Prior authorization & UM · AI utilization management
Xsolis
Xsolis is an AI utilization-management platform for providers and payers. It supports status determination and collaboration so UM teams can reduce manual review friction. It is not a consumer telehealth brand or a basic fax prior-auth portal.
Strong fit
- Health systems and payers that want AI help with utilization review and patient status decisions
- Teams that track avoidable hospital days and review workload during stays
- Groups willing to connect clinical data so the AI can help with decisions
Weak fit
- Groups that only need a fax portal for occasional prior authorization forms
- Buyers who do not want to change how review nurses work
- Groups that cannot share the clinical data the AI needs
Bottom line
Xsolis is worth using for health systems and payers modernizing utilization management with AI that helps decide patient status and lets providers and payers work together. It suits teams that will track avoidable days and retrain review staff. Specialty practices needing prior authorization help may prefer Silna.
Score breakdown
Weights: Outcomes 35% · Product 30% · Implementation 20% · Pricing clarity 15%.
Xsolis applies AI and clinical data to utilization review so providers and payers can make patient status decisions with less manual work.
It belongs with prior authorization and utilization review tools, not general claims software.
Results look strongest when review leaders track avoidable days and review workload. Projects stall when the tool becomes a side dashboard.
Setup needs access to clinical data and change management for review staff.
Set measures up front and train reviewers to both trust and question the AI's output. Projects fail when the software is installed and review habits stay the same.
Pricing is not published.
Among prior authorization and utilization tools we review, Xsolis scores highest, ahead of Agadia and Silna. Silna suits specialty providers that need prior authorization and benefits work handled together.
Competitor landscape
| Vendor | Overall | Ease of implementation |
|---|---|---|
| Anterior | 8.1 | 8.1 |
| Xsolis | 7.8 | 7.3 |
| Infinitus | 7.7 | 7.4 |
| Humata Health | 7.7 | 7.4 |
| Agadia | 7.6 | 7.2 |
| Careviso | 7.6 | 7.3 |
| Silna Health | 7.3 | 7.1 |
| Itiliti Health | 7.3 | 7.1 |
| Banjo Health | 7.2 | 7.0 |
| Hindsait | 7.0 | 6.7 |
| Rhyme | 6.5 | 6.3 |
Pricing
| Item | Detail |
|---|---|
| Model | Software contracts for large and mid-sized buyers of utilization review and patient status tools. |
| What usually drives cost | Number of facilities or covered members, modules, and how much EHR and payer system integration is needed. |
| What to ask before you buy | First-year cost at your volume, which data feeds are required, and targets for avoidable days. |
| Published pricing | Xsolis does not publish prices. Expect a custom quote. |
Prerequisites for purchase
| Need | Why it matters |
|---|---|
| What you need to get Xsolis to function | |
| Clinical data access for the AI | Without data feeds, the AI cannot suggest patient status. |
| Review leaders willing to change how reviews are done | Dashboards alone do not free days. |
| Agreements to work with payers or providers where needed | The network only pays off when both sides take part. |
| Targets such as avoidable days or review turnaround | Programs that are not measured drift. |
| IT capacity for EHR and analytics integration | Utilization review platforms are data projects. |
| What will maximize your value | |
| Pilot on the busiest service lines first | Trying every service line at once hides what is working. |
| Track when nurses override the AI to tune how much they trust it | Blind trust and blind distrust both fail. |
| Share outcome dashboards with finance | The CFO should see avoidable days. |
| Update review criteria when policies change | Outdated criteria bring back manual work. |
| Budget for change management, not only licenses | Workflow adoption is where these programs stall. |
| Deal-breakers | |
| You only need occasional faxed prior authorization forms. | |
| You cannot provide clinical data access. | |
| Review leaders will not change habits for reviews during the stay. | |
| No one owns the avoidable day or turnaround numbers. | |
| IT cannot integrate for the next two quarters. | |
Value creation time frame
| # | Stage | Typical range |
|---|---|---|
| 1 | From signing to kickoff | 4-8 weeks for security review, data mapping, and choosing pilot units |
| 2 | From kickoff to first use | 3-6 months for a meaningful utilization review pilot |
| 3 | From first use to steady results | 4-8 months of adjusting before expanding to more facilities |
Leadership
Methodology
| Weight | Factor | What it measures |
|---|---|---|
| 35% | Customer outcomes | Whether buyers get measurable operational or clinical-workflow results after go-live |
| 30% | Product | Capability depth, reliability, and fit for the job the category buys |
| 20% | Implementation | How hard it is to stand up, integrate, train, and stabilize |
| 15% | Pricing clarity | Whether a buyer can model total cost without a mystery quote |
| Label | Meaning |
|---|---|
| Highly recommend | Strong outcomes and product with manageable caveats |
| Recommend | Solid fit for the right buyer; know the tradeoffs |
| Conditional | Only with a specific use case or heavy caveats |
| Not recommended | Avoid for most buyers in this category |
Read our full methodology for how we weight scores and assign recommend labels.