About
We are not a software company that learned healthcare.
We are healthcare professionals who built software because the tools we needed did not exist. Our founders bring an unusual combination: the clinical instincts to know what documentation matters at the point of care, and the financial fluency to know exactly what that documentation is worth on a claim. That intersection, where care decisions become cost outcomes, is the problem Intelyra was built to solve.
The founding story
Built from years inside the systems, not from market research about them.
Intelyra was founded by healthcare professionals who spent careers inside the systems that need fixing, not consulting from the outside. Our founders have sat with Quality Directors the night before QPP submission, stood inside CDI departments where $2 million in DRG shift was left on the table because physician response rates fell below 70%, and worked through prior authorization workflows where the difference between an approval and a denial was one missing lab value that the payer required but never communicated.
We built Intelyra because we knew exactly what tool we needed and could not find it in the market. The platform is not a theoretical answer to a studied problem. It is the tool we would have used ourselves.
The platform is shaped by years inside the systems it now connects. The prior authorization workflow reflects how authorization nurses actually work. The CDI workbench reflects how clinical documentation specialists think through a physician query. The ACO quality calculator reflects the specific anxiety of a Quality Director at 10pm on March 28th, three days before QPP submission.
This depth of operational knowledge is not a feature of Intelyra. It is the foundation.
What we bring
Three categories of depth no consulting firm can replicate.
Clinical depth
Quality measure methodology, MIPS, APP Plus, flat benchmarks, HEDIS. CDI query methodology and DRG shift analysis. Home health OASIS and PDGM payment logic. Prior authorization coverage criteria across NCD, LCD, and commercial payer policy.
Financial depth
RCM middleware architecture, X12 EDI, FHIR R4, 278/835/277 transactions. Denial reason code taxonomy and appeal strategy by payer. QPP submission mechanics. Shared savings calculation and quality performance standard methodology.
Regulatory depth
CMS-0057-F implementation requirements and timeline. Da Vinci CRD/DTR/PAS implementation guides. HHVBP national expansion. CY2026 rate-setting mechanics. eCQM transition requirements.
Long-horizon
Intelyra exists because the intelligence that determines whether care is approved, paid for, and delivered should not be hoarded by well-resourced hospitals.
That is the long-horizon answer to why we exist. The short-horizon answer, what we will build for you in the next 90 days, lives on the platform page.