Coordination of Benefits: Full-Service Offering
Our tech-enabled service uses Alivia’s powerful, configurable Payer Analytics Platform to quickly and accurately coordinate benefits for two or more health plans, paying their appropriate share for the care. We run models determining potential members with other coverage (Commercial Carriers and Medicare), identify members with additional coverage, secondary, tertiary, etc., and submit the required member information and claims needed for reclamation or recoveries.
In-Scope Membership:
- Commercial (Fully Insured / ASO)
- Federal Employees Plan
- Medicaid
- Medicare
- Commercial to Commercial
- Commercial to Medicare
- Medicaid to Medicare
- FEP to Medicare
Alivia’s Feedback Loop
Rules Based Engine
COB engine based on standard COB industry rules set
Machine Learning Enhancements
ML continuously enhances algorithms. Find the coverage data that others can’t
External Data Sources
Data intelligence perpetuates greater accuracy and efficiencies
AI ASSIST FUNCTIONS
Alivia’s AI capabilities extend beyond traditional data analysis, providing predictive modeling, real-time decision support, and automated workflows that enhance operational effectiveness. By leveraging AI, we help organizations avoid fraud, optimize their payment processes, and confidently make data-driven decisions.
Alivia Healthcare LLMs
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