Healthcare Fraud Detection Solutions

Our AI-enabled fraud, waste, abuse (FWA) products and services help commercial and government health plans reduce healthcare spending and prevent and recover financial losses from FWA overpayments.

FWA Finder™

The backbone of our powerful, configurable Payer Analytics Platform is Alivia’s FWA Finder which accelerates SIU / fraud investigations. It offers fast, actionable insights to prevent and recover financial losses from fraudulent provider behaviors that are plaguing the healthcare system.

Alivia Case Manager™

Our Case Manager for healthcare fraud detection is unique in the industry. It works seamlessly with Alivia’s FWA Finder and existing workflows, providing a comprehensive solution for managing large volumes of fraud cases—fully compliant for reporting to CMS and regulatory agencies.

SIU Services

When resources are limited, Alivia’s investigators and clinical staff pinpoint potential FWA using our FWA Finder and Case Manager. We work closely with SIU and Compliance teams to proactively pursue improper payment recoveries, administrative actions, and support fraud referrals to law enforcement.