For US Healthcare Payers

Reduce unnecessary care.
Control costs.

Medroid is an AI-powered triage and care-routing platform designed for scale. We help insurers and plans guide members to the right level of care, earlier—reducing avoidable ER utilization.

HIPAA-ready
Enterprise API
Clinically Grounded
Sarah M.
"Persistent headache for 3 days"
Medroid AI
Analyzing symptoms...
Low acuity Non-urgent
RECOMMENDED
Telehealth Visit
Available now
~$75
Save $1,725
2.3s
Triage
96%
Accuracy
$1.2M
Saved/Mo

The Problem Payers Face

Care is accessed late, expensively, and often unnecessarily. Members are unsure where to go, leading to high-cost utilization driven by low-acuity presentations.

Avoidable ED Utilization

Emergency Departments used for non-emergency conditions due to lack of guidance.

Fragmented Front Doors

Poor engagement with digital tools leaves members guessing until the claim is incurred.

Rising MLR

The result is avoidable spend and poor member experience.

The Medroid Solution

Intelligent clinical triage at the front door of care.

Medroid sits before the claim—at the moment a member seeks help. Using clinically validated AI, we route members to the appropriate setting, escalating safely when required.

Target Outcome Pre-claim Cost Avoidance
Key Metric Reduced MLR
2–5% Total Med Spend Reduction

Core Capabilities for Payers

Designed to be conservative where risk exists and efficient where low acuity is identified.

AI-Powered Clinical Triage

Evaluates member symptoms in real-time to assign care pathways: self-care, PCP, urgent care, or telehealth.

A&E / ER Deflection

Identifies non-emergent presentations and redirects members to virtual care or scheduling, reducing high-cost claims.

Care Navigation & Booking

Medroid doesn't just advise—it executes. Book members into in-network providers or connect to telehealth immediately.

White-Label Experience

Fully white-labelled for the payer or employer. Own the digital front door and improve brand trust.

Risk Stratification

Insights into symptom trends and high-risk cohorts for earlier intervention and smarter population health.

Enterprise APIs

Integrates with member apps, care navigation platforms, claims systems, and provider networks via API-first modules.

Quantified Impact

Real-world cost avoidance for US Payers.

Case Study

Mid-Size Health Plan

Covered Lives
100,000
ER Visits Avoided
2,400
Annual Savings
$3.12 Million
Case Study

Self-Insured Employer

Members
25,000
Deflection Rate
15%
Annual Savings
$500,000+
Interactive Model

Payer-Specific ROI Calculator

Estimate pre-claim cost avoidance based on your population.

Inputs
US Average: 280
Conservative Estimate
Plan Type:
ESTIMATED Y1 SAVINGS
Net Medical Savings
ER Visits Avoided
Break-Even Point
Gross Cost Avoided
Redirected Care Cost
Download Detailed Report

Figures based on industry benchmarks: $1,300/ER visit vs $120/redirected care. View methodology.

Why Medroid is Different

  • Clinical reasoning, not questionnaires

    Real-time symptom analysis rather than static decision trees.

  • Care execution, not just advice

    We book the appointment. We connect the call. We close the loop.

  • Payer Economics

    Designed for pre-claim cost avoidance, not consumer novelty.

Deployment Options

API-Only Integration
Embedded Modules
Full White-Label Platform
Typical pilot timeline: 4–8 weeks

Enterprise & White-Label Pricing

Pricing is based on covered lives, deployment model, and API volume. Contact us for a custom quote.

Contact Enterprise Sales

Frequently Asked Questions

Move care upstream.
Reduce cost before the claim.