Babel Health
Babel Health is a cloud-based encounter data management platform that pre-validates, corrects, and submits risk adjustment data for U.S. health plans serving Medicare Advantage, Medicaid, CHIP, ACA, and APCD programs; founded 2015 and acquired by Veradigm in 2022.
- Company typePrivate
- Founded2015
- HeadquartersPittsburgh, United States
- Headcount1–10
- GTM typeB2B
- OfferingSoftware
What Babel Health does
Babel Health is a cloud-based encounter data management platform that helps regional and national health plans submit, validate, and reconcile risk adjustment data for U.S. government-sponsored healthcare programs, including Medicare Advantage, Managed Medicaid, CHIP, ACA/EDGE, and APCD. The platform is built around a proprietary ETL engine that pre-validates 100% of submission data against CMS and state requirements, assigns Hierarchical Condition Category (HCC) codes, determines risk-eligibility during data upload, and supports configurable online error correction, re-submission workflows, and multi-format file import. A 360-degree data view provides visibility from claims intake through response file processing, and risk revenue prioritization is layered on top to focus correction effort on highest-impact encounters. The product operates in a CMS-approved, HIPAA-compliant environment.
The company monetizes via a fully managed SaaS subscription model sold through an enterprise field sales motion to health plans, with quote-based annual contracts (no public pricing) and conversion through 'Request a Proposal' and 'Contact Us' channels. Go-to-market is supported by content marketing, webinars, podcasts, and thought leadership targeting value-based care, real-world data, and AI in healthcare topics, all funneled to a sales-assisted closing motion. Babel Health was founded in 2015, raised approximately $8.95M across three funding rounds (2017-2019) led by Draper Triangle, and was acquired by Veradigm (formerly Allscripts) in 2022, after which the product was rebranded Veradigm Comprehensive Submissions and integrated into the Veradigm Payer Analytics portfolio alongside risk adjustment analytics, quality management, and provider engagement offerings. As of the most recent data, Babel Health operates with 1-10 employees as a lean product line within the publicly traded Veradigm (NASDAQ: VRD).
Babel Health firmographics
Firmographics- Name
- Babel Health
- Legal name
- Babel Health (now part of Veradigm LLC)
- Website
- https://babelhealth.com
- Company type
- Private
- Founded year
- 2015
- Operating status
- Acquired
- Headcount range
- 1–10 employees
- Short description
- Babel Health is a cloud-based encounter data management platform that pre-validates, corrects, and submits risk adjustment data for U.S. health plans serving Medicare Advantage, Medicaid, CHIP, ACA, and APCD programs; founded 2015 and acquired by Veradigm in 2022.
- Ownership category
- akta.pro rank
Babel Health industry classification
Industry- Product category
- Healthcare Risk Adjustment Software
- NAICS
- Computing Infrastructure Providers, Data Processing, Web Hosting, and Related Services (518)
- SIC
- Services-Prepackaged Software (7372), Services-Computer Programming, Data Processing, Etc. (7370), Services-Computer Processing & Data Preparation (7374)
- akta.pro primary industry
- Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)
- akta.pro secondary industries
- Clinical & Claims Data Integration for Population Health (payer-provider data fusion) (HLACAHAI), Data Engineering, Integration & ETL/ELT Services (BPAEAHAB)
Keywords
Where Babel Health is headquartered
LocationHeadquarters
- HQ city
- Pittsburgh
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Babel Health business model
Business model- GTM type
- B2B
- Offering type
- Software
- Cost components
- Technology or R&D, Personnel, Operations, Marketing or Sales, Infrastructure
Revenue model
- SaaS Platform Subscription: Fully managed, cloud-based encounter data management platform delivered as subscription service to health plans. Revenue generated through software-as-a-service fees for access to the Comprehensive Submissions platform which handles encounter data submission for government-sponsored programs including Medicare Advantage, Managed Medicaid, CHIP, ACA/EDGE and APCD.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Annual | Enterprise subscription model - quote-based pricing for health plans |
Go-to-market motion1 record
Distribution channels1 record
Marketing channels5 records
Babel Health product offering
Product offeringCore offering
Babel Health provides a fully managed, cloud-based encounter data management platform that streamlines and improves submissions and vendor management for government-sponsored healthcare programs. The platform uses proprietary ETL tooling to pre-validate 100% of submission data, assign HCC and risk-eligibility codes, and support integrated online error correction across Medicare Advantage, Managed Medicaid, CHIP, ACA/EDGE, and APCD programs. It is now offered as Veradigm Comprehensive Submissions within the Veradigm Payer Analytics portfolio.
Product overview
Babel Health operated as a specialized risk adjustment and data submissions solution provider before being acquired by Veradigm in 2022. The core product, now known as Veradigm Comprehensive Submissions (formerly Reconcili8 and Babel Health), is a cloud-based encounter data management platform designed for health plans. It provides end-to-end submission and reconciliation processes that ensure regulatory compliance and mitigate revenue leakage, assigning HCC codes and determining risk-eligibility for Medicare Advantage, Managed Medicaid, and other government programs.
Differentiator
Problem solved
Functional benefit
Brands
- Veradigm Payer Analytics: Portfolio including former Pulse8 solutions delivering complete visibility into Risk Adjustment, Quality Management, and Pharmacy programs.
- Veradigm Comprehensive Submissions
Products and services
- Veradigm Comprehensive Submissions (formerly Babel Health/Reconcili8) Fully managed, cloud-based encounter data management platform that streamlines and improves submissions and vendor management for government-sponsored healthcare programs including Medicare Advantage, Managed Medicaid, (S)CHIP, ACA/EDGE and APCD. Designed for health plans and payers that need to validate 100% of encounter data, assign HCC and risk-eligibility, and correct errors prior to regulatory submission.
Quantifiable outcome
- Pre-validates 100% of submission data prior to submission
- +2 more outcomes
Companies that use Babel Health
Customer profileSegments1 record
Ideal customer profiles1 record
Babel Health technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Feature6 records
Babel Health partnerships and signals
Strategic signalRecent moves6 records
Expansion highlights4 records
Babel Health competitors and assessment
Company assessmentDirect peers
- Inovalon: Inovalon provides risk adjustment, quality, and payer analytics to health plans, including encounter data validation and HCC analytics. Directly comparable to Babel Health's risk-adjustment submission and HCC assignment capabilities for government program payers.
- Cotiviti: Cotiviti (formed via Verscend merger) delivers payment accuracy, risk adjustment, and quality analytics to health plans. Competes head-to-head with Babel Health on encounter submission accuracy, RADV audit support, and HCC capture.
- Edifecs: Edifecs provides healthcare data interoperability and X12 EDI management solutions for payers and providers, including encounter/claims submission workflows. Overlaps with Babel Health's X12-based pre-validation and submission tooling.
- Availity: Availity operates a payer-provider collaboration and data exchange platform, including clinical data submission and risk-adjustment-adjacent workflows (incorporating Pareto Intelligence). Comparable to Babel Health's pre-validation and submission lifecycle focus.
- Cedar Gate Technologies: Cedar Gate provides value-based care analytics, including risk adjustment and payer-provider performance solutions. Comparable to Babel Health's HCC and risk-eligibility prioritization for government program payers.
Broad incumbents
- Optum (UnitedHealth Group): Optum offers risk adjustment analytics, clearinghouse services (formerly Change Healthcare), and end-to-end payer data solutions. A broad incumbent that competes with Babel Health across risk adjustment, encounter submission, and payer analytics.
- Change Healthcare (now part of Optum): Change Healthcare operated one of the largest healthcare clearinghouses and payer data exchange networks before Optum acquisition. Comparable to Babel Health in X12 encounter transmission and validation, though at vastly greater scale.
- HealthEdge: HealthEdge provides a core payer technology platform (claims, benefits, provider data) used by health plans. Adjacent to Babel Health because its claims-processing foundation overlaps with encounter data lifecycle management.
Emerging players
- SCIO Health Analytics (now emids): SCIO Health Analytics provided risk adjustment and payer analytics services before being acquired by emids. Comparable to Babel Health on encounter data analytics, HCC capture, and audit support for health plans.
- Persivia: Persivia delivers population health and risk adjustment analytics for payers and providers, including HCC capture and submission validation workflows. Comparable to Babel Health's HCC assignment and encounter data management focus.
Market position
Strengths5 records
Weaknesses5 records
Competitive moat4 records
Key risks6 records
Key highlights6 records
Customer concentration
Babel Health social profiles
Digital presenceBabel Health compliance and trust
Trust signalCompliance2 records
Babel Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Babel Health leadership team
Management profileNumber of profiles
Profiles4 records
Babel Health funding detail
Funding detailFunding overview
Funding rounds3 records
Investors3 records
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Babel Health M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Babel Health
What does Babel Health do?
Babel Health provides a fully managed, cloud-based encounter data management platform that streamlines and improves submissions and vendor management for government-sponsored healthcare programs. The platform uses proprietary ETL tooling to pre-validate 100% of submission data, assign HCC and risk-eligibility codes, and support integrated online error correction across Medicare Advantage, Managed Medicaid, CHIP, ACA/EDGE, and APCD programs. It is now offered as Veradigm Comprehensive Submissions within the Veradigm Payer Analytics portfolio.
Is Babel Health a public or private company?
Babel Health is a private company. It is classified as corporate owned and is currently acquired.
When was Babel Health founded?
Babel Health was founded in 2015. It employs 1 to 10 people.
Where is Babel Health based?
Babel Health is headquartered in Pittsburgh, United States, in the North America region.
How does Babel Health make money?
One revenue line is on record: saaS Platform Subscription.
Who are Babel Health's main competitors?
Direct peers on record are Inovalon, Cotiviti, Edifecs, Availity and Cedar Gate Technologies. Broad incumbents are Optum (UnitedHealth Group), Change Healthcare (now part of Optum) and HealthEdge. Emerging players are SCIO Health Analytics (now emids) and Persivia.
Does Babel Health have an API?
No public API is recorded for Babel Health.
What industry is Babel Health in?
Babel Health's product category is Healthcare Risk Adjustment Software. Its primary akta.pro industry code is HLACABAK, Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment), with a secondary code of HLACAHAI, Clinical & Claims Data Integration for Population Health (payer-provider data fusion). Its NAICS code is 518 and its SIC code is 7372.