Healthcare Analytics · HIPAA-Compliant Cloud · Live in Production

Healthcare analytics products
that turn data into revenue.

Built for health plans, CCOs, and provider organizations across the United States. Started in Oregon. Designed to work wherever value-based care and fee-for-service revenue intersect.

See the Products LinkedIn Profile →
Scroll
The Problem

Revenue that should be yours is going elsewhere.

Healthcare organizations lose revenue in ways that rarely show up on a single report. Encounter data errors quietly erode capitation rates. HCC coding gaps understate risk scores for your highest-complexity members. Payers systematically underpay claims in ways that only become visible when you look across hundreds of remittances at once.

Optivida started with Oregon's Coordinated Care Organizations, where these patterns are well-documented in public OHA data. The same dynamics apply to Medicaid managed care organizations, Medicare Advantage plans, FQHCs, hospitals, and multispecialty groups across the country.

Where Revenue Leaks

🏥
Patient
Encounter
Diagnosis codes,
procedures filed
↓
Coding gaps
→
📋
Claim
Submission
837 files sent
to payer
↓
Denials & errors
→
💳
Payer
Adjudication
Contract terms
applied
↓
Underpayments
→
📊
Remittance
Received
835 files with
payment detail
↓
Unrecovered
→
✅
Optivida
Detects It
Patterns surfaced
in real time

↑ Revenue leaks at every stage — most organizations never see it. Optivida makes each leak visible and recoverable.

Optivida makes revenue leakage visible, measurable, and recoverable.
See the Products
$7.65B
Annual capitation payments to Oregon CCOs tracked in Optivida RIE
Source: OHA CCO Metrics 2024 Final Report (oregon.gov/oha). Quality Pool of $325M at 4.25% of aggregate PMPM implies total capitation of approximately $7.65B.
$325M
2024 Oregon CCO Quality Incentive Pool
Source: OHA CCO Metrics 2024 Final Report. Set at 4.25% of aggregate PMPM capitation payments to CCOs.
$382M+
Estimated statewide recovery opportunity across Oregon CCOs
Optivida estimate based on OHA capitation data. Assumes conservative 5% combined leakage rate across encounter data quality, HCC, and underpayment domains. Not independently verified.
Sample Demos

Three products. One platform.

Each product is operational and deployed on a HIPAA-compliant cloud infrastructure. The demos below use synthetic data so you can explore the full interface without any real patient information involved.

💰
Revenue Intelligence Engine
Finance Edition

Identifies systematic payer underpayments at the pattern level for hospitals, FQHCs, and multispecialty groups. Works with both professional (837P) and institutional (837I) claims. Quantifies recovery opportunity by payer and generates dispute-ready documentation.

CFOVP Revenue CycleDirector PFS
Sample demo using synthetic data. No real patient information.
Demo Login
Email: guest@optividaanalytics.com
Password: Optivida2026
Explore Sample Demo →
📋
Contract Payment Accuracy Engine
CPAE

Extracts reimbursement terms from payer contracts using AI, compares them against remittance data, and flags every underpayment with the supporting contract clause and regulatory citation. Tracks the full review and dispute workflow.

Revenue CycleComplianceContracting
Sample demo using synthetic data. No real patient information.
Demo Login
Email: guest@optividaanalytics.com
Password: Optivida2026
Explore Sample Demo →
🏥
Revenue Intelligence Engine
CCO Edition

Six-domain revenue leakage platform built for Oregon Coordinated Care Organizations. Covers Encounter Data Quality, HCC Risk Adjustment, Denial Prediction, Charge Capture, Payer Underpayment, and Quality Incentive tracking against the OHA capitation base.

CCO FinanceQuality LeadershipAnalytics
Sample demo using synthetic data. No real patient information.
Demo Login
Email: guest@optividaanalytics.com
Password: Optivida2026
Explore Sample Demo →
Getting Started

What does onboarding look like?

Getting started with Optivida requires four things. No lengthy implementation. No new software on your end.

1
Signed BAA
A Business Associate Agreement executed between your organization and Optivida. Standard template available immediately. HIPAA-compliant data handling from day one.
2
One Month of Claims
Your 837 professional or institutional claim files for a recent month. No need to reformat or resequence your existing data. We work with files exactly as you generate them.
3
Matching Remittance
Your 835 electronic remittance files for the same period. This is the data your clearinghouse already sends you. No new reports or extracts needed.
4
Your Payer Contract
The fee schedule or contract between your organization and the payer being analyzed. PDF or spreadsheet format accepted. Optivida's AI extracts the reimbursement terms automatically.

Ready to start a conversation?

Reach out at sanjay@optividaanalytics.com or connect on LinkedIn. A typical pilot engagement begins within two weeks of a signed BAA.

Sanjay Prasad

Sanjay Prasad · Camas, WA

About
Sanjay Prasad
Founder, Optivida Health Analytics

15 years in healthcare data and analytics at Optum/UnitedHealth Group, Kaiser Permanente Northwest, and Apprise Health Insights (Oregon Hospital Association). During that time I led a $100M+ quality incentive program at Optum and built a $1M+ ARR data product line at Apprise, a division of the Oregon Hospital Association that serves member hospitals across the state.

Optivida is what I built when I decided to apply that experience from the outside. Three production products on Google Cloud Platform. Real data infrastructure. Real claims analysis. Built independently while also exploring senior leadership roles in healthcare analytics and AI product management.

If you lead analytics, finance, or revenue cycle at a health plan, CCO, or provider organization, I would welcome a conversation about what you are trying to measure and recover.

Healthcare Analytics AI and GenAI GCP and BigQuery Risk Adjustment Value-Based Care Revenue Cycle HEDIS Medicare Advantage
Connect on LinkedIn → Send Email →
Thought Leadership

Insights from the field

A six-part series on healthcare revenue leakage, published on LinkedIn. Grounded in OHA public data and written for CCO finance and quality leaders. Click any post to read the full analysis on LinkedIn.

Week 1
$382M+ Is Hiding in Oregon's CCO Data

Oregon CCOs receive billions in annual capitation payments, but encounter data errors and HCC coding gaps drain millions from that base every year. This post shows how to quantify the leakage before the next OHA rate cycle.

Read on LinkedIn →
Week 2
Which Oregon CCOs Are Most Exposed?

Not all CCOs face the same revenue risk. Tier 1 CCOs carry both quality incentive exposure and capitation understatement, a compounding disadvantage that transfers dollars directly to better-performing competitors via the OHA Challenge Pool.

Read on LinkedIn →
Week 3
How Encounter Data Quality Drives Capitation Underpayment

Every encounter with a missing diagnosis code, invalid NPI, or late submission quietly erodes the data OHA uses to calculate your next rate. The gap compounds annually and stays invisible until it is too late to act.

Read on LinkedIn →
Week 4
HCC Risk Adjustment: The Silent Revenue Lever

HCC coding accuracy determines capitation rates for your highest-complexity members. One HCC gap on a member with diabetes, CHF, and COPD can represent thousands of dollars in annual capitation understatement per member.

Read on LinkedIn →
Week 5
Denial Prediction: Stopping Revenue Loss Before It Starts

The most effective denial management happens before submission. Pre-submission scoring flags claims most likely to be denied while there is still time to correct them. This post examines the patterns machine learning can identify at scale.

Read on LinkedIn →
Week 6
Introducing Optivida: Built for Revenue Leaders

After 15 years building analytics platforms at Optum, Kaiser Permanente, and the Oregon Hospital Association, this is the tool I always wanted to have. Three production products, real cloud infrastructure, open for pilot conversations.

Read on LinkedIn →
Infrastructure and Technology
HIPAA-Compliant Cloud
Google Cloud Platform
BigQuery
Cloud Run
Firebase Auth
FastAPI and Python
React
Advanced SQL
GenAI and LLMs
AES-256 Encryption
Apply for a Pilot

Ready to see your own data?

We are accepting a small number of pilot organizations in 2026. Tell us a little about your organization and we will be in touch within 48 hours.

We respond within 48 business hours. A signed BAA is required before sharing any real data.

✅

Application received

Thank you for your interest in Optivida. Sanjay will be in touch within 48 hours at the email you provided.

In the meantime, explore a working sample demo using the credentials on this page.

Get in Touch

Let's Talk

Exploring a pilot, evaluating a partnership, or considering Sanjay for a leadership role? The conversation starts here.

sanjay@optividaanalytics.com linkedin.com/in/sprasadhome 360-487-0001