Alivia Analytics Expands Payment Integrity Solutions for Healthcare Payers

PHILADELPHIA, Sept. 18, 2024 /PRNewswire/ — Alivia Analytics, a leading AI-powered healthcare data analytics and technology company, announced the expansion of its payment integrity solutions designed to help healthcare payers reduce payment errors and improve financial accuracy – backed by a powerful, configurable platform.

The offerings focus on key areas critical to ensuring payment integrity across the healthcare spectrum, which include:

• Prospective Claims Editing: Alivia’s advanced first-pass pre-payment editing identifies coding errors and ensures compliance with healthcare regulations before claims are processed. By preventing billing mistakes, healthcare payers can reduce unnecessary expenditures and improve overall efficiency.
• Clinical Reviews & Audits: Utilizing a configurable analytics platform, Alivia offers both pre- and post-payment clinical reviews to identify and correct improper payments. A team of certified auditors review claims for medical necessity, coding accuracy, and compliance, ensuring the highest standards are met.
• Data Mining & Advanced Analytics: Alivia’s AI-driven platform provides healthcare payers with the tools to uncover payment irregularities and prevent overpayments. The platform’s advanced analytics surpass traditional business rule engines, helping organizations achieve higher recoveries while reducing manual intervention.

The solutions are delivered as Tech-Enabled Services and Software as a Service (SaaS) that identify new recoveries missed by legacy vendors, deliver actionable pre- and post-payment analytics, and offer automated pre-payment corrections and savings.

“We are committed to addressing the most pressing challenges for healthcare payers,” said Michael Taylor MD, Chief Executive Officer of Alivia Analytics. “Our payment integrity solutions and modules are administered within the same analytics platform as our fraud detection modules, which makes for an efficient and unique system in the marketplace.”

Learn more about Alivia’s payment integrity solutions.

About Alivia Analytics

Alivia Analytics leverages responsible AI and healthcare claims expertise to help commercial and government health plans lower costs by avoiding fraud, waste, abuse, and overpayments, optimizing payment processes, and confidently making data-driven decisions. The powerful, configurable Alivia Platform provides adaptive pre- and post-payment flexibility with tech-enabled services and SaaS offerings that holistically address challenges in payment integrity, fraud detection and investigation case management, and data management. Alivia’s healthcare payer clients broaden ROI with increased operational efficiencies, decreased medical expense spending, bigger savings/recoveries, and lower provider and member abrasion. More information at aliviaanalytics.com

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SOURCE Alivia Analytics