6 Degrees Health

What 6 Degrees Health does

6 Degrees Health, operating as 6 Degrees Health Dx, LLC, is a U.S. healthcare payment integrity and cost containment company founded in 2011, headquartered in Portland, Oregon with operations in Amarillo, Texas. The company serves health plans, insurance carriers, and self-funded employers through an integrated suite of services spanning Clean Claim Reviews (itemized bill reviews for high-dollar inpatient hospital claims), Data Mining & Recovery (overpayment identification and recovery), Custom Out-of-Network Solutions, Reference-Based Pricing health plans, and Transplant and Specialty care management.

The technology backbone is the MediVI platform—an AI-enabled analytics and workflow application hosted on Google Cloud that provides provider search, claims benchmarking, code research, case submission, and member click-to-call functionality across web and mobile. Clinical review is delivered through the Fennec platform with proprietary rules, supported by in-house registered nurses, NICU specialists, and a Chief Medical Officer. Add-on modules include MediShield (legal representation for No Surprises Act disputes) and MediCash (prepay solution). Security and compliance posture includes SOC 2 Type II certification (December 2023) and HITRUST r2 certification (March 2025).

Revenue is generated through professional services and managed services engagements with quote-based, non-publicly-disclosed pricing. Distribution combines direct enterprise field sales—targeting C-Suite, VP of HR, and VP of Payment Integrity buyers at health plans and large self-funded employers—with channel partnerships through benefits advisors, insurance brokers, and TPAs. The company reports customer outcomes including 20-40% savings versus traditional PPO plans for reference-based pricing, $100M+ in savings for a national payer on itemized bill review, 100x ROI on specialized solutions, and 80% recovery rates on validated overpayments. Everest Group recognized the company as a Top 10 Payment Integrity Market Innovator in September 2025, and it was named to the 2025 Inc. 5000 list of America's fastest-growing private companies.

Name

6 Degrees Health

Legal name

6 Degrees Health Dx, LLC

Website

https://6degreeshealth.com

Company type

Private

Founded year

2011

Operating status

Operating

Headcount range

51–100 employees

Short description

6 Degrees Health is a U.S. healthcare payment integrity and cost containment provider serving health plans, insurance carriers, and self-funded employers with Clean Claim Reviews, Data Mining & Recovery, Reference-Based Pricing, and the MediVI analytics platform.

Ownership category

akta.pro rank

Product category

Healthcare Payment Integrity

NAICS

Health and Welfare Funds (525120)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Eligibility & Benefits Verification (HLACACAD)

akta.pro secondary industry

Payer-Provider Data Exchange (X12, prior auth, claims/clinical attachment) (HLACABAK)

Keywords

• Healthcare payment integrity
• Claims review services
• Reference-based pricing
• Overpayment recovery
• Out-of-network solutions

Headquarters

HQ city

Hillsboro

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Technology or R&D, Operations, Marketing or Sales, Infrastructure

Revenue model

1. Payment Integrity Services: Clean Claim Reviews (itemized bill reviews) for high-dollar inpatient hospital claims, data mining and recovery services for identifying and recovering overpayments, and coordination of benefits (COB) and subrogation services for Medicare Supplemental carriers. Services delivered through prospective and retrospective solutions.
2. Reference-Based Pricing Solutions: Employer health plan solutions replacing traditional network-based plans with reference-based pricing. Includes facility and professional claims repricing, provider contracting, and integrated cost containment services. Delivers 20-40% savings compared to traditional PPO plans.
3. Out-of-Network Solutions: Customized out-of-network claim solutions including repricing, No Surprises Act support, Independent Dispute Resolution (IDR) assistance, and member bill navigation and negotiation services.

Pricing tiers

Go-to-market motion2 records

Distribution channels3 records

Marketing channels5 records

Core offering

6 Degrees Health delivers healthcare payment integrity and cost-containment services to health plans, self-funded employers, and benefits intermediaries. Its core offerings include Clean Claim Reviews (itemized bill review of high-dollar inpatient hospital claims), Data Mining & Recovery (overpayment identification and recovery), Custom Out-of-Network Solutions, Reference-Based Pricing plans, and Transplant and Specialty services, all powered by its proprietary MediVI analytics platform and Fennec claim review platform hosted on Google Cloud.

Product overview

6 Degrees Health is a healthcare cost containment company offering an integrated platform of payment integrity and employer solutions. The core product portfolio consists of Clean Claim Reviews (powered by Fennec platform), Data Mining & Recovery, Custom Out-of-Network Solutions, Reference-Based Pricing, and Transplant/Specialty services. Central to the offering is the MediVI platform—an AI-driven analytics and workflow platform that powers provider search, benchmarking, code research, case submission, and member support across all solutions. Add-on modules include MediShield (legal support), MediCash (prepay solution), and MediVI Mobile App. The Fireside Chats webinar series provides educational content supporting the product ecosystem.

Differentiator

Problem solved

Functional benefit

Brands

• MediVI: Healthcare analytics platform powered by advanced analytics and AI, offering mobile and desktop applications for provider search, case submission, and cost insights. Also includes MediShield (legal support), MediCash (prepay solution), and Professional Plus (physician wrap services).

Products and services

• Clean Claim Reviews Itemized bill review (IBR) component of the Payment Integrity program providing detailed clinical reviews of inpatient hospital claims, powered by the Fennec platform, with full support through disputes and appeals. Targeted at health plans and self-funded employers.
• Data Mining & Recovery Overpayment identification and recovery solution that combines advanced analytics with a proprietary library of overpayment concepts to examine claims payment data and recover validated overpayments for health plans. Includes distinct expertise in small-dollar balances.
• Custom Out-of-Network Solutions Tailored out-of-network claim solutions that allow customizable repricing levels to drive savings while providing a full suite of member services, utilizing MediVI technology for claims analysis. Includes No Surprises Act and Independent Dispute Resolution (IDR) support and member bill navigation.
• Reference-Based Pricing Health plan pricing solution using reference-based pricing and preferred provider contract solutions for self-funded employers, delivering 20-40% savings compared to traditional PPO plans. Includes facility and professional claims repricing, provider contracting, and integrated cost-containment services, powered by the MediVI platform.
• Transplant and Specialty Specialized solutions for transplant and specialty care that leverage nationwide provider contracts, specialized clinical and negotiation expertise, and 6 Degrees Health's cost-containment infrastructure to deliver significant savings for self-funded employers and health plans.
• MediVI Platform Industry-leading healthcare data platform offering advanced analytics and AI-driven mobile and desktop applications for provider search, claims benchmarking, code research, case submission, and member click-to-call functionality. Available to clients, benefits advisors, and members.

Quantifiable outcome

• 20-40% lower healthcare costs vs traditional PPO plans with reference-based pricing
• +6 more outcomes

Named customers2 records

Segments3 records

Ideal customer profiles3 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability4 records

Feature6 records

Scale indicators13 records

Recent moves6 records

Expansion highlights5 records

Direct peers

• Zelis: Zelis is a healthcare cost management and payments platform offering claim cost containment, out-of-network solutions, and reference-based pricing services. It is the closest direct competitor to 6 Degrees Health across payment integrity, OON repricing, and RBP for payers and self-funded employers.
• MultiPlan: MultiPlan is a leading provider of healthcare cost management solutions, including PPO networks, PBM-related services, and payment integrity through its Discovery, Zelis-adjacent, and data mining offerings. It competes directly with 6 Degrees in OON repricing, RBP, and claim cost containment for payers and large employers.
• Cotiviti: Cotiviti provides payment accuracy, claim editing, and recovery solutions to health plans and retailers. It is a direct peer in payment integrity and overpayment recovery, with comparable analytics-driven claim review capabilities.
• Lyric (formerly ClaimsXten / Lyric): Lyric (formerly ClaimsXten) provides claim editing, payment integrity, and AI-powered clinical validation for payers. It is a direct peer in pre-pay and post-pay claim review, with overlapping Fennec-style rule-based claim auditing capabilities.

Broad incumbents

• Optum (UnitedHealth Group): Optum is the healthcare services arm of UnitedHealth Group, offering payment integrity, RCM, analytics, and care management at massive scale. It is a broad incumbent competing across every 6 Degrees Health product line, with the advantage of vertical integration with a major payer.
• Change Healthcare (Optum Insight): Change Healthcare, now part of Optum, provides revenue cycle management, claims editing, and payment integrity solutions to payers and providers. It overlaps with 6 Degrees in claim analytics, eligibility/benefits verification, and overpayment identification.

Emerging players

• Health Catalyst: Health Catalyst is a healthcare data and analytics platform serving providers and payers with cost, quality, and operational analytics. It overlaps with MediVI's analytics capabilities and is an emerging player in payer-side cost containment.
• Premier Inc. Premier Inc. provides healthcare cost containment, supply chain, and performance improvement services to hospitals and health systems. Its payment integrity and analytics offerings create partial overlap with 6 Degrees' employer-focused solutions.
• Clarify Health: Clarify Health offers an analytics platform combining claims, clinical, and social data for value-based care and cost analysis. It overlaps with MediVI's benchmarking and analytics use cases, serving payers and providers with cost and quality insights.

Others

• Datavant: Datavant is a health data exchange and interoperability platform that connects payer, provider, and life sciences data. It is an adjacent/ecosystem player rather than a direct competitor, but shares the data infrastructure and analytics theme underlying 6 Degrees' MediVI platform.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks5 records

Key highlights6 records

Customer concentration

• Xx.com/6degreeshealth
• Facebookfacebook.com/6DegreesHealth
• LinkedInlinkedin.com/company/6-degrees-health-inc-

Compliance2 records

Revenue estimate

Valuation estimate

Number of profiles

Profiles10 records

Funding overview

Funding rounds1 record

Investors1 record

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about 6 Degrees Health