Helm
Manage population health
Identify care gaps in high-risk populations, track quality and utilization, and create follow-up lists with the member and provider context your team needs.
Built for health plans, ACOs, PACE orgs, and risk-bearing providers
Care management,payment integrity, andperformance analytics.Together in one place.
Find what’s driving spending. Identify care gaps in high-risk populations. Investigate improper payments. Protect contract revenue. Falcon connects the data and evidence your team needs to decide where to act—and track what changes.
Falcon HealthProduct tour
You see the shortfall. Now find the cause.
More hospital visits? A billing problem? Patients missing follow-up? Falcon helps you follow the evidence across care, claims, and payments—then decide what needs attention.
The Falcon products
From the financial warning to the work that needs doing.
Population health, claims investigation, provider intelligence, and Medicare Advantage operations—with healthcare expertise, benchmarks, and repeatable workflows built in.
Sentinel
Find preventable spend
Investigate suspicious billing and potential overpayments with claims patterns, provider research, and Medicare coverage evidence for your team to review.
Pulse
Evaluate provider partners
Compare provider and ACO performance, investigate utilization patterns, and evaluate network partners with market and benchmark context.
Scope
Run MA and PACE data operations
Manage encounter submissions and reconcile enrollment, risk-adjustment, and payment data so your team can find discrepancies that put MA and PACE Program revenue at risk.
How it works
Find the cause. Act with evidence. Track what changes.
When spending rises, check whether the cause is incomplete data, changes in care, or unusual billing. Keep the supporting evidence with the investigation, then create reports, chase lists, and scheduled monitoring for your team.
01
Connect claims, payments, and CMS reports
Bring MA data, financial and claims context, and the business definitions your team already trusts into one foundation.
02
Investigate the cause with supporting evidence
Ask an urgent operational or savings question and trace it across the data, analysis, and supporting evidence.
03
Act on findings and monitor what changes
Turn findings into case files, reports, and follow-up lists. Reuse trusted methods and schedule monitoring so your team can track changes over time.
Client data
CMS + public
Benchmarks
Falcon foundation
Context, methods, Skills, memory, and governed AI
Helm
Sentinel
Pulse
Scope
↺Feedback and validated work improve the foundation
See Falcon in action