concert genetics (formerly nextgxdx, inc.)

What concert genetics (formerly nextgxdx, inc.) does

Concert Genetics (formerly NextGxDx, Inc.) is a healthcare technology company founded in 2010 that provides a cloud-based precision health payment accuracy platform. The company serves health plans, hospitals and health systems, diagnostic laboratories, and technology partners with software, data, and services designed to harmonize clinical guidelines, coding, evidence, policy, and payment rules for diagnostic and precision therapy services. The company was recently acquired by Lyric, a strategic operating company seeking to advance healthcare decision intelligence and expand the Lyric42 Platform.

The platform's core technology is a proprietary Coding Engine that generates machine-readable clinical guidelines and links them to services and coding rules, delivering real-time intelligence directly into clinical and financial workflows for automated claim editing and payment decisions. Notable proprietary components include the GTU® Test Identifier (a registered trademark for genetic test classification) and a Real-time Intelligence Platform that automates policy enforcement across multiple payment systems. The platform is organized into four core capabilities — Payment Accuracy, Clinical Policy, Network Management, and Test Result Integration — alongside solution modules including the Diagnostic Benefit Program and Test Order Management.

Concert operates a B2B enterprise SaaS model, monetizing through recurring platform subscriptions delivered via direct enterprise sales. GTM targets health plans, hospitals and health systems, and laboratories through a consultative solution-selling motion, with content marketing (whitepapers, blog, newsletter) supporting top-of-funnel demand generation. Prior to the Lyric acquisition, the company operated as NextGxDx, Inc. before rebranding to Concert Genetics to reflect its broader precision health positioning.

Name

concert genetics (formerly nextgxdx, inc.)

Website

https://concertgenetics.com

Company type

Private

Founded year

2010

Operating status

Acquired

Short description

Concert Genetics provides a cloud-based precision health payment accuracy platform for health plans, hospitals, diagnostic laboratories, and technology partners, automating clinical guidelines, coding, and payment policy enforcement for diagnostic and precision therapies.

Ownership category

akta.pro rank

GTM type

B2B

Offering type

Software

Cost components

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

Revenue model

1. Platform/SaaS Subscription: Cloud-based software platform providing payment accuracy, clinical policy, network management, and test result integration capabilities delivered as subscription services to healthcare organizations

Go-to-market motion1 record

Distribution channels1 record

Marketing channels3 records

Core offering

Concert Genetics provides a cloud-based Precision Health Payment Accuracy Platform that harmonizes guidelines, policy, coding, and payment for diagnostic and precision health services. The platform generates machine-readable clinical guidelines, links them to services and coding rules, and delivers them directly to multiple payment systems to enable automated claim editing, clinical policy enforcement, test order management, and insurance alignment for health plans, providers, and laboratories.

Product overview

Concert offers a unified Precision Health Payment Accuracy Platform — a cloud-based integrated solution combining tests, coding, evidence, policy, and payment rules. The platform includes four core capabilities (Payment Accuracy, Clinical Policy, Network Management, Test Result Integration) and four solution modules (Diagnostic Benefit Program, Test Order Management, GTU® Test Identifier) designed to serve health plans, providers, laboratories, and partners. The platform generates machine-readable clinical guidelines, links them to services and coding rules, and delivers real-time intelligence to payment systems, enabling automated policy enforcement and accurate claims processing across the precision health ecosystem.

Differentiator

Problem solved

Functional benefit

Products and services

• Precision Health Payment Accuracy Platform

Named customers3 records

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability4 records

Feature3 records

Partnerships

One partnership is on record.

• LyricmajorStrategic or Co-development PartnerLyric acquired Concert to advance healthcare decision intelligence and expand the Lyric42 Platform. This acquisition positions Concert's technology and expertise within Lyric's broader healthcare decision intelligence ecosystem.

Scale indicators1 record

Recent moves5 records

Expansion highlights3 records

Direct peers

• Inovalon: Inovalon delivers cloud-based healthcare data analytics and payer-facing platforms, including payment integrity and risk adjustment — comparable to Concert's data-driven approach to clinical policy and coding intelligence for health plans.
• Cotiviti: Cotiviti provides payment accuracy, claim editing, and analytics for health plans — directly comparable to Concert's core payment accuracy capability, but operating across broader clinical and pharmacy spend rather than precision diagnostics specifically.
• Edifecs: Edifecs provides healthcare data interoperability and payment accuracy solutions for payers and providers, with capabilities in clinical policy and coding rule automation that overlap directly with Concert's Coding Engine and clinical policy modules.
• Apixio (now part of Centene): Apixio applies AI to clinical data extraction, coding, and risk adjustment for health plans — closely aligned with Concert's evidence-based policy and machine-readable guideline approach to automating payer-side decisions.

Broad incumbents

• Optum (UnitedHealth Group): Optum is the largest healthcare analytics, payment integrity, and care management franchise in the U.S. It competes with Concert indirectly through its payer-services portfolio and could either acquire similar capability or replicate it at scale.
• Change Healthcare (now Optum): Change Healthcare, now part of Optum, is the dominant U.S. healthcare payment integrity and claims-processing platform. It overlaps with Concert's payment accuracy and coding engine offerings but at vastly greater scale and breadth across all claim types, not just precision diagnostics.
• McKesson: McKesson is a diversified healthcare services and IT conglomerate whose payer-services and data analytics offerings overlap with Concert's laboratory and provider-facing reimbursement and coding solutions at a much broader scale.
• R1 RCM: R1 RCM is a leading provider of revenue cycle management technology and services to hospitals and health systems — adjacent to Concert's provider-side test order management and insurance alignment capabilities, though focused on end-to-end RCM rather than precision diagnostics specifically.

Emerging players

• Olive AI: Olive AI applies AI-driven automation to healthcare administrative workflows, including prior authorization and claim management — adjacent to Concert's policy automation and claim editing value proposition in the precision health segment.
• Health Catalyst: Health Catalyst offers healthcare data and analytics infrastructure for providers and payers. While broader in scope, its data-platform approach overlaps with Concert's real-time intelligence and integration capabilities across clinical and financial workflows.

Market position

Strengths4 records

Weaknesses4 records

Competitive moat3 records

Key risks6 records

Key highlights6 records

Customer concentration

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

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 concert genetics (formerly nextgxdx, inc.)