Exponential AI
Accelerating the Process of Building and Implementing AI Solutions

The healthcare industry is witnessing a steady shift toward consumerization, bringing more focus to value-based care and improved health outcomes. As a result, today's healthcare leaders actively seek cutting-edge AI solutions to address various stakeholders' challenges and augment care provision. However, AI adoption in healthcare comes with its fair share of challenges. Most organizations either contract or purchase services from vendors or specific point solutions providers. In such cases, vendors own the data, and the intelligence built using the data. That's why it becomes a cumbersome task for entities to make real-time decisions according to their specific needs. Also, the idea of democratizing intelligence using AI is not necessarily applicable in healthcare as the healthcare member population differs based on geography. To this end, healthcare entities need tools and techniques to go deeper into the market data and healthcare information, identify insights that are more specific and relevant to them, and apply those learnings into day-to-day workflows.
Enter Exponential AI. The company accelerates enterprise digital transformations with AI. Its Enso platform enables rapid development, training, deployment, and scaling of enterprise AI solutions. Multiple Fortune 500s across healthcare, financial services, and retail use it to automate complex processes.

In an interview with us, Nikhil Mendhi, the COO of Exponential AI, shares insights on how they drive the adoption of decision intelligence solutions in healthcare through their flexible AI platform.

Please give us a brief overview of Exponential AI.

We accelerate the process of building, deploying, and scaling enterprise-grade AI solutions to help clients make quick evidence-based decisions and automate complex processes. Our team consists of experts who have years of experience in the healthcare industry. They understand the challenges that clients come across when it comes to AI adoption. This enables us to serve clients better.

Could you elaborate on your platform Enso and its different features and functionalities? .

Enso is an artificial intelligence platform that is architected to deploy decision agents. These agents are a collection of algorithms designed for specific healthcare functions such as processing payment claims, interpreting the lab data, and analyzing the impact of specific high-dollar claims on ROI. Clients use Enso and its prebuilt decision agents to construct an end-to-end solution to meet their business needs and market demands. They can build their own AI solutions in a low code/no-code environment using our army of digital agents. This way, our unique platform accelerates the adoption of AI solutions in the healthcare sector.

The algorithms and agents of Enso work in the background. They learn from human behaviour. By identifying trends within that behaviour, they automate repetitive tasks. This allows clients to dedicate more time to tasks that need attention and have predictable outcomes with increased productivity. Since these agents and algorithms work in the background, they do not replace any existing workflow or system. They are integrated into data flows and translate learnings from data, decisions, and feedback into pre-emptive actions in a live production environment. This allows client teams to handle complex tasks more efficiently without disrupting their current process.

What is the methodology that you follow while delivering your solution?

Apart from providing technology, we also train clients and their partners in building solutions using agents on our platform. Enso is built on highly flexible architecture and can easily integrate into the client environment within weeks. More importantly, clients can build incremental solutions by reusing decision agents in adjacent functions or processes.

Once Enso is deployed, it does not take more than two to three weeks to get started. And then any incremental solution takes anywhere between two to three months to be production-ready in the client environment. The trust the first solution wins enables clients to add more solutions by reusing agents already available in Enso. For example, a client adopted our platform to build a solution for healthcare medical claims. We trained their team on how to use Enso for creating their own solutions. The client developed more than 20 solutions within a year, spanning claims, utilization management, procurement, and payment integrity. All these solutions collectively saved approximately $15 billion annually. Currently, more than 40 individuals are actively building solutions. The client realized that their speed to build and implement solutions dramatically increased after adopting Enso.

Please tell us about the different solutions that you deliver.

Our Audit solution enables payers to scale their audit capability from a sample-based audit to a 100 percent claims audit using AI algorithms. It also allows them to move from postpay audit to prepay audit and reduce revenue leakage. More importantly, the learnings that are available through audit can be applied to provider environments. This increases the accuracy of claims sent by providers to the Plan. It helps in saving a significant amount of money by improving accuracy and reducing administrative waste.

Secondly, we have a Payment Integrity suite of solutions that focuses on reducing waste and fraud abuse in the healthcare environment. Our Decision Agent-driven PI solutions continually learn from data, decisions and feedback to offer new insights on potential savings across the prepay and postpay Payment Integrity Value Chain. We help clients predict savings and reduce a huge amount of administrative and clinical waste from the healthcare system.

How has the journey been so far for Exponential AI, and what does the future hold for the company?

It's been almost five years since we laid the foundation of Exponential AI. Over the years, we have continuously grown, and our clientele has doubled in size. The adoption of our solutions has significantly increased during the pandemic. Moving forward, we plan to continually enhance Enso's capabilities by implementing more robust features on the platform. This will help us align better with client's expectations while accelerating the adoption of healthcare AI solutions within any client environment.