Banjo Health vs Xsolis (2026)
Two well credentialed vendors working different determinations. Banjo is pharmacy benefit weighted, reading prescriber notes directly and producing a structured recommendation with the evidence attached rather than an opaque score, backed by certification at the more demanding risk based tier. Xsolis works medical necessity and sits between payer and provider, scoring continuously so both sides argue from the same number, with peer reviewed research behind that score. The shared score is the more interesting idea, because most utilization disputes are arguments about evidence rather than rules. Neither publishes what proportion of AI informed adverse determinations get overturned on appeal, which is the number that would show either side is calibrated.
- It is pharmacy benefit weighted and reads prescriber notes directly, producing an inspectable structured recommendation with evidence attached rather than a score.
- Certification is held at the risk based two year tier, which incorporates privacy requirements and is the more demanding assessment.
- For a pharmacy benefit operation, the formulary determination workflow differs from medical necessity and this is built for it.
- It sits between payer and provider rather than serving one side, scoring medical necessity continuously so both parties argue from the same number.
- Teams at Baylor Scott & White and Yale New Haven Health published peer reviewed evaluations of its score in 2025.
- Xsolis announced HITRUST r2 certification, the risk based two year tier, for its platform in 2022.
This comparison is published by AI Health Index, an independent research platform that compares healthcare AI vendors objectively. Banjo Health and Xsolis are each graded against the same capability taxonomy, from each vendor's own public materials and the regulatory record, under the AI Health Index verification standard. No vendor pays for placement, and no vendor has reviewed this page. How this evidence is graded
Plain facts
| Fact | Banjo Health | Xsolis |
|---|---|---|
| Primary category | RCM & Prior Auth AI | RCM & Prior Auth AI |
| Founded | Not recorded | 2013 |
| Headquarters | Washington, District of Columbia | Franklin, Tennessee |
| Website | banjohealth.com | xsolis.com |
Side by Side
Select any grade to read the note behind it.
Product updates
The latest logged changes from each vendor, newest first, each linked to its source.
Xsolis
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Product / capability
Xsolis launched GenAI Peer-to-Peer Clinical Synopsis as an add on inside Dragonfly Advise.
Source
Each vendor in one paragraph
Written to be quoted whole. Each paragraph opens the AI Health Index profile of the vendor: what the product is, who buys it and what it does.
Prior authorization, appeals and grievances platform for health plans and pharmacy benefit managers, across medical and pharmacy benefits. BanjoPA uses CARE (Computer Assisted Review Engine) to extract information from faxed and digital requests, create the case and match it against the plan's clinical criteria, recommending approve, deny or request more information with evidence and an explanation; a human reviewer confirms or adjusts every recommendation.
Source: AI Health Index, August 2026
Xsolis sells AI utilization management to hospitals and health plans. Its Dragonfly platform scores each admitted patient's likelihood of needing inpatient care or observation, using machine learning over the hospital record, so the hospital and the payer can work from the same clinical evidence when they decide status and concurrent authorization.
Source: AI Health Index, August 2026
Questions buyers ask
How do Banjo Health and Xsolis work with the EHR?
Banjo says it works with EHRs, eligibility verification tools, claims management systems, ePA vendors and API ready portals, ingests faxed and digital requests, and runs appeals through the same ePA vendor as the original request.
With Xsolis, the shared clinical access between a health system and its payers through Dragonfly is a distinct integration pattern, since both parties read the same record view. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
How are Banjo Health and Xsolis priced and sold?
In Banjo Health's case, enterprise agreements with health plans and pharmacy benefit managers. CMS prior authorization rules are the stated adoption driver, so contracts may be negotiated under a compliance deadline, and the pricing page does not say whether pricing reflects the deadline driven implementation or steady state operation.
For Xsolis, the offering is a hybrid: alongside the platform the company sells Physician Advisor Services covering night and weekend gaps or operating fully outsourced, so the buy can be software, staffed service, or both. A clinical staffing component behaves very differently from a license. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
How do Banjo Health and Xsolis handle patient data?
Banjo's October 2025 post states its AI is proprietary, designed from the ground up, and not an open source model, giving it control over every layer of the technology stack, so case data is not described as reaching an outside model provider. It also says the AI is constantly learning and adapting, which implies customer determinations improve the models, and nothing says whether that learning stays within one plan's boundary.
Xsolis announced HITRUST r2 certification for the platform in March 2022 and described it as a proactive approach to protecting health information; the website privacy policy covers site visitors only. Nothing published states how long clinical data drawn from hospital records is kept, whether it is de identified, or whether it trains the Care Level Score. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
What evidence is published for Banjo Health and Xsolis?
Banjo reports 50 percent faster intake to decision, 70 percent less time drafting and updating decision trees and a 33 percent reduction in appeals, with no baseline, period or customer.
With Xsolis, the Care Level Score predicted inpatient discharge status with an area under the curve of 0.89, and a score of 76 or higher classified status correctly 86 percent of the time. Combining the score with a commercial screening tool did worse than the score alone. From the AI Health Index, drawn from each vendor's own published materials and the regulatory record, verified August 4, 2026. No vendor pays for placement.
Related comparisons
Other published head to head assessments involving these vendors or their closest peers.
In utilization management an AI output can end in care being denied, and neither vendor publishes a bias evaluation or subgroup performance analysis. Neither publishes the calibration number for its own side: the proportion of AI informed adverse determinations overturned on appeal.
A carrier remains responsible for prior authorization compliance regardless of which vendor performed the work, and at least one state requires the program to meet a recognized accreditation standard, so establish which accreditations apply to the specific program you are buying.