Alivia Expertise for Commercial Health Plans

Commercial

Commercial health plans face several challenges which include: measuring and managing payment integrity and value-based care; preventing financial losses from fraud, waste, abuse (FWA) and overpayments; navigating a variety of regulatory and compliance requirements; safeguarding PHI from cybersecurity threats; maintaining legacy claims systems with limitations and high costs; and handling disparate claims data sources.

Our Expertise

We have deep expertise across Private Health Insurance Plans, Employer-Sponsored Insurance (ESI), Third-Party Administrators (TPAs), and Self-Insured Employers.

Alivia’s products and services include:

  • Precision fraud detection analytics with an integrated case manager for large volumes of fraud cases
  • Payment integrity solutions that identify new recoveries, deliver actionable pre- and post-pay analytics, and offer automated pre-pay corrections
  • Data and IT services with unique and innovative approaches