Certilytics and IKS Health Expand Agentic AI Partnership to Bridge the Payer-Provider Gap and Transform Healthcare Workflows
AI / Machine Learning | 4 min read
Certilytics Inc. (a leading innovator in AI-driven healthcare intelligence; established agentic AI solutions for healthcare since 2014), has announced the expansion of its strategic collaboration with IKS Health (founded 2006; global leader in care enablement solutions; listed on NSE: IKS and BSE: 544309; recognised by Black Book as the top provider of AI-driven RCM services for two consecutive years, by KLAS for performance and client satisfaction, and by Google Cloud with the 2025 DORA Award for "Augmenting Human Expertise with AI"). Through this enhanced partnership, IKS Health will license and integrate Certilytics' BrainstormAI® Studio and CertHLM™ (Certilytics Healthcare Language Model) into its Health Agentic Care Enablement Platform — creating an ecosystem in which AI agents manage complex tasks such as prior authorisation and patient outreach under continuous expert-in-the-loop human clinical oversight. The collaboration is designed to bridge the historic divide between payers and providers by turning predictive insights into safe, coordinated clinical actions.
"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. By expanding our partnership, we are building a bridge between payer rules and provider workflows. We are combining Certilytics' deep predictive brain with our agentic hands while ensuring our proven human-in-the-loop model remains the ultimate safeguard for clinical and administrative accuracy."
— Sachin K. Gupta, Founder and CEO, IKS Health
Three Strategic Workflows — Prior Authorisation, Member Engagement, and Price Transparency
The collaboration centres on three strategic healthcare workflows. First, prior authorisation transparency — moving beyond traditional "rules of thumb" to real-time, payer-specific rule sets, with more than 70% of all prior authorisation workflows handled autonomously, significantly reducing provider burden while accelerating patient care delivery. Second, member engagement — scaling proactive outreach beyond simple notifications to create meaningful clinical connections that actively close care gaps and improve patient outcomes. Third, consumer price transparency — giving patients and employers accurate financial outlooks at the point of care rather than waiting weeks for cost information, enabling informed healthcare decisions. The integration of BrainstormAI® Studio — with its library of more than 1,000 predictive models — and CertHLM™ — debuted at HIMSS26 in Las Vegas as an agentic, AI-powered interface delivering instant, explainable intelligence — powers these workflows through IKS Health's Agentic Care Enablement Platform.
"We are excited to partner with IKS Health to help health plans, payers, plan sponsors and providers take advantage of opportunities generative AI can offer. Since 2014, Certilytics has developed and commercialised agentic AI solutions purpose-built for healthcare — enabling trusted, real-time analysis while meeting the industry's highest standards for security, governance and validity."
— Andrew Ottum, Executive Vice President, Certilytics
Key Takeaways
- • Certilytics Inc. (AI-driven healthcare intelligence; agentic AI solutions for healthcare since 2014; CEO Merle A. Ryland; Chief Data Scientist Robert Dwyer PhD; EVP Andrew Ottum) and IKS Health (founded 2006; Founder and CEO Sachin K. Gupta; global leader in care enablement; NSE: IKS / BSE: 544309; Black Book top AI-driven RCM two consecutive years; KLAS performance; Google Cloud 2025 DORA Award "Augmenting Human Expertise with AI") have expanded their strategic partnership — announced 21 April 2026. Built on two years of prior collaboration.
- • Integration: IKS Health licenses and integrates Certilytics' BrainstormAI® Studio and CertHLM™ (Certilytics Healthcare Language Model) into its Health Agentic Care Enablement Platform. BrainstormAI® Studio: healthcare-focused ML and predictive model deployment platform with 1,000+ predictive models — empowers proactive, safe, and coordinated clinical actions between payers and providers. CertHLM™: agentic AI-powered interface delivering instant, explainable intelligence — debuted at HIMSS26 in Las Vegas; streamlines workflows and delivers decision-support guidance.
- • Three strategic workflows: (1) Prior authorisation transparency — real-time payer-specific rule sets replacing generalised "rules of thumb"; 70%+ of prior authorisation workflows handled autonomously, reducing provider burden and accelerating patient care. (2) Member engagement — proactive clinical outreach that closes care gaps rather than sending simple notifications. (3) Consumer price transparency — patients and employers receive accurate financial outlooks at the point of care rather than weeks later.
- • The human-in-the-loop model: the partnership's defining design principle is expert-in-the-loop oversight — AI agents manage complex tasks (prior authorisation, patient outreach) under the continuous oversight of human clinical expertise. Sachin K. Gupta's framing is explicit: the human-in-the-loop model "remains the ultimate safeguard for clinical and administrative accuracy." This positions the integration as moving from systems of intelligence (identifying risks) to systems of action (executing work) — with governance embedded at every step.
- • IKS Health broader platform context: Care Enablement platform integrates AI, agentic workflows, and human expertise across the care journey for health systems, physician groups, and specialty practices across the US. MyCareHub™ — IKS Health's agentic patient engagement platform integrated with Epic and available in the Epic Connection Hub — uses a multi-agent behavioural algorithm for adaptive, autonomous, patient-first engagement (debuted at AMGA April 2026). Certilytics platform: BrainstormAI® and CertHLM™ help health plans, employers, and provider networks identify cost savings and improved outcomes.