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You’re in Good Company.

Alivia Analytics is the trusted partner and software solution that empowers healthcare payment integrity business leaders and experts to operate with unparalleled efficiency, accuracy and speed. Our customers are tired of pushing the FWA boulder up the hill and want a better way to achieve healthcare payment integrity.

With Alivia Analytics You Can:

Achieve healthcare payment integrity
Get actionable answers
Prevent FWA
Pursue the right cases faster
Simulate future forecasts

Investigations

Preventing and recovering FWA is easier when you have actionable answers at your fingertips. Our FWA Finder creates the efficiency you need to uncover new schemes, automate requirements, increase cases and investigate faster.

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Vivida Health: Customer Success Story

Vivida Health, a Managed Care Organization (MCO), needed to comply with State of Florida Healthcare Payment Integrity Requirements within their first year of operations. Their investigations consultant Justice Group activated Alivia Analytics FWA Finder™.

As a result, Vivida Health was able to achieve more:

  • Uncovered dozens of new fraud schemes that were previously unknown to them
  • Automated quarterly and annual reporting requirements
  • Increased case volume by 1000% without needing to add additional staff
  • Received State of Florida certification

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Recovery

When you need to recover FWA, you need accuracy and speed. Chasing the wrong cases is a waste of time and money and can lead to provider abrasion. Alivia Analytics is built to give you the lowest false positive rates in the industry so you can work the right cases faster.

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Pacific Blue Cross: Customer Success Story

As the #1 provider of health, dental and travel benefits for over 75 years, Pacific Blue Cross needed to significantly improve their payment integrity efficiencies with a primary goal of increasing payment recovery. They engaged Alivia Analytics and took advantage of our FWA Finder.

As a result, Pacific Blue Cross was able to achieve more:

  • Increased their ROI by 11x in the first 12 months of going live
  • Performed 2 years of work in 4 months
  • Reduced time-to-recover from 12 months to 3 months
  • Reduced false positive rate to under 1%

“The Alivia Analytics team has helped bring our investigators into the future of identification and recovery.” - Suzanne Solven, Pacific Blue Cross

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ClaimSecure: Customer Success Story

As one of the largest Third Party Administrators in Canada, ClaimSecure wanted to streamline their FWA identification and recovery process to increase customer success and revenue. They put Alivia Analytics FWA Finder™ and Alivia Analytics Case Manager™ to work.

As a result, ClaimSecure achieved more:

  • Higher productivity with minimum additional staff
  • Increase in monthly FWA case creation by over 1000%
  • 70x improvement over prior analytics solution
  • 300% increase in recoveries

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Simulation

Predicting the future of your ever-changing healthcare claims business is impossible - until now. Alivia Analytics makes accurately forecasting your business and risk portfolio a reality. Alivia Analytics Outcome Simulator™ delivers powerful insights that allow you to simulate business scenarios to predict your health care payment integrity trends with precision.

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Pacific Blue Cross: Customer Success Story

Pacific Blue Cross needed to accurately forecast their high-cost drug spend. If they overestimated the amount, they would overcharge their large corporate customers and risk customer churn. If they underestimated the future charges, Pacific Blue Cross would suffer direct losses. Pacific Blue Cross turned to Alivia Analytics Outcome Simulator™ to deliver accurate predictions for their high-cost drug spend.

As a result, Pacific Blue Cross achieved more:

  • 10x increase in high-cost drug spend accuracy
  • Reduced customer churn
  • Increased the bottom line

"Our risk management team is able to leverage the Alivia Analytics Outcome Simulator™ - its robust machine-learning capability helps us better project our pooled costs for our clients. Our previous forecasting system relied heavily on pooled costs remaining relatively static over time, even though these costs tend to fluctuate drastically due to changes in the client’s member population or other exogenous events, like COVID-19. With Alivia Analytics Outcome Simulator™, we are now able to dynamically adjust our rates to match the ever-changing landscape around us, making us a nimbler business equipped to confront hard-to-predict, unforeseen events." - Jason Welch, VP of Group Business

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