For commercial health insurers
B2B · Procurement

Continuous recovery coverage for the moments your claims data can't see.

Give payer teams a continuous recovery companion for high-risk enrollees: overnight crisis coverage when the queue is quiet, between-session monitoring when encounters are weeks apart, and escalation telemetry that lets care managers begin with the context behind a rising-risk signal.

Procurement guide: Read the overnight coverage explainer →

Overnight crisis coverageBetween-session monitoring for high-risk enrolleesEscalation telemetry for care managers
How it embeds in your payer operation

Three visibility gaps to close without replacing your care-management stack.

Embertide adds a continuous layer around the workflow your medical directors and care managers already own. The watch runs between encounters, the cascade follows the contract, and the read-back is ready when the next review begins.

  1. 01Overnight coverage

    Close the overnight crisis gap

    Embertide keeps the watch running after the case-management queue goes quiet. When a high-risk enrollee signals a crisis overnight, the configured cascade moves toward a named human responder before the window closes — with 988 as the safety net, not the default first move.

  2. 02Between-session monitoring

    See rising risk between sessions

    Daily check-ins, missed touches, and peer-conversation signals become one bounded trajectory for each consented enrollee. Care managers begin the next review with the between-session context that claims refreshes and scheduled encounters cannot provide on their own.

  3. 03Escalation telemetry

    Give care managers a read-back they can act on

    Every handoff returns with the signal, tier reached, actor, recipient, and timestamp. Care managers see what happened during the dark hour, while payer leaders get an aggregate view of response patterns without opening a member's private conversation stream.

routing_actions · representative snapshot

The telemetry a payer team can bring into the next utilization review.

A commercial-insurer pilot can define the measures that matter to your panel: how quickly a named responder acknowledges, how often the in-network cascade absorbs the handoff, and whether every action is ready for an audit read-back.

Median acknowledgement< 5 minIllustrative signal-to-named-responder timing in a representative routing_actions view.
Reached before 98882%Representative in-panel handoff share before the safety-net tier is reached.
Audit completeness100%Illustrative routing actions carrying actor, recipient, tier, and timestamp.
Signals surfaced3.1×Representative increase in rising-risk context available to a care manager per week.

Representative marketing fixtures only — these figures are not live performance data, claims outcomes, or a promise about a specific payer population.

Purchaser concerns

The questions a medical director, security reviewer, and care-management lead ask before a pilot.

Procurement should make the data boundary, workflow boundary, and measurement plan explicit. These answers describe the posture to bring into that conversation.

Need a security or integration brief? Contact the team.

Commercial payer procurement

Bring the gaps your claims refresh cannot see.

Share your covered population, care-manager cadence, contracted responder chain, and the routing_actions measure your reviewer needs to see. We'll shape a pilot scope around overnight coverage, between-session monitoring, and a measurable escalation read-back.

Scoping this for a public payer instead? See state Medicaid programs →

What to bring

  • · Covered population and risk profile
  • · Care-manager cadence and queue ownership
  • · Contracted responder chain and tier order
  • · Security, claims, and reporting requirements
Talk to our team

Tell us where your care-management workflow loses the thread.

Send a procurement note and we'll come back with a focused conversation about your overnight coverage, high-risk between-session cohort, escalation telemetry, and the audit-ready routing_actions view your team needs.

Prefer email? Reach us at embertide-2@polsia.app.

Want the operating model first? Read how Embertide works →

Please do not include member names, claims identifiers, or other protected health information in this form.