For payers
Sanoki AI agents read every case against the clinical record, the guidelines and your contracts, from the authorization request to the bill. Your clinical team decides on every finding.
Where medical cost goes
net savings AI can reach on a private payer’s total cost within five years
NEJM Catalyst, 2026
Contracting
Pay each line at the rate in the contract, and compare prices across your network.
1.8–3.5%of payer spend AI can save in provider relationshipsNEJM Catalyst, 2026
Authorizations
Decide each request against your coverage rules and the clinical guidelines, with the record in front of the reviewer.
60%of prior authorizations still handled partly or fully by handCAQH Index, 2025
Bills
Read every bill against the record and the contract before you pay it.
3–10%of health care spending lost to fraudNHCAA estimate
How it works
How the case lives today
Clinical records, bills, contracts and coverage rules, each in a different system.
Inputs that decide a case
Each source connected in the format it already has.
A model of your health plan
Each record tied to its context, each rule to where it applies.
Workflows on your cases
Some report, some act, each traceable to its rule. Your reviewers decide, and the system learns from every verdict.
Applications
The agents learn how your health plan contracts, authorizes and pays. You deploy one application at a time, and the next one builds on the data already connected.
Contracting
Contract intelligence
Answers what was agreed, rate by rate.
Payment variance
Finds what was billed off contract.
Rate benchmarking
Compares prices across your network.
Authorizations
Prior authorization review
Evaluates each request against criteria.
Prospective medical necessity review
Checks necessity before care starts.
Concurrent review
Follows the episode while it runs.
Bills
Medical necessity review
Validates each charge against the record.
Fraud, waste and abuse detection
Uncovers improper patterns at scale.
Claims editing
Catches coding errors and duplicates.
Why Sanoki
One decision can need the history, the authorization, the contract and the bill at once. Sanoki reads and relates all of it in one connected model, from the thousand-page hospitalization bill to the few-hundred-dollar expense.
Rules, tariffs and behaviors shift all year, and the model keeps up. A correction lands once and every case after runs on it, so more gets caught earlier.
Each finding states its rule and its evidence, and traces back through the chain that produced it. Verdicts from your reviewers land in the memory; the next case runs on all of it.
Sanoki runs the whole payment-integrity cycle, from contract to payment. You take the recovered value where you need it: more cases reviewed with the same team, or a lower medical loss ratio.
Case study
“It evaluates items a normal audit does not reach, given the time available to find them: routine lab work, low-cost medications, low-cost supplies.”
Complex hospitalization bills · Latin America
Next steps