IKS Health and Certilytics Expand Strategic Collaboration to Bridge the Payer-Provider Gap with Agentic AI and Human-in-the-Loop Oversight

BusinessWire India
Dallas (Texas) [US] / Mumbai (Maharashtra) [India], March 25: IKS Health, a global leader in care enablement solutions, and Certilytics, Inc., an innovator in AI-driven healthcare intelligence, today announced an expansion of their strategic partnership. The new collaboration is designed to bridge the historic divide between payers and providers by turning predictive insights into safe, coordinated clinical actions.

As healthcare enters the era of agentic AI, the industry is moving beyond systems of intelligence that simply identify risks to systems of action that execute the work. By integrating Certilytics' BrainstormAI® Studio and CertHLM™ with the IKS Health Agentic Care Enablement Platform, the companies are creating a premier ecosystem where AI agents manage complex tasks, such as prior authorization and patient outreach, under the continuous oversight of human expertise.
"At IKS Health, our mission is to enable care by removing the chores that prevent great outcomes. But for AI to be truly effective in healthcare, it must be responsible," said Sachin K. Gupta, Founder and Global CEO of IKS Health. "By expanding our partnership with Certilytics, we are connecting payer rules and provider workflows through predictive analytics with our proven human-in-the-loop model serving as the ultimate safeguard for clinical and administrative accuracy."
The collaboration initially centers on three key strategic use cases and workflows:
- Prior authorization transparency: Moving beyond "rules of thumb" to real-time, payer-specific rule sets where more than 70% of all prior authorization workflows are handled autonomously, reducing the burden for providers and speeding up care for patients.
- Member engagement: Scaling outreach that isn't just a notification, but a proactive clinical connection to close care gaps.
- Consumer price transparency: Giving patients and employers true financial outlooks at the point of care, not weeks later.
"We are equally excited about this unique partnership with IKS Health to bring providers, health plans, payers, and plan sponsors together in making full use of the science and computing power of generative AI capabilities," said Merle A. Ryland, CEO of Certilytics. "Since 2014, the Certilytics team has developed, tested and commercialized exclusively healthcare agentic AI applications that empower authorized, credentialed users the ability to maximize the value of their data and expertise by generating more timely answers and analysis with all the necessary governance, security, and validity inherently necessary in applying AI science to healthcare."
This partnership continues an ongoing collaboration based on the shared vision of bridging the payer-provider gap through agentic AI, human oversight, and unified action.
"In collaborating with IKS Health over the past two years, our data science and engineering teams have created truly practical, readily deployable AI architected tools that we believe will deliver on the immense promise of this science," said Robert Dwyer, Ph.D., Chief Data Scientist of Certilytics.
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