Discovery Health Partners

The firm primarily serves healthcare payer customers, including those in the Medicare Advantage, Medicaid, and commercial markets. At the time of its acquisition, the company worked with about 80 healthcare payers, including nine of the ten largest in the United States. The business model is centered on deploying a data-driven technology platform, sophisticated analytics, and deep healthcare expertise to address challenges such as regulatory changes, complex reimbursement models, and poor data quality that lead to administrative waste. Its services aim to help clients improve operational efficiency and achieve financial integrity.

The company's suite of solutions encompasses premium restoration, coordination of benefits, data mining, subrogation, and clinical audits. These offerings are designed to help healthcare payers improve the integrity of their payment and revenue processes, spanning the entire claims lifecycle to ensure the legitimacy of payment requests and premium collections. Over the years, Discovery Health Partners expanded its capabilities through strategic acquisitions, including HealthMind in 2019 to add secondary code edit and provider audit functionalities, and Consova's payment integrity business in 2020 to bolster its data mining expertise.