XSOLIS

XSOLIS provides the Dragonfly platform for utilization management, applying AI to medical necessity determination, alongside physician advisor services and denial services. It is unusual in serving both payers and providers, which are ordinarily on opposite sides of the same decision.

Serving both is the notable structural choice. Utilization management is inherently adversarial: the provider argues a patient needs inpatient care, the payer assesses whether the criteria are met, and each employs clinicians to argue with the other's clinicians. A vendor supplying the same objective assessment to both parties changes what they are disagreeing about, because if both see the same evidence and score, the discussion moves from whose review is right to what the case actually shows.

Medical necessity is the specific determination at issue: not whether a treatment is appropriate but whether it meets criteria for a level of care, which drives what is paid. It is a clinical judgement with a financial consequence, which is exactly why it is disputed so often.

Physician advisor and denial services sit alongside the platform, reflecting that this work still needs clinicians. Software can score a case and prioritise attention, but a contested determination is ultimately argued between doctors.