About Claimalytics

AI that understands
pharmacy benefits.

We're building the AI workforce for the $500 billion pharmacy benefit management industry — purpose-built agents that speak PBM, deployed in your own cloud.

Our Mission

Make the collective knowledge of pharmacy benefit management instantly accessible, citation-grounded, and trustworthy — so PBM professionals can focus on decisions, not document searches.

Why PBM

A $500B industry,
ready for transformation.

Pharmacy benefit management sits at the intersection of healthcare, finance, and regulation. It's complex, document-heavy, and ripe for AI — but generic tools don't work here.

Fragmented by Design

PBM operations span formulary management, clinical review, pricing negotiation, claims processing, and regulatory compliance — each in a different system, format, and workflow.

Regulatory Tailwind

10–15 new federal reporting requirements in 2026. CMS Part D transparency rules. State PBM reform laws. The regulatory burden is accelerating — manual compliance can't keep up.

Generic AI Fails Here

PBM has specialized terminology, unique document formats (formularies, PA criteria, SPDs), and domain-specific workflows that general-purpose AI chatbots can't handle.

Massive Operational Leverage

A 10-person clinical team spends 25–42 hours daily on manual research. AI that actually works in PBM doesn't just save time — it multiplies team capacity.

Team

Built by people who understand
both AI and PBM.

We combine deep PBM domain expertise with enterprise AI engineering. Our team has built and scaled healthcare technology platforms.

CA

Coming Soon

Founding Team

We're assembling a team with deep experience in PBM operations, healthcare AI, and enterprise cloud infrastructure.

Get Started

Ready to see Claimalytics
in action?

We'll walk you through a live demo with your own documents.

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