Xsolis

Franklin, TN All United States companies → — Founded 2013

Healthcare Analytics / BI Prior Authorization Automation Revenue Cycle / Billing

Family Medicine Hospital Medicine Internal Medicine

Medical Billing & RCM

Series C / Private Equity-Backed

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Products

AI-driven Denial Management

Xsolis

Medical Billing & RCM

Xsolis offers an AI-driven denial management tool that analyzes denial trends, identifies root causes, and helps prevent claims issues before submission, shifting from reactive to proactive denial management.

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About Xsolis

Xsolis is a healthcare AI company that aims to create a more efficient and “frictionless” healthcare system by bridging the gap between healthcare providers and payers. The company’s proprietary AI-driven platform, Dragonfly, leverages machine learning and real-time predictive analytics to provide objective insights into medical necessity and appropriate levels of care for patients. This technology helps streamline workflows for physicians and other clinical staff, reducing administrative burdens associated with tasks like utilization review, case management, and denials management.

For physicians, Xsolis’ solutions, including its Physician Advisory Services, are designed to enhance clinical expertise and support data-driven decision-making. The Dragonfly platform synthesizes clinical and financial data from Electronic Medical Records (EMR) to create a real-time clinical profile of each patient, allowing physicians to quickly access actionable data and focus on high-risk cases. This approach helps in making consistent, evidence-based medical necessity and concurrent authorization decisions, ultimately aiming to improve patient outcomes, optimize care settings, and reduce administrative delays and denials. Xsolis has been recognized for its Physician Advisory Services, ranking No. 1 in Best in KLAS Awards for five consecutive years (2021-2026).

Focus Areas

Utilization Management Revenue Cycle Management Payer-Provider Collaboration Case Management Denial Management Physician Advisory Services Healthcare Analytics Artificial Intelligence Machine Learning

Business Intelligence

Technology

Cloud-native, AI-driven platform (Dragonfly, formerly CORTEX) utilizing predictive analytics, machine learning, and cognitive computing to unify real-time clinical data and provide objective insights for medical necessity and care level determinations.

What Physicians Need to Know

Utilization Management

Xsolis' AI-driven Dragonfly platform streamlines utilization review by automating processes, prioritizing high-impact cases, and aligning clinicians and payers. It uses real-time predictive analytics to assign an objective medical necessity score and assess the anticipated level of care for every patient. This approach has led to significant time savings, with one national health plan achieving up to 83% more efficiency in case reviews. The platform also helps reduce observation rates and improve patient status accuracy.

Revenue Cycle Management

Xsolis enhances revenue cycle operations by leveraging AI and predictive analytics to ensure correct reimbursement and reduce revenue leakage. Their solutions, like Dragonfly Revenue Integrity Insights, provide real-time, intelligent insights into medical necessity criteria, helping to prevent denials and optimize claims processing. This includes automating charge capture, flagging high-risk claims, and enhancing documentation for compliance. Xsolis' approach has helped clients save over $1.5 billion, with an average lifetime ROI of 11.3x.

Payer-Provider Collaboration

Xsolis acts as a bridge between payers and providers, fostering collaboration through its AI-driven Dragonfly platform. The platform provides real-time access to a normalized and concise view of each patient's clinical picture, promoting a neutral, data-driven patient story. This shared data framework eliminates silos, accelerates data-driven decisions, and improves concurrent authorization case review efficiency. This collaboration reduces administrative burden, friction, and delays, ultimately benefiting all stakeholders.

Case Management

Xsolis' Dragonfly platform unifies data, technology, and clinical expertise to achieve optimal case management. It delivers instantaneous, actionable insights, increasing collaboration among utilization management, case management, and revenue cycle stakeholders. AI-powered case management tools automate routine tasks, improve decision speed and consistency, enhance data-driven resource planning, and flag high-risk patients earlier. This allows case managers to focus more on care coordination, leading to reductions in length of stay and improvements in patient flow.

Denial Management

Xsolis offers AI-powered denial management services and solutions to reduce denials and recover revenue faster. Their machine learning algorithms identify and prioritize denial resolution cases with strong clinical merit. The platform defends admissions decisions to payers both concurrently and retrospectively, with complex denials being reviewed and resolved 3-5 times more efficiently. Xsolis' approach shifts denial management from reactive to preventive strategies, addressing root causes before claims submission.

Physician Advisory Services

Xsolis has been ranked No. 1 Best in KLAS for Physician Advisory Services for five consecutive years (2021-2026). Their services offer flexible support, allowing organizations to supplement internal physician advisor teams or leverage comprehensive external support. Xsolis Physician Advisors leverage real-time analytics and clinical insights from the Dragonfly platform to navigate complex cases, resulting in stronger peer-to-peer success rates (e.g., 71% for Hackensack Meridian Health).

Healthcare Analytics, AI, and Machine Learning

Xsolis is an AI-driven technology company that has pioneered the use of AI in healthcare since 2013. Their proprietary AI-driven platform, Dragonfly, uses real-time predictive analytics, machine learning, and natural language processing to synthesize clinical and financial data from EMRs. This generates objective medical necessity scores and actionable insights, with over 300 million encounters processed and 2.9 billion predictions generated to date. Xsolis' AI solutions improve level of care authorizations, length-of-stay management, and payer-provider alignment.

Physician Tip

Xsolis' Dragonfly platform and Physician Advisory Services empower physicians by providing real-time, objective clinical data and predictive analytics, reducing administrative burden and allowing more focus on patient care. The Care Level Score (CLSu2122) offers a complete and holistic view of the patient's clinical picture, guiding decision-making and ensuring appropriate level of care. This leads to more confident and efficient case reviews, stronger peer-to-peer success, and improved alignment with payers on medical necessity. Physicians can leverage Xsolis' tools to identify trends, improve efficiency, and strengthen alignment across clinical and administrative teams.

Xsolis' Dragonfly platform interfaces with all major EMR vendors, ingesting real-time data feeds. They also leverage AWS for their technology stack, utilizing services like Amazon EC2, Amazon Managed Streaming for Apache Kafka (MSK), Amazon DynamoDB, Amazon RDS, Amazon OpenSearch, and AWS X-Ray for scalability, extensibility, maintainability, and high reliability. Xsolis also partners with Trend Micro for platform security solutions. The platform is designed to eliminate data silos and interoperability issues, fostering collaboration across a connected network of payers and providers.

At a glance

Founded 2013

HQ Franklin, TN · United States

CEO Joan Butters

Funding Series C / Private Equity-Backed

Products 1

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Products by Xsolis

1 product in the directory

AI-driven Denial Management

Xsolis

Medical Billing & RCM

What the Web Says

Xsolis is a healthcare technology company that utilizes AI and cognitive computing to improve healthcare operations, particularly in utilization review and denials management. Their flagship product, Dragonfly (formerly CORTEX), aims to streamline medical necessity decisions and foster collaboration between providers and payers. While the product receives positive feedback for its efficiency and impact on patient care and financial performance, the company as an employer has mixed reviews, with some employees citing a toxic work environment and lack of diversity.

Overall: Mixed

Strengths

Improved efficiency in utilization review and medical necessity decisions.
Reduced denials and accelerated payer approvals.
Enhanced collaboration and transparency between healthcare providers and payers.
Positive impact on financial performance for healthcare organizations.
Good work-life balance and work-from-home benefits for some employees.
Supportive peers and teams.

Limitations

Toxic work environment and poor management reported by some employees.
Limited opportunities for advancement and lack of career growth.
Lack of diversity, particularly in leadership positions.
Poor communication between product/management and engineering teams.
C-suite centric culture that may undermine employee morale.
Recent data breach affecting nearly 1.4 million individuals.

Based on reviews from: Indeed.com, FeaturedCustomers, SimplyHired, KLAS Research, Xsolis (Company Website/Press Releases), Zippia, Reddit, YouTube

Last updated: 2026-08-24

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Press & Coverage

TechRadar

US healthcare AI platform Xsolis confirms data breach that affects 1.4 million individuals

Xsolis, a healthcare technology company, disclosed a cyberattack that occurred in January 2026, resulting in the loss of sensitive data for almost 1.4 million individuals due to a phishing attack on an employee.

2026-06

TechTarget

Healthcare AI platform Xsolis suffers data breach impacting 1.4M individuals

Xsolis, a health tech company, reported a data breach impacting 1.4 million individuals after a targeted phishing attack in January 2026, with affected organizations including Mayo Clinic and UW Medicine.

2026-06

Xsolis Press Releases

Xsolis Wins Pinnacle AI Award For 2026, Highlighting Continued Leadership In AI-Driven Healthcare Innovation

Xsolis received the Emerald Pinnacle AI Award for 2026 in the Healthcare & Life Sciences' Clinical Decision AI category for its Dragonflyu00ae AI platform, recognized for its impact on healthcare operations.

2026-03

Xsolis Press Releases

Peer-Reviewed Studies at U.S. Health Systems Validate AI in UM

Xsolis highlighted new peer-reviewed research from three major U.S. healthcare systems (Baylor Scott & White Health, Yale New Haven Health, and Mayo Clinic Health System) validating its AI platform's performance in utilization management.

2026-04

Morningstar (via Business Wire)

HTEC and Xsolisu2019 Strategic Partnership to Tackle Inefficiencies in Healthcare Decision-Making with AI

HTEC announced a strategic partnership with Xsolis to advance the Dragonfly platform, aiming to improve healthcare provider and payer collaboration and streamline medical necessity decisions using AI.

2026-06

PR Newswire

Xsolis Partners with Beacon Health to Provide Innovative Generative AI Solution to Maximize Clinical Efficiencies During Medical Necessity Reviews

Xsolis partnered with Beacon Health to implement a generative AI solution that significantly reduced the average time for medical necessity reviews by 68%, from 15 minutes to 4.7 minutes per review.

2025-01

Xsolis Press Releases

Xsolis Launches New Generative AI Solution to Improve Clinician Efficiency in Mid-Revenue Cycle

Xsolis launched a new generative AI solution to streamline appeals in the mid-revenue cycle, with MultiCare Health System piloting the technology to expedite documentation and appeal letter creation.

2024-12

Xsolis

Xsolis Secures $75m Growth Investment from Brighton Park Capital

Xsolis secured a $75 million minority growth investment from Brighton Park Capital to accelerate its growth, scale operations, expand its customer footprint, and deliver new solutions to the market.

2021-06

Frequently Asked Questions

How does Xsolis's AI-driven platform specifically improve Utilization Management (UM) and what are its key features for physicians and healthcare administrators?

Xsolis's AI-driven platform, known as Dragonfly, leverages real-time clinical data to provide a dynamic, objective view of patient acuity and medical necessity. This helps physicians and UM teams make faster, more consistent decisions, reducing manual review times and improving inter-rater reliability. It offers features like predictive analytics for discharge planning and automated identification of cases requiring physician advisor intervention.

In what ways does Xsolis facilitate Payer-Provider Collaboration and how does this impact revenue cycle management and denial prevention?

Xsolis promotes payer-provider collaboration through its common platform, allowing both parties to work from the same real-time clinical data and objective medical necessity scores. This transparency and shared understanding reduce friction, streamline the review process, and proactively address potential denials before they occur, ultimately improving revenue cycle efficiency and reducing administrative burden.

What specific tools or functionalities does Xsolis offer to assist with Denial Management and how do they integrate with existing case management workflows?

Xsolis's platform helps prevent denials by providing clear documentation of medical necessity and patient acuity from the outset. For existing denials, it offers robust analytics to identify root causes and provides data-driven insights to support appeals. The system integrates with existing case management workflows by providing a centralized hub for clinical information and communication, enabling proactive intervention and efficient appeal management.

How does Xsolis ensure compliance with healthcare regulations (e.g., HIPAA, InterQual/MCG guidelines) and what measures are in place for data security and privacy?

Xsolis prioritizes compliance by building its platform to align with industry standards and regulations like HIPAA. The platform incorporates evidence-based guidelines such as InterQual and MCG criteria into its AI algorithms to ensure medical necessity reviews are consistent and defensible. Data security and privacy are maintained through robust encryption, access controls, and regular security audits to protect sensitive patient information.

What is the typical implementation timeline for Xsolis's platform, what kind of ongoing support is provided, and what is the general pricing structure?

While implementation timelines can vary based on the size and complexity of the healthcare system, Xsolis aims for efficient integration with existing EHRs and workflows. They offer comprehensive onboarding, training, and ongoing customer support, including dedicated account management and technical assistance. Pricing is typically subscription-based, often tied to the volume of cases or beds, with specific details provided after an initial assessment of an organization's needs.

How does Xsolis leverage Artificial Intelligence and Machine Learning to go beyond traditional healthcare analytics, and what are the tangible benefits for physician advisors?

Xsolis utilizes AI and Machine Learning to move beyond retrospective analytics by providing predictive insights into patient progression and potential care gaps. For physician advisors, this means receiving prioritized alerts for complex cases, access to objective acuity scores, and data-driven recommendations that support their medical necessity determinations, ultimately enhancing their efficiency and impact.

Can you describe Xsolis's partnerships within the healthcare ecosystem (e.g., with EHR vendors, other technology providers, or payers) and what this means for system interoperability and future development?

Xsolis actively pursues partnerships with key players in the healthcare ecosystem, including EHR vendors for seamless data exchange and various payers to foster collaborative UM processes. These partnerships are crucial for ensuring system interoperability, expanding the platform's capabilities, and driving future innovations that benefit both providers and payers by creating a more connected and efficient healthcare experience.

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