Lumiknox
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    Medical Coding HEDIS Quality STARS Performance RADV & Risk Adjustment Agentic AI Billing Claims Processing AI AI/ML Analytics
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    Health Plans Third-Party Administrators Hospitals & Physicians
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Industries

We work the U.S. healthcare dollar from three sides.

Our pods are configured to the realities of each industry — different platforms, different regulators, different commercial pressures. The same audit-grade chassis underneath.

Health plan operations

Health Plans

Commercial, Medicare Advantage, Medicaid, ACA, and duals — coding, HEDIS, STARS, RADV, and analytics on a single delivery model.

For Health Plans →
TPA claims operations

Third-Party Administrators

First-pass adjudication uplift, edit resolution, COB, and stop-loss data integrity for TPAs serving self-funded employers.

For TPAs →
Hospital revenue cycle

Hospitals & Physicians

CDI support, facility & profee coding, denials & appeals, and AR follow-up for IDNs, ASCs, and physician groups.

For Providers →
Lumiknox

Revenue integrity, risk adjustment, and agentic AI solutions for U.S. health plans, TPAs, and providers.

HQ  ·  Wilmington, Delaware
APAC  ·  Hyderabad, India
SEA  ·  Manila, Philippines
Solutions
  • Medical Coding
  • HEDIS Quality
  • STARS Performance
  • RADV & Risk Adjustment
  • Agentic AI Billing
  • Claims Processing
  • AI/ML Analytics
Industries
  • Health Plans
  • TPAs
  • Hospitals & Physicians
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