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Genzeon Payer Intelligence Suite - Fabric IQ on Microsoft Fabric

Genzeon

Member, claims, and clinical data scattered across 15+ siloed systems. Prior auth, fraud review, and outreach still running on slow manual work. Star Ratings and HEDIS demanding accurate, always-on reporting.

Genzeon's Payer Intelligence Suite — powered by Microsoft Fabric IQ — changes that.

Fabric IQ is the semantic intelligence layer for your existing payer data estate. It sits on top of Facets, HealthEdge, TriZetto, and more — adding one governed meaning across your data. Nothing moves; Fabric IQ adds the intelligence layer on top.

At its core, Fabric IQ delivers six capabilities working together as a shared brain for your payer organization:

Six Core Components of Fabric IQ:

  • Ontology — one definition for every payer entity, enforced everywhere
  • Graph — maps relationships to surface hidden fraud and care gaps
  • Data Agent — plain-English answers drawn from live, governed payer data
  • Operations Agent — always-on monitoring with real-time alerts, 24/7
  • Planning — live MLR and Star Rating forecasts, not stale spreadsheets
  • Power BI Semantic Model — one certified model, zero conflicting numbers

Built Across the Payer Value Chain:

  • Member 360 — from fragmented records to a single intelligent member view
  • Prior Authorization — from days of delays to minutes of intelligent auto-approval
  • Risk Adjustment — capture every diagnosis, close every coding gap
  • Network Optimization — build a smarter, higher-value provider network
  • HEDIS / Star Ratings — from year-end scramble to year-round quality excellence
  • Fraud, Waste & Abuse — catch suspicious activity before payment leaves the door

FORGE — Fabric IQ Accelerator:

FORGE (Fabric Ontology Readiness Gateway for Enterprise Payers) is Genzeon's Fabric IQ accelerator — six purpose-built components that turn months of ontology design into weeks. Ontology entities are coded to FHIR R4, ICD-10, CPT & CMS data standards — no custom mapping required:

  • Payer Ontology Library — pre-built definitions for Member, Claim, Provider & more
  • Source Connector Pack — plug-and-play connectors for Facets, HealthEdge, TriZetto, EDI 837/835
  • Agent Template Manager — pre-tested prompts for care managers & compliance teams
  • Compliance & Governance Pack — HIPAA/HITRUST configurations built in from day one
  • Power BI Semantic Model Accelerator — ontology-aligned dashboards ready in days
  • Data Agent Intelligence Pack — curated context behind governed, accurate answers

Fabric IQ QuickStart — 6 Weeks:

Phases: Scope & Assess (Weeks 1–2) → Build & Configure (Weeks 3–4) → Test & Transition (Weeks 5–6)

QuickStart deliverables:

  • Fabric IQ workspace enabled on your Azure tenant
  • Ontology built for one selected use case
  • Up to 3 data sources connected via OneLake
  • 1 Data Agent + 1 Operations Agent workflow configured
  • Graph visualization, demo walkthrough & knowledge transition

Projected Business Impact:

  • 60%* reduction in fraud investigation time
  • 85%* of prior auths auto-processed
  • $10M+* potential annual savings

*Modeled on Fabric IQ's FORGE architecture. Actual results may vary.

Why Genzeon for Fabric IQ:

  • Deep Payer Domain DNA — 12+ years and 75+ healthcare clients; we don't learn your domain, we bring it
  • Full Fabric Stack Expertise — across Fabric IQ, OneLake, Power BI, Azure ML & Microsoft Purview
  • End-to-End Ownership — one partner from data readiness through managed services; no hand-offs

Investment: $50K – $60K | Duration: 6 Weeks | Azure Tenant Required | Complexity-Based Pricing

De un vistazo

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