Alivia Analytics

Expansive #PaymentIntegrity solutions provide pre- and post-payment flexibility and considerable #costSavings across the #healthcare claims management process. More... -- Clinical and Non-Clinical Audit Scenarios -- First- and Second-Pass Claims Editing -- COB/TPL Supports #medical, #pharmacy, #vision, and #dental claims. Powered by the Alivia Platform that seamlessly transitions between #FWAdetection modules with #AIassistance. #ReducedPaymentErrors #NewRecoveries #PowerfulAnalytics #ResponsibleAI #AutomatedCorrections Learn more: https://lnkd.in/eW6ZRUsi

Honored to be part of this event with Alivia Analytics and Council Capital and to work with the team at both organizations!

[Free eBook] Discover How #AI Boosted ROI by 10,000% & Transformed Staff Efficiency. DOWNLOAD https://lnkd.in/eTjpEtdz | Unlock the power of AI to reduce costs, enhance accuracy, and streamline operations in #healthcare claims management. This eBook dives into critical areas like fraud detection, case management, and claims editing, showcasing how AI increases fraud case capacity while minimizing provider abrasion. Explore how Alivia’s innovative solutions, including #FWAfinder, Alivia #CaseManager, and #PaymentIntegrity solutions, help healthcare payers: -- Simplify complex claims workflows. -- Extract actionable insights from unstructured data. -- Ensure compliance with ever-evolving regulations. Real-world #UseCases & #SuccessStories reveal how AI has uncovered hidden fraud schemes, boosted case volumes tenfold, and delivered unmatched efficiency for leading organizations.

A great start to #NHCAA2024 by the National Health Care Anti-Fraud Association with a wonderful Dueling Pianos event last night and informative Sessions today on Derisking #FWA Plans and the Future of #FraudPevention. Go Alivia team! Lucas Gallardo, Joe Croce, Alex Kormushoff, Carrie Cunningham, Lynn Crowell MHA, RN, CPC, CRC, CPCO, Owen McAdoo, Dave Santivasci, Ryan Berberian, Matthew Perryman, Douglas Fezenko, Michael Boutte #FraudDetectionAnalytics #PaymentIntegrity #DataITacceleration #AI

Thought leaders will exchange insights on emerging strategies and innovative techniques for enhancing fraud detection. This 20-min discussion will focus on the integration of diverse data sources, scalable approaches to processing large datasets, and secure methods of data sharing. It will also explore the synergy between home-built technologies and cutting-edge #FraudWasteAbuse solutions, such as #AI assisted social network mapping and advanced spatial data visualization. This Chat is designed to share concepts and inspire new ideas, offering a visionary look at the #FutureOfFraudPrevention. WED 11/20, 12:45 PM – 1:05 PM | Join Wendy Luc-Pepin, Senior Director, United Strategic Platform – #PaymentIntegrity / #FWA & Error Operations at UnitedHealth Group and Matthew Perryman, Chief Analytics Officer at Alivia. VIEW ALIVIA’S #NHCAA2024 PAGE: https://lnkd.in/eaGsmaS7 National Health Care Anti-Fraud Association Annual Training Conference #Recoveries #ResponsibleAI #advancedAnalytics #HealthcarePayers #CaseManagement #Overpayments

Learn how one health plan is leveraging cutting-edge technology and refined operational processes to derisk their organizations. This session will showcase a collaborative approach between Alivia and CareSource that has enhanced the Special Investigations Unit’s (#SIU) focus on advanced #AI tools, process optimization, and measurable improvements. Examine how this partnership maximizes the SIUs functions to remain in regulatory compliance, generate leads, and manage reporting requirements ultimately leading to significant #CostSavings and #OperationalEfficiency. WED, 11/20, 10:15 AM – 11:15 AM | Join Kelly Anderson, VP of Program Integrity at CareSource and Matthew Perryman, Chief Analytics Officer at Alivia. National Health Care Anti-Fraud Association Annual Training Conference   VIEW ALIVIA’S #NHCAA2024 PAGE: https://lnkd.in/eaGsmaS7 #Recoveries #ResponsibleAI #advancedAnalytics #HealthcarePayers #CaseManagement #FWA #FraudWasteandAbuse #Overpayments

We are proud sponsors at the National Health Care Anti-Fraud Association Annual Training Conference in New Orleans, Nov 19-22. Here's what's on tap… DEMOS & DISCUSSIONS for Adaptive Pre- & Post-Pay Flexibility: ✅ #FraudDetection & Prevention. Case Management. #SIU Services. #AI Assist Functions. ☑ #PaymentIntegrity Solutions: Claims Editing. Clinical Reviews. COB. Data Mining. 📅 Alivia will also co-present a SESSION with Kelly Anderson at CareSource (11/20 10:15 AM) and sponsor a FRAUD SIDE CHAT that shares ideas with Wendy Luc-Pepin at UHG (11/20 12:45 PM). VIEW MORE DETAILS: https://lnkd.in/eaGsmaS7 #NHCAA2024 #Savings #Recoveries #Efficiencies #ResponsibleAI #advancedAnalytics #ActionableAnswers #HealthcarePayers #FraudWasteandAbuse #Overpayments

Alivia’s Medi-Cal experts look forward to discussions with California Health Plans at #CAHP2024. We will share our innovations which #LowerCosts by avoiding #FWA and overpayments, optimizing payment processes, and confidently making data-driven decisions. Discussions will include the powerful, configurable Alivia Platform with adaptive pre- and post-payment flexibility. It offers tech-enabled services and SaaS to holistically address challenges in #PaymentIntegrity, #FraudDetection, investigative #CaseManagement, and #DataManagement. LEARN MORE: https://lnkd.in/eFKnJUC4 CA Association of Health Plans #Savings #Recoveries #Efficiencies #ResponsibleAI #advancedAnalytics #FWAfinder #SIUservices #ClaimsEditing #ClinicalReviews #COB #DataMining #OptimizedClaimSystems

VIEW NEWS & VIDEO: https://lnkd.in/ebF4GPsC | Alivia welcomes Manny Fernandez as SVP of Government Solutions: More about Manny... Manny is responsible for expanding Alivia’s product and service partnerships with State agencies and government health payers that face challenges measuring and managing healthcare quality, #paymentintegrity, and preventing financial losses from overpayments and #fraudwasteabuse (#FWA). This includes #Medicaid, State Employee Benefit Plans, #Medicare, Medicare Advantage, and Medicaid Managed Care Plans. He brings proven leadership and over 20 years of experience in the #healthcare payer market in eligibility and enrollment, coordination of benefits, third-party liability, program integrity, population health, and IT services. Prior to joining Alivia, Fernandez was Senior Principal at Gainwell Technologies. Manny also served in senior management capacities at HMS, now a Gainwell Technologies Company. He is a graduate of Texas Woman’s University. Supporting assistance programs has always been Manny’s personal passion. In his spare time, he and his family volunteer with multiple organizations that support those with food insecurities and lack of access to basic medical care. #welcometotheteam Alivia transforms healthcare payers with superior technology and analytics for #frauddetection, payment integrity, and #dataandITservices

READ NEWS: https://lnkd.in/epdpejjQ | Our expanded #PaymentIntegrity solutions 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 -- Clinical Reviews & Audits -- Data Mining & Advanced Analytics The solutions are delivered as Tech-Enabled Services and 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, CEO 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.” THE ALIVIA ADVANTAGE: -- Vendor Insourcing & Team Integration -- Adaptive Pre- and Post-Pay Flexibility -- Holistic Approach to Accurate, Compliant Audits Why Alivia? View Details: https://lnkd.in/e4_GjVpT   #ReducedPaymentErrors #NewRecoveries #CostSavings #PowerfulAnalytics #ResponsibleAI #AutomatedCorrections