PHILADELPHIA, June 24, 2025 /PRNewswire/ — Alivia Analytics, a leader in AI-powered FWA detection and analytics for healthcare payers, today announced the official debut of Alivia 360™, its unified platform for pre- and post-payment fraud, waste, and abuse (FWA) detection. As part of the launch, Alivia is introducing FWA Claims Manager™, a new pre-payment analytics solution that helps health plans and government agencies act earlier to prevent improper payments before they occur.
FWA Claims Manager™ focuses on identifying high-risk providers and suspicious billing behavior that fall into the Gray Zone, subtle, often-overlooked activity between error, fraud, waste, and abuse that traditional rules-based systems fail to catch. By flagging these patterns before payment is issued, FWA Claims Manager enables earlier intervention, minimizes downstream effort, and protects plan resources.
This advancement complements Alivia’s established post-payment suite, where its AI-powered FWA Finder™ and centralized Alivia Case Manager™ continue to deliver value by detecting new leads, accelerating investigations, and streamlining fraud workflows.
To further strengthen recovery outcomes, Alivia reinforces its post-pay payment integrity solutions, including Clinical Audits, Data Mining, and Code Editing. These capabilities help validate billing accuracy, medical necessity, and compliance across high-risk claims, driving greater audit precision and improved recoveries.
“At a time when healthcare payers are under pressure to reduce losses and act faster, Alivia 360 provides one platform to detect and manage FWA from every angle,” said Michael Taylor, MD, CEO of Alivia Analytics. “With the introduction of Early FWA Detection and expanded recovery analytics, we’re equipping our clients with the tools to make smarter decisions across the entire claims lifecycle.”
Alivia 360™ also integrates proprietary data transformation services, enabling the rapid ingestion and standardization of fragmented claims data into analytics-ready formats, accelerating insights and driving operational impact across payer environments.
About Alivia Analytics
Alivia Analytics helps health plans and government agencies address complex claims challenges, combining AI-powered technology, expert services, and integrated analytics to reduce improper payments and recover more, faster. Our Alivia 360™ platform uncovers what rules-based systems miss, identifying hidden risks in the “Gray Zone” between error, fraud, waste, and abuse to deliver earlier detection and stronger results across the pre- and post-pay spectrum. Backed by data and IT transformation services, we help clients achieve faster results, greater savings, and reduced provider and member abrasion.
SOURCE Alivia Analytics
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