FAQ

Frequently Asked Questions

Everything you need to know about Spark Predict — organized by topic.

5 topics
46 questions
Claims Data Requirements & Format
What data format and structure do you require for onboarding? +
We accept standard file formats for claims and eligibility data, including CCLF, 837 EDI, and CSV. No reformatting required, and no complex API integrations to get started.
How much historical claims data is needed to get started? +
We can begin with as little as a single recent quarter for descriptive analysis. Our modeling and forecasting performs best with ~12 months of data. Additional history (2+ years) enhances modeling depth but is not required.
Data Types & Scope
Do you only work with claims data? +
We can work with many types of healthcare data, but claims data alone unlocks significant value: cost trending, PMPM analysis, utilization patterns, provider performance, risk adjustment, HCC identification, care gaps, quality measure tracking, etc. Claims are the fastest path to value, serving core analytical needs across your organization.
Can you handle data from multiple lines of business simultaneously? +
Yes. We can ingest and analyze data across Medicare Advantage, Commercial, Medicaid, ACO/MSSP, and ACA Exchange populations within a single environment.
Can you incorporate other clinical data? +
Yes. We incorporate clinical data from EMR extracts, structured formats such as CCD, and HL7 feeds where available.
What other kinds of supplemental data files can you incorporate? +
We can incorporate eligibility and enrollment files, provider rosters and attribution data, care management enrollment data, revenue and payment data, benefit design metadata, and value-based contract terms. These add context that claims alone cannot provide — accurate member denominators, provider attribution, and program effectiveness measurement. During onboarding, we help identify which files will add the most value for your priorities.
Data Submission & Updates
What's the data submission process? +
We typically start with SFTP to get up and running quickly with minimal IT lift. From there, we can layer in more integrated approaches such as direct API connections.
How often should we update data, and how is refresh handled? +
Most clients update monthly; some prefer weekly for fresher data. Once pipelines are established, updates are ingested and available automatically.
What's your SLA for processing updated data files? +
During onboarding, initial processing may take up to 1 week as data is mapped and validated. After that, updates are typically processed within 24–48 hours depending on size and complexity.
Healthcare Domain Coverage and Expertise
Which lines of business does the platform support? +
SPARK Predict works across Medicare Advantage, Commercial, Medicaid, ACO/MSSP, and ACA Exchange. More importantly, it understands the distinct economics, quality measures, and risk adjustment logic of each — so analysis reflects how each business actually operates.
How does the platform handle risk adjustment across models and programs? +
The platform supports CMS-HCC, HHS-HCC, RxHCC, ESRD, and related models, and adapts to the specific program context — including nuances like state-level variation where the data supports it.
Analytical Depth & Methods
What statistical methods and models power your predictions? +

We train machine learning models on large longitudinal datasets (~1.9M members, 5 years, ~40M claims) using techniques like gradient-boosted trees. Models are validated on independent holdout data before being applied to your population to generate forecasts and surface emerging risks.

We also use traditional statistical methods (regression, time series, survival analysis) where appropriate. Our Supervisor agent validates model assumptions and discloses methodology in each response.

How does your training data relate to our data? Will you train models on our data? +
Our predictive models are trained on large internal datasets (40M+ records) and applied to your data to generate population-specific insights. We do not use your data to train our models or support analyses for other clients. For customers interested in custom model development on their own data, we offer that as an advanced capability — always opt-in and governed by clear data use agreements.
How do you handle different definitions of key metrics? +
Metric definitions are configurable and transparent, aligned to your internal standards. For ambiguous metrics, our Supervisor agent asks clarifying questions before generating results.
Can users specify custom methodologies without coding? +
Yes. Users can define logic, cohorts, and metric calculations directly through natural language.
Integration & Interoperability
Does this replace our existing BI tools or work alongside them? +
SPARK Predict works alongside your existing tools, but represents a fundamentally different way of interacting with your data. Rather than building dashboards or submitting requests, users ask questions in natural language and get answers with full methodology. Over time, teams often shift analytical work into Spark Predict or build integrations with their existing tools.
Can we export results, reports, or visualizations for use elsewhere? +
Yes. Results, data tables, and visualizations can be exported in multiple formats (CSV, Excel, PDF, PNG) for use in emails, presentations, or reports. We're also building AI-generated presentations, summaries, and draft communications.
Do you integrate with our existing data warehouse or analytics infrastructure? +
For initial deployment, integration is not required — we start with data files via SFTP to minimize IT lift. As the partnership evolves, we can integrate with your data warehouse, cloud storage, or analytics platforms.
Data Privacy & Usage Rights
Will you use our data to train models for other clients? +
No. Your data is yours. We do not use your data to train models that benefit other clients unless you explicitly opt in. All data use is governed by clear agreements that specify exactly how your data can and cannot be used.
Who can see the questions we're asking and the results we're getting? +
Only users within your organization with appropriate role-based permissions. We do not access your data or monitor your activity except to provide maintenance and support.
How is our data isolated from other customers' data? +
Each customer environment is fully isolated within our multi-tenant architecture. There is no cross-customer data access.
What are your PHI handling and HIPAA BAA terms? +
We operate under HIPAA-compliant infrastructure and execute a BAA with every customer. We can use your standard BAA or provide ours. PHI is protected through encryption, access controls, and audit logging.
Where does our claims data go and how do you handle ongoing data security? +
Your data is stored in a secure, HIPAA-compliant cloud environment with encryption at rest and in transit. Access is governed by strict role-based controls and monitored through comprehensive audit logging. We are SOC 2 Type II certified and conduct regular security assessments to continuously validate our security posture.
What happens to our data if we end the engagement? +
Upon termination, we will securely delete all of your data from our systems within a defined period, and provide written confirmation of deletion. If you need a data export before termination, we can provide that. Retention and deletion terms are specified in the contract and BAA.
Accuracy, Validation & Transparency
How do you ensure accuracy and validate results? +
Every analysis goes through our validation system: the Analyst agent generates results, the Supervisor agent reviews methodology and checks for errors, and both are governed by quality guardrails.
Can we see how results were produced? +
Yes. For any result, you can view the underlying logic, assumptions, and methodology used to generate it.
What happens when the system doesn't know or lacks sufficient data? +
The system recognizes uncertainty. When data is insufficient or a question is ambiguous, it says so, explains what's missing, and suggests next steps rather than guessing.
What if the AI gives a wrong or misleading answer? +
SPARK Predict is a decision-support tool — it informs your team's judgment, it does not make decisions on its own. Every response includes the methodology and assumptions used, so your team can evaluate the output before acting on it. Our Supervisor agent catches errors, flags uncertainty, and discloses limitations. When the system is unsure, it says so. That said, no analytical tool is infallible, and we encourage users to apply their domain expertise when interpreting results — just as they would with any analyst's work product.
Can we audit your methodology? +
Yes. You can review the methods, assumptions, and data sources behind results for audit and compliance.
Getting Started
What does 'minimal IT lift' actually mean? What is required from our team? +
Minimal IT lift means you don't need backend integrations, API development, or database connections to get started. What you do need: someone who can export your claims data files and upload them via SFTP. That's it for the technical side.
What's the typical implementation timeline? +
Typically 1–2 weeks from data receipt to first insights. Week 1 is data upload and processing; week 2 focuses on validation, onboarding, and running your first queries. More complex setups may take up to 4 weeks.
What does the onboarding process look like? +
We start with a kickoff to align on goals and key metrics, followed by data intake and validation. We then set up users and access, provide a brief training session, and support your team through initial use.
The Initial Trial
What's included in the initial trial period? +
The trial grants full platform access to a limited number of users. Your team can run real analyses across cost, risk, quality, and utilization. The goal is to answer your actual business questions, compare outputs to your current workflows, and validate value.
How much data do we need to provide for a meaningful trial? +
We can start with as little as one quarter of data and expand from there. For the full range of analytics, 12 months of recent data is ideal.
Is there a cost for the trial period? +
Trial terms vary depending on the engagement. We'll discuss pricing and structure during our initial conversations to find an arrangement that works for both sides.
What happens at the end of the trial if we want to continue? +
If the trial is successful, we move into full deployment with expanded access across your organization. This includes onboarding additional users, broadening data coverage, and aligning on ongoing workflows. There is no reimplementation — your existing environment and analyses carry forward.
Organizational Adoption
How does this work with our existing analytics or data teams? +
SPARK Predict acts as an accelerator for your analytics team. It handles ad hoc questions, reduces backlog, and allows analysts to focus on more strategic work such as deeper investigations, custom modeling, and advising the business.
What training do users need? +
Minimal. The interface is conversational, so most users are productive in their first session. We provide a short intro session to cover key use cases.
How many concurrent users can access the platform? +
No practical limit for typical enterprise usage. Access is managed through role-based permissions, so different teams — executives, analysts, care managers, operations — can work simultaneously with appropriate data controls.
Ongoing Support & Evolution
What kind of ongoing support do you provide? +
We provide direct access to our team, regular check-ins, and responsive troubleshooting. Early on, we stay closely engaged to support adoption. Over time, support becomes more on-demand.
How do product updates get deployed? +
Updates deploy continuously with no disruption to your environment. We communicate clearly when changes are relevant to your workflows.
What's on your product roadmap? +
We are focused on expanding three core areas: (1) Intelligence Hub, which delivers proactive, personalized insights based on each user and enables more effective monitoring; (2) Analyst Mode, which enhances transparency and collaboration by making methodology more accessible to analytics teams; and (3) Member Action Center, allowing care managers and operational teams to quickly act on insights and drive real-world impact on a member-by-member basis.
How do you incorporate customer feedback? +
Customer feedback directly shapes our roadmap. We incorporate input from active users, prioritize high-impact use cases, and iterate with customers to refine features before broader release. During the trial, we schedule monthly check-ins to review your experience and gather feedback.
Pricing & Business Model
How is pricing structured? +
Pricing is typically structured at the organization level, based on scope of use, data coverage, and number of users. This allows broad access across teams without limiting usage.
What's the ROI compared to current tools and analyst headcount? +
Spark Predict reduces time to insight from days or weeks to seconds, which accelerates decision-making and reduces reliance on manual analysis. Customers see value through faster iteration, improved decision quality, and more efficient use of analyst time.

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