A Map of Medicine Hidden in Billing Data
- Published
- Author
Yubin ParkCo-Founder / CTO
What procedure co-occurrence reveals about care settings, practice models, and emerging payment-integrity concerns.
Read moreBlog - Insights from the Frontlines
Deep dives into healthcare fraud detection, AI innovation, and program integrity insights from our team.
Which MOR Is This? A Surprisingly Expensive Question
- Published
- Author
Dr. Prince BaawuahHead of Medicare Advantage Solutions
CMS ships the monthly and the annual final Model Output Report with byte-identical record layouts — the only thing distinguishing them is the dataset name, and that name rarely survives the parse. Stack the files together and you double-count risk scores. Deduplicate them and you may delete the settled year-end scores outright. The fix is two date fields read in the right direction.
Read moreUnderstanding Medicare Overpayment Risk
- Published
- Author
Evan BrocinerData Product Lead
A plain-language walkthrough of how Medicare overpayments happen, who becomes liable once one is identified, and why contestations—the flip side of overpayment—are a recovery opportunity most risk-bearing orgs leave on the table.
Read moreIntroducing Falcon MCP: Your LLM, Falcon's Data
- Published
- Author
- Yubin ParkPhD, Co-Founder
Enterprise organizations with OpenAI or Anthropic accounts can now connect their LLM platforms directly to Falcon's proprietary healthcare data—and seamlessly hand off to Falcon for deeper investigation without losing context.
Read moreResearch Brief: Anomalous Urinary Catheter Billing and the ACO Exposure
- Published
- Author
- Yubin ParkCo-Founder / CTO
The first in our research brief series. Medicare spending on urinary catheter codes A4352 and A4353 jumped roughly 20x in two years — and ACOs absorbed the cost. Download the full white paper.
Read moreHow ACOs Should Approach FWA Campaigns: The Case for Structured Outreach
- Published
- Author
- Yubin ParkCo-Founder / CTO
Most ACOs sit on claims data that could surface millions in billing irregularities — but lack a clear strategy for acting on it. Here's how structured, evidence-based outreach gets providers to self-correct without formal enforcement.
Read moreWho Is My Member? A Surprisingly Complex Question
- Published
- Author
- Dr. Prince Baawuah & Yubin ParkHead of Medicare Advantage Solutions & PhD, Co-Founder
Medicare Advantage membership is a moving target — Medicaid eligibility shifts, CMS databases lag, and if you miss a rejection without proactively reaching out, the loss is yours. We built the Transaction Monitor so plans can stay on top of every enrollment transaction, year-round.
Read moreEvery Facility, Every Provider, One Search Away
- Published
- Author
- Yubin ParkPhD, Co-Founder
New Pulse Landscape views and Web Search Agent give you instant access to thousands of facilities and providers across ACOs, FQHCs, and SNFs — powered by public and proprietary data sources.
Read moreFrom Co-Analyst to Autonomous Intelligence: Our Vision for Healthcare AI
- Published
- Author
- Yubin ParkCo-Founder / CTO
Why we're building AI that starts as your conversational partner and evolves into the autonomous intelligence layer running your healthcare operations. The gap in the market, what we're learning, and where this is all heading.
Read moreIntroducing Falcon Skills: Domain Expertise On Demand
- Published
- Author
- Yubin ParkPhD, Co-Founder
Load specialized healthcare knowledge, SQL templates, and analytical frameworks into your AI conversations. Skills transform complex domain expertise into reusable, shareable building blocks.
Read moreSchedule Your AI Tasks: Automated Reports on Your Terms
- Published
- Author
- Yubin ParkPhD, Co-Founder
Set up recurring AI-powered reports delivered daily, weekly, or monthly. Turn your one-time data pulls into automated workflows that keep your team informed.
Read moreYour Falcon Health Journey: A Step-by-Step Guide
- Published
- Author
- Yubin ParkPhD, Co-Founder
Get started with Falcon Health in three simple steps. From signing in to exploring Sentinel and Pulse, we'll show you the way.
Read moreMoving at the Speed of Thought: AI That Gives Teams Autonomy
- Published
- Author
- Yubin ParkCo-Founder / CTO
Introducing Pulse & Sentinel v0.0.14—the first step in our vision to eliminate coordination overhead. When lean, expert teams can execute directly without handoffs, healthcare analytics moves at the speed of thought.
Read moreKnowledge Without Bottlenecks: Transparency, Data Access, and Analytical Freedom
- Published
- Author
- Yubin ParkCo-Founder / CTO
Introducing Pulse & Sentinel v0.0.13—removing the three fundamental bottlenecks in healthcare analytics: opaque AI, fragmented data, and technical barriers. Now with transparent tool usage, unified data access, and automatic visualization generation.
Read moreSet a thief to catch a thief
- Published
- Author
- Yubin ParkCo-Founder / CTO
To effectively combat healthcare fraud, we need to think like fraudsters. Learn how understanding fraudster tactics (from timing and threshold gaming to identity manipulation) reveals critical system vulnerabilities and enables more effective fraud detection.
Read moreNo Sales Calls, No RFPs, No Waiting: Healthcare Analytics That Respects Your Time
- Published
- Author
- Yubin ParkCo-Founder / CTO
Most healthcare data platforms make you jump through hoops before you can evaluate if they're right for you. We think that's backwards. Now you can try Pulse, Scope, and Sentinel (all three products) with just an email address.
Read moreBeyond Pattern Matching: How FalconHealth's AI Agents Think Like Healthcare Fraud Investigators
- Published
- Author
- Yubin ParkCo-Founder / CTO
With healthcare fraud draining $760+ billion annually, pattern-matching detection methods are fighting a losing battle. Learn how investigative AI agents are revolutionizing fraud detection by reasoning like human experts instead of memorizing historical cases.
Read moreThree Pillars of Data for FWA Research: How AI Agents Transform Healthcare Fraud Investigation
- Published
- Author
- Yubin ParkCo-Founder / CTO
Manual fraud investigation across internal datasets, digital footprints, and public records takes weeks. Our AI agent orchestrates specialized sub-agents across all three data pillars, delivering comprehensive investigation reports in hours instead of days.
Read moreBridging General Intelligence to Actionability: Making AI Actually Useful for Healthcare Fraud Investigation
- Published
- Author
- Yubin ParkCo-Founder / CTO
Despite impressive general intelligence, AI models struggle with specialized healthcare fraud detection. The gap isn't capability, it's context. Here's how Falcon AI bridges general intelligence to actionability by giving AI the right domain-specific tools, achieving 8.3/10 performance vs 6.5-7.2 for baseline models.
Read moreWhy Healthcare's Most Critical Database is Nearly Impossible to Search
- Published
- Author
- Yubin ParkCo-Founder / CTO
The Medicare Coverage Database governs $32 billion in improper payments yet finding relevant policies requires navigating 10,000+ documents with inconsistent medical terminology. Current search tools fail, forcing analysts to manually hunt through irrelevant results. Here's how Falcon Healthcare built AI that actually understands healthcare data.
Read moreThe Health Insurance Crash of 2025: What's Behind the Selloff, And How to Fix It
- Published
- Author
Neil AhujaFounder / CEO
When "recession-proof" becomes free-fall, and billions vanish overnight
Read moreDigging Up Signal from the Noise: How Real-Time Utilization Tracking Can Save Your MLR
- Published
- Author
- Yubin ParkCo-Founder / CTO
Stop being blindsided by utilization spikes and fraud schemes that traditional analytics miss. See how enhanced completion factor methodology with adaptive service grouping transforms reactive payers into proactive ones.
Read moreThe Million-Dollar Keystroke: How One Character Can Trigger an Audit
- Published
- Author
- Yubin ParkCo-Founder / CTO
HHS-OIG revealed their keystroke error detection algorithm in 2023. We analyzed real client data and found 12.81% of I110 codes might be I10 typos, representing millions in audit exposure.
Read moreEquipping the Right Tools for Our AI Investigator Agent
- Published
- Author
- Yubin ParkCo-Founder / CTO
How we built custom domain-driven tools for our AI investigator to navigate Medicare coverage databases, turning fuzzy policy language into precise, searchable criteria that dramatically improve fraud detection accuracy.
Read moreReady to put an AI co-analyst to work for your team? Let's talk.
Our offices
- Palo Alto, CA
Corporate HQ - Atlanta, GA
Technology Branch