About
Arbiter (formerly MyndYou) is a Care Orchestration Platform designed to address the nearly $1 trillion in annual waste caused by fragmented data, technology, and incentives across the U.S. healthcare system. The platform brings together patients, payers, and providers on a single intelligent operating layer, delivering the right care at the right time through agentic AI and workflow automation. At its core, Arbiter runs on the Record-Action-Alignment model — a continuous engine that transforms healthcare fragmentation into coordinated flow. The Record layer unifies clinical, financial, and policy data into a longitudinal source of truth. The Action layer uses agentic AI to recommend and automate next-best steps in real time. The Alignment layer monitors outcomes and continuously learns to improve performance. Key platform capabilities include Gap Detection & Clinical Triggers (surfacing referral opportunities directly in the EMR based on quality gaps and risk data), a Provider Graph & Routing Engine (matching patients to in-network providers optimized for cost, quality, and availability), Automated Prior Authorizations (codifying payer policy documents to accelerate approvals and reduce cancellations), and Patient Engagement & Scheduling (multi-channel outreach, real-time booking, reminders, and follow-up to close the care loop). Arbiter is purpose-built for health plans, payers, and large provider organizations. Its team combines decades of experience from UnitedHealth Group, Cigna, VillageMD, and Eli Lilly with technologists from One Medical, Oscar, Meta, Apple, and Google — making it a uniquely credible, insider-built solution for enterprise healthcare operations.
Key Features
- Gap Detection & Clinical Triggers: Surfaces referral opportunities in real time based on quality gaps and risk adjustment data — such as missed screenings or overdue labs — directly within the EMR.
- Provider Graph & Routing Engine: Matches every patient to the right in-network provider by optimizing referrals for cost, quality, and availability, reducing leakage and improving site-of-care decisions.
- Automated Prior Authorizations: Streamlines delegated and standard prior auth by structuring payer criteria and codifying raw policy documents, resulting in faster approvals and reduced administrative burden.
- Patient Engagement & Scheduling: Engages patients at the moment of referral with multi-channel outreach, real-time scheduling, reminders, and follow-up to increase appointment completion rates and reduce no-shows.
- Record-Action-Alignment Engine: A continuous AI model that unifies clinical, financial, and policy data into a single longitudinal source of truth and automates next-best-action recommendations in real time.
Use Cases
- A health plan uses Arbiter to automate prior authorization workflows, reducing approval turnaround time and minimizing manual review for delegated authorizations.
- A large provider group embeds Arbiter into its EMR to detect quality care gaps in real time and trigger structured referrals for missed preventive screenings.
- An ACO leverages Arbiter's routing engine to match patients with in-network specialists optimized for cost and quality, reducing out-of-network leakage.
- A payer organization uses Arbiter's patient engagement module to reach patients post-referral with multi-channel reminders, improving appointment completion rates and reducing no-shows.
- A value-based care operator deploys Arbiter to unify clinical, financial, and claims data into a single longitudinal record, enabling risk-adjusted care management across millions of patient lives.
Pros
- Built by Healthcare Insiders: The team brings deep operational expertise from UnitedHealth Group, Cigna, VillageMD, and leading health-tech companies, ensuring the platform solves real industry pain points.
- Unified Platform vs. Point Solutions: Unlike traditional vendors offering fragmented point solutions, Arbiter provides a single operating spine for referrals, authorizations, and care coordination — reducing tool sprawl.
- Embeds Into Existing Workflows: The modular platform integrates directly into existing EMRs and workflows, minimizing disruption and accelerating time-to-value for health systems and payers.
- Proven at Scale: Deployed by operators managing $25B+ in annual healthcare payments and millions of patient lives, demonstrating enterprise-grade reliability and scalability.
Cons
- Enterprise-Only Scope: Arbiter is designed exclusively for large payers, health plans, and provider organizations — making it inaccessible to smaller practices or individual clinicians.
- No Public Pricing: Pricing is not disclosed and requires a custom demo, which adds friction for organizations conducting early-stage vendor evaluations.
- Integration Complexity: Embedding into existing EMRs and payer systems may require significant technical effort and change management, particularly for organizations with legacy infrastructure.
Frequently Asked Questions
What is the Arbiter platform?
Arbiter is a Care Orchestration Platform that unifies patients, payers, and providers on a single intelligent system. It automates referrals, prior authorizations, and care coordination using agentic AI and real-time data integration.
Who is Arbiter built for?
Arbiter is purpose-built for enterprise healthcare organizations — including health plans, payers, ACOs, and large provider groups — that manage high volumes of referrals, authorizations, and patient populations.
How does Arbiter integrate with existing systems?
Arbiter is modular and designed to embed within existing EMR and workflow environments. It surfaces insights and automation directly inside the tools clinicians and administrators already use, minimizing workflow disruption.
What is the Record-Action-Alignment model?
It is Arbiter's core AI engine. 'Record' unifies clinical, financial, and policy data into a longitudinal source of truth. 'Action' recommends and automates next-best steps in real time. 'Alignment' monitors outcomes and continuously learns to improve performance.
How does Arbiter handle prior authorizations?
Arbiter streamlines both delegated and standard prior authorizations by structuring payer criteria and codifying raw policy documents into actionable rules — accelerating approvals, reducing cancellations, and cutting administrative burden for payers and providers alike.
