Healthcare Decision Intelligence
Payment accuracy at first pass. Nine of the top 10 U.S. health plans verify claims with Lyric before payment moves.
Discover Our PlatformHealthcare Decision Intelligence in Real Time
35+ Years of Proven Results
2M
Transactions Per Hour
10B
Claim lines a year
$20B
Annual savings realized by clients
WHY WE BUILT LYRIC
Better healthcare starts with better decisions
We believe in better healthcare for humankind. That starts with getting the decision right. Less waste, less friction, less cost to care.
The U.S. healthcare system runs to nearly $5 trillion. Administrative waste consumes $300 billion a year in rework, errors, disputes, and redone claims. That money never reaches care. Instead, people end up carrying more than $220 billion in medical debt.
Health plans, providers, and the people they serve all want the same thing: the right decision, made once, backed by evidence. Waste is what wrong decisions cost. We defined healthcare decision intelligence to get it right at first pass, and to build toward a system that runs on trust, truth, and transparency.
Healthcare decision intelligence platform
Multiple signals in one reconciled recommendation
Lyric42 reconciles signals from every Lyric® solution and connected partner into one recommendation, with the rationale attached.
Your decision.
HOW WE OPERATE
Trust, Truth, Transparency
Trust
A human is always in the loop. Clinical experts review the recommendations Lyric delivers, and the decision is always yours.
Truth
One standard: get it right the first time. Recommendations are verified against policy, codes, and documentation. The proof travels with it.
Transparency
Recommendations trace to their sources: the policy, the excerpt, the effective date. We show the work, because that is how trust is earned.
Governed AI
How Lyric uses AI responsibly
35+ years of clinical expertise informs every thing we build.
AI helps accelerate bringing innovations to clients.
Human judgment stays at the center.
Expert Validation
At Lyric, AI supports human expertise rather than replacing it. AI is applied inside a governed architecture, so experts can work with clearer, more consistent information grounded in clinical context, policy knowledge, and traceable rationale.
Explainable Intelligence
Our approach is intentionally designed with multiple layers of control, combining governed AI, expert review, client-controlled implementation, traceable rationale, source documentation, and protected data.
Client Control
Clients configure business rules, review thresholds, and decision constraints to match their policies and governance requirements. Override or tighten any of them at any time.
Our Solutions
Accurate Payments Explainable Findings More Confidence
More signals. Faster recommendations. Optimal decisions.
Verify every claim before payment moves
Catch errors before the dollar goes out, across millions of claims a day.
- Execute in Real Time: Lyric42 evaluates claims in milliseconds, at the scale you run.
- Source, Govern, and Maintain: Lyric tracks guidance from CMS, AMA, specialty societies, and hundreds of other authorities on a continuous cadence, turning regulatory changes into production-ready content.
- Adapt to Your Health Plan: You configure the rules, policies, thresholds, and carve-outs on one source of truth, built around how your plan operates.
- Deliver Comprehensive Coverage: Tens of millions of curated edits and mappings span professional, facility, inpatient, and specialty claims, continuously validated and maintained.
Every finding ends an error
Identify what automated editing missed. Then stop the same error from surfacing again.
- Target the risk: Lyric surfaces the claims most likely to carry coding inaccuracies, and other scenarios.
- Validate the finding: Nurses, auditors, certified coders, and data analysts apply established methodologies, standards, plan requirements, and investigative workflows through governed processes. Findings carry their rationale.
- Continuously shift left: Findings that repeat can move from post-pay into pre-pay and can become automated edits over time.
- Keep pre-pay claims moving: Intelligent triage routes and prioritizes pended claims, so complex cases get attention without slowing adjudication.
Run payment integrity on your own terms
Operate your own program on one data set and one view.
- Author the content: Policy Studio turns your policies, contracts, and plan documents into deployable content.
- Expose the rationale: C3 gives providers transparency into the policy and reasoning behind a recommendation, for fewer avoidable billing errors before submission.
- Execute Smarter Audits: Replay combines analytics, prioritization, and configurable workflows to identify what matches your audit criteria. Audit yield and productivity rise without adding headcount.
- Control your program: Virtuoso centralizes audits, recoveries, appeals, documents, outcomes, and vendor activity in one environment.
Execute multiple workflows from one evidence base
Operate from one source of truth, so the same claim gets the same answer everywhere.
- Keep pace with innovation: Clinical and coding experts turn emerging evidence into structured policy.
- Deploy across workflows: One policy set supports payment integrity, provider engagement, and other policy-driven workflows.
- Trace the answer: Answers carry the policy behind them, so systems, teams, and vendors can work from the same source.
- Govern the updates: Lyric's clinical experts revise policies as evidence changes, and version the changes.
Lyric Leadership
Meet the team
History of Innvovation
About Lyric
