Your AI Agent for Actionable Healthcare Claims Insights
Ask questions in natural language and get instant insights from healthcare claims data via our vertically trained AI. Experience faster time to value with complete transparency and control.
Diabetes Claims Cost Analysis
The average cost per claim for diabetes patients in 2024 is $1,245.32, which is 12.3% higher than 2023. This is based on 3,421 claims from 1,890 unique patients.
Insulin medications (+18%) and CGM supplies (+24%) are the main cost drivers
65% of patients are over 50, with higher costs in the 60-70 age group
Experience the AI Agent
See how SemantIQ's AI agent transforms complex healthcare claims data into instant, actionable insights through natural language.
SemantIQ AI Agent
Hello! I'm your healthcare claims AI assistant. Ask me anything about your claims data, and I'll provide instant insights with full transparency.
Show me the top 5 procedures by total cost for cardiology
The top 5 procedures by total cost for cardiology are: 1. Cardiac Catheterization: $2.4M 2. Coronary Angioplasty: $1.8M 3. Echocardiogram: $1.2M 4. Stress Test: $950K 5. Holter Monitor: $780K
Data sources: Claims database (2020-2024), Provider network data
The Problem
Traditional claims analytics are slow, siloed, and frustrating. Black-box tools obscure assumptions, endless rework drains time and money, and critical insights remain trapped behind data gatekeepers.
Black Box Tools
Outputs lack visibility into assumptions or how data was filtered, joined, or aggregated, making it impossible to trust or verify results.
Endless Rework
Broken assumptions and fragmented data drive costly cycles of confusion, delay, and rework.
Reliance on Gatekeepers
Simple insights are gated by IT and Data teams, trapped behind brittle, outdated, rules-based systems.
The SemantIQ AI Agent
Our AI agent empowers users to ask natural–language questions and receive instant, transparent answers from their claims data – no engineering needed. Every output includes full lineage, explainability, and the flexibility to bring your own data.
Rapid. Trusted. Actionable insights – delivered faster and more affordably than ever before.
Advance Data Equity
Provide real-world data and tools to underrepresented groups that are often overlooked by commercial platforms.
Natural language processing
No SQL or coding knowledge required
Instant, accurate responses
Lower the Barrier to Entry
Design products that are easy to adopt, with minimal demands on time, technical infrastructure, cost, or team size.
Complete data lineage
Transparent methodology
Verifiable results
Level the Playing Field
Empower small and mid-size organizations with the same powerful insights traditionally reserved for large, well-funded enterprises.
Quick setup with your existing data
No lengthy implementation cycles
Immediate time-to-value
AI-Native Infrastructure
Embedded expertise via AI agents, not manual consultants. Bring your own data and leverage our intelligent access and automation.
Bring your own data
Works with your existing systems
Secure and compliant
How Our AI Agent Works
SemantIQ's AI agent uses advanced natural language processing to understand your questions and provide transparent, accurate insights from your healthcare claims data.
Natural Language Query
Ask questions in plain English without needing technical knowledge or SQL skills. Our AI agent interprets your question and identifies relevant data sources.
Structuring the Question
Our AI agent structures your question with transparent assumptions and data lineage, giving you full control to modify values before analysis begins.
Data Analysis and Outputs
The system analyzes your healthcare claims data and generates a data output with an explanation and recommendations for further analysis.
Actionable Insights and Visualizations
Unlock insights through summaries and intuitive visualizations, empowering faster decisions, and ensuring complete trust in your data journey.
Extensive Training for Unparalleled Accuracy
Our AI agent has been meticulously trained on both public and commercial claims data, providing domain-specific expertise that generic AI models simply cannot match.
Comprehensive Training Dataset
Benefits of Healthcare-Specific Training
Domain-Specific Understanding
Our agent understands healthcare terminology, coding systems, and clinical concepts with unprecedented accuracy.
Longitudinal Analysis
Track patterns and trends across patient journeys with a comprehensive understanding of healthcare data evolution.
Cross-Payer Insights
Compare performance and identify opportunities across different payer types and networks.
Contextual Intelligence
The agent understands the context behind healthcare claims data, not just the raw numbers.
100% Explainable AI
Unlike black-box solutions, SemantIQ provides complete transparency into how insights are generated, including data sources, methodologies, and assumptions.
AI Agent Use Cases
Discover how healthcare organizations are leveraging SemantIQ's AI agent to transform their claims data into actionable insights.
Cost Analysis
Identify cost drivers and opportunities for savings across different service lines, providers, and patient populations.
"What specialty providers are driving the highest costs for biologic medications in our network?"
Utilization Management
Monitor service utilization patterns to identify overutilization and opportunities for care optimization.
"Show me providers with the highest imaging order rates for lower back pain patients"
Population Health
Segment patient populations and analyze care patterns to improve outcomes and reduce costs.
"Which endocrinologists have the best A1C outcomes for diabetic patients on Medicare?"
Sales Prospecting
Identify high-value prospects and optimize outreach strategies through intelligent analysis of customer data and engagement patterns.
"Find oncologists treating EGFR+ lung cancer patients who haven't prescribed our targeted therapy"
Market Benchmarking
Compare your organization's performance against industry peers to identify opportunities for improvement and competitive advantages in cost, quality, and operational efficiency.
"How does our specialty network's DOAC prescribing compare to regional benchmarks?"
Health Equity
Analyze provider network adequacy to ensure equitable access to healthcare services across diverse populations and geographic areas.
"Identify zip codes with limited access to rheumatologists for minority patients with lupus"
About SemantIQ
Our Story
SemantIQ was founded by leaders with deep expertise in AI, data, and healthcare analytics who have helped create over $50B in enterprise value across companies like CVS, Optum, Datadog, PlaceIQ and Google AdMob.
Our Founding Principles
Real-world data deserves real-world transparency. We built SemantIQ on three core principles that guide everything we do:
Advance Data Equity
Provide real-world data and tools to underrepresented groups that are often overlooked by commercial platforms.
Lower the Barrier to Entry
Design products that are easy to adopt, with minimal demands on time, technical infrastructure, cost, or team size.
Level the Playing Field
Empower small and mid-size organizations with the same powerful insights traditionally reserved for large, well-funded enterprises.
Founding Team
CPO & Co-Founder
Applied Math and Actuarial Science expert turned healthcare analytics product leader, with deep experience building data-driven solutions. Adam has held leadership roles at Optum Insights, CVS, Cotiviti (acquired by Verscend), Health Dialog (acquired by BUPA), and Rowdmap (acquired by Cotiviti).
Ready to Transform Your Healthcare Analytics?
Request a demo of our AI agent today and see how SemantIQ can revolutionize your approach to healthcare claims data.
We'll notify you when a demo spot becomes available.