Xficient – Transforming Healthcare Administration with Generative AI

Transforming Healthcare Administration with Generative AI

Leveraging Generative AI to empower TPAs with smarter, faster, and more efficient solutions for benefits administration.

Healthcare administration is broken. GenAI can fix it.

Third-party administrators (TPAs) are overwhelmed by unstructured, siloed data. Critical plan and member information—scattered across formats, platforms, and systems—makes it difficult to ensure accuracy, meet deadlines, scale operations, and drive business growth.

$300B

Administrative inefficiencies in healthcare cost the U.S. over $300 billion every year, with unstructured data as a major contributor

50%

TPAs spend nearly half their time on manual processes like data reconciliation and compliance, limiting their ability to scale and innovate

95%

An estimated 95% of healthcare data exists in unstructured formats, creating bottlenecks in efficient benefits administration

McKinsey’s Report: “Unlocking the potential of digital healthcare.” McKinsey & Co., 2021
“Healthcare Benefits Administration Trends,” Optum, 2020
“The state of healthcare data in 2021”, HealthIT.gov

The Future of Healthcare Administration is GenAI

Generative AI transforms healthcare administration by simplifying complex activities such as Plan Design and Claims, cutting waste and boosting efficiency. With human oversight integrated where it matters, our solution ensures accuracy, compliance, and the perfect balance of innovation and reliability—empowering TPAs to focus on growth and client success.

Self-insured employers cover healthcare for 100M Americans through TPAs across a complex value chain

Xficient is developing a revolutionary new Operating System that can help TPAs.

Xficient’s TPA OS transforms the value chain by structuring data in a manageable and scalable way.

Before Xficient

Unstructured data lies at the root of a huge healthcare waste problem.

After Xficient

Xficient harnesses GenAI with deep healthcare expertise for a solution that actually works.

Our TPA OS helps TPAs achieve

50%

time and cost savings while avoiding downstream errors

We are powering innovation through strategic partnerships & customer cohorts

At Xficient, we believe in the power of collaboration. Our strategic partnerships are key to driving innovation and delivering cutting-edge solutions that address the unique challenges faced by TPAs. By working closely with industry leaders and strategic partners, we’re able to leverage shared expertise, resources, and insights to create solutions that are not only effective but also transformative for the entire benefits administration ecosystem.

Our team is uniquely positioned to address this opportunity

Xficient’s team combines deep expertise in healthcare, business, AI, and technology, ensuring we have the right background to deliver practical, effective solutions for TPAs.