Run your whole Medicare Advantage member experience on one platform.
Provider, pharmacy, facility, and drug search your members rely on. The provider-directory API CMS requires by 2027. The network-adequacy numbers you file with regulators. One white-label platform, live with three U.S. health plans and about 90,000 providers.
- FHIR R4 Plan-Net
- Section 508 / ADA
- HIPAA-aligned
- 1-week onboarding
Provider A, MD
AcceptingProvider B, DO
AcceptingProvider C, MD
Live in production with U.S. Medicare Advantage plans
Three problems health plans pay real money to fix.
Member search, network adequacy, and the FHIR directory all run on the same provider data. Most plans buy them as three systems that disagree with each other. We don't.
A missed network-adequacy threshold.
Fall short on coverage in even one county-and-specialty cell and it doesn't stay quiet. It can trigger an enrollment freeze, a corrective action plan, and the cost of remediating under deadline.
A directory CMS marks inaccurate.
Roughly half of MA directory entries fail CMS review. Inaccuracies draw corrective action plans and rising penalties — and starting with plan year 2027, your directory is public on Medicare Plan Finder, where members and competitors can see it.
The FHIR directory you don't have yet.
CMS now requires every MA plan to publish a machine-readable provider-directory API — the FHIR Plan-Net API, due by January 2027. Machine-readable means other systems can pull your directory automatically. Plans without one tend to learn it from a complaint, not their roadmap.
One platform. Six capabilities. One set of data.
Four ways your members find care, the FHIR directory API CMS requires, and the analytics that prove your network is adequate. All white-labeled to your plan, all running on the same provider data — so what members see, what your executives track, and what you file never disagree.
Members find the right doctor in two clicks.
They filter by what actually decides the choice — specialty, language, whether the doctor is taking new patients, and how far away they are — and get an answer in well under a second.
- Faceted sidebar, autocomplete, EN/ES localization
- 30-mile radius from ZIP, 2dsphere geo-indexed, distance-sorted
- Atomic UUID-tagged refresh — zero downtime during data updates
Provider A, MD
AcceptingProvider B, DO
AcceptingProvider C, MD
Three plans run on this every day.
Three U.S. Medicare Advantage plans and about 90,000 providers run on InsureLytix in production. Since our first launch in 2023, every plan that has gone live on the platform is still on it — through renewals, channel changes, and procurement transitions.
Medicare Advantage + D-SNP
Multi-state MA + D-SNP plan
Multi-state, Southeast U.S.
“One directory serving both MA and D-SNP members across the Southeast — no parallel system to maintain.”
Medicare Advantage
Regional Medicare Advantage plan
Southeast U.S. (multi-state)
“Provider directory and FHIR Plan-Net live on the plan's own domain, with no directory-accuracy audit findings reported.”
Medicare Advantage I-SNP
Provider-led MA I-SNP
Florida
“A provider-led group standing up its own MA plan — directory and compliance handled, so the team stays focused on care.”
Every requirement your regulator checks for, already on.
Each plan ships with the same compliance posture. There's no upgrade tier for being CMS-ready, because it's the default — the directory API, the adequacy numbers, accessibility, and audit logging are live from day one.
Provider-directory API
The FHIR Plan-Net API CMS requires, with bulk export and secure machine access. Live in production today.
Network adequacy
Coverage scored by county and specialty, weighted by real care patterns and the 65-plus population. Exports the HSD table you file in CMS's HPMS system.
Accessibility
Keyboard navigation, screen-reader support, semantic structure, and contrast checked across the whole member experience. VPAT available.
Audit & data safeguards
Every request logged with a trace ID, every plan's data isolated, encrypted in transit and at rest, with time-limited signed downloads.
Standards conformance
All seven Plan-Net resources implemented to the spec — not FHIR-flavored REST, actual FHIR.
The number on the CFO's dashboard and the number in your CMS filing are the same number.
Your network coverage is re-scored by county and specialty every time provider data changes, and the same scores export as the network-adequacy file you submit to CMS. Operations and compliance read off one set of numbers, so they can't drift apart.
- Coverage flagged by county and specialty — adequate, moderate, or critical
- Weighted by how patients actually use care, not a rigid 1-to-1 specialty match
- Based on the 65-and-over Medicare population, so the ratios stay honest
- Refreshes with zero downtime whenever your provider roster changes
Network adequacy · live
Endocrinology · Diabetes · Sample service area
Counties
6
in service area
Adequate
2
≤ 10 patients/provider
Critical
1
action required
County coverage · patients per provider
- County 017.2
- County 029.4
- County 0314.1
- County 0422.6
- County 0517.8
- County 0611.3
"Most plans inherit three systems that argue with each other — the directory, the adequacy filing, the member site. We made a different call: put all three on one set of provider data. Members, executives, and CMS end up looking at the same truth. That decision is the whole company."
— Amandeep Singh, founder, InsureLytix Inc.
InsureLytix, in plain terms.
InsureLytix is white-label software for U.S. Medicare Advantage health plans. It runs the member-facing provider, pharmacy, facility, and drug search; the FHIR provider-directory API that CMS requires; and network-adequacy analytics — on one platform, branded as the plan. It's live in production with three U.S. MA plans, covering about 90,000 providers.
Ready when you are
Bring this platform to your plan.
If your provider data is ready, a new white-labeled tenant goes live in about a week. Compliance certification runs alongside it, not as a later phase.