed twice.

Guardiant’s proprietary taxonomy is one model of how a risk-bearing organization’s data fits together. Each payer’s sources map onto it, and from then on everything reads from one set of definitions — performance by practice, by payer, by contract, by line of business — so a roll-up means something.

We map your portfolio onto it, payer by payer, and we own the pipeline from there.

Per-practice performance, with the reason attached

A ranked list of practices is management theater. The useful version says why: documentation completeness against the conditions the panel actually carries, utilization and referral patterns, leakage to out-of-network specialists, emergency and inpatient use, and the gap between what a practice documented and what was ultimately credited.

That distinction matters commercially. A practice losing money because its panel is sicker than its documentation says has a fixable problem. A practice losing money because it refers everything out has a contract problem. Those need different conversations, and today they get the same one.

Prove what was submitted

Hand over the claims a practice believes it sent. Every one gets matched against the warehouse and walked through the whole trail: accepted or rejected, filtered out of risk adjustment or credited, still open or settled. Per claim, per condition.

Each gap comes back classified — denied, never submitted, never arrived, filtered out, still pending — so a dispute stops being about whose spreadsheet is right and becomes a list of specific claims with specific dispositions.

Done by hand that is days of analyst time per dispute, which is why it doesn’t get done, which is why the asymmetry persists.

The enablement layer you already promise — in your brand

The reason a practice joins you is that you carry the burden it can’t. So give it the view: its own panel, its own open conditions with the deadline attached, its own quality gaps, its own claim answers — scoped so each practice sees only its own.

Carry it under your name. White-label is how most of our MSO customers will want this, because the point isn’t our logo on their screen — it’s that your practices log into something you gave them, on a Tuesday, and stay. It retains the practices you have and it’s the hardest part of your pitch for a competing MSO to match.

One relationship with us reaches every practice under your umbrella.

Where you can take risk next

The same engine that answers a plan’s network sufficiency question answers a growth question from your side of the table: where your network is genuinely deep, where it’s thin, which specialties and counties would make you the obvious delegated partner, and which would expose you.

Useful before a contract negotiation rather than after one — and considerably more persuasive than a roster count when a plan asks what you can actually cover.

And it can answer your practice-support line

Your practices’ billers spend their day on hold — sometimes with payers, often with you. The same capability that answers a plan’s provider-services line answers yours: claim status, payment detail, authorization status, eligibility, denials explained in plain language, in English or Spanish, out of the record rather than out of a model.

It is the one capability on this page your practices will notice in the first week.

What it isn’t

Not an EHR, not a billing system, not a practice management replacement, not a care-management workflow tool. It reads what your systems and your payers’ systems already produce. Nobody changes how they document anything to use it.

Next

Risk-share settlement modeled end to end — premium, medical cost, reinsurance, reserves, completion factors, the contracted share — so a settlement statement can be checked line by line before it’s signed, and modeled before a contract is. In development.

Next step

The contract whose data is cleanest, or the one whose settlement came in worst.

Bring us one payer and one month