One Platform to Stop Healthcare Fraud. Gain Total FWA Control, From Pre to Post Pay.
We combine early detection with advanced behavioral modeling to reduce improper payments before they happen. Our Alivia 360™ platform targets the “Gray Zone” between error, fraud, waste, and abuse, uniting recovery analytics and payment integrity to uncover hidden patterns missed by rules-based systems. Backed by AI and data & IT transformation services for faster results and savings.
SOLVING COMPLEX CHALLENGES
We help health plans and government agencies address financial losses caused by FWA, errors, missed recoveries, fragmented data, and outdated processes.
Pre-Pay Preventive Analytics
Our FWA Claims Manager™ flags high-risk providers before payment using advanced scoring, configurable pend-and-review triggers, and built-in compliance checks—helping reduce improper payments and streamline early case review.
Post-Pay Recovery Analytics
Our FWA Finder™ uncovers hidden leads and accelerates SIU investigations, while Alivia Case Manager™ streamlines case volumes and workflows. Combined with Clinical Audits and Data Mining, we recover more from overlooked FWA and errors.
Innovative Data & IT Services
Our DataChrome™ standardizes claims data into analytics-ready formats and supports all ingestion needs. We also optimize and migrate Claims Systems and Safeguard PHI, advancing payer transformation with secure, scalable infrastructure.
Responsible AI
Alivia’s AI supports as an optional “assistant” to enhance productivity, not a replacement, prioritizing ethical use, human oversight, and compliance with industry standards.
Serving Payers of All Sizes
Alivia delivers trusted solutions to a broad range of payers, from Medicaid, Medicare, and state programs to private health plans, TPAs, and self-insured employers. Clients range from small regional plans to national payers with millions of members, each supported with tailored oversight and measurable results.
