Alivia Analytics at 2025 HPRI Chicago, FWA & Payment Integrity

September 10-11, 2025
InterContinental Chicago Magnificent Mile
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Alivia Analytics is a proud Sponsor and Keynote Speaker of the 2025 HPRI Conference in Chicago, hosted by the Healthcare Payment & Revenue Integrity Congress. During this two-day event, we’ll showcase how our Alivia 360™ platform helps payers solve complex claims challenges across the pre- and post-payment spectrum. Our platform unifies AI-powered technology, expert services, and integrated analytics to combat fraud, waste, and abuse (FWA), validated by Payment Integrity solutions. By uncovering what rules-based systems miss, Alivia 360™ identifies hidden risks in the “Gray Zone” between error, fraud, waste, and abuse—delivering earlier detection, fewer improper payments, and faster recoveries for commercial health plans and state Medicaid agencies alike.

Solutions

One Platform. Powered by Early Detection.
Gain Total FWA Control, From Pre to Post Pay.

Pre-Pay FWA Preventive Analytics flags high-risk providers before payment using advanced scoring, configurable pend-and-review triggers, and built-in compliance checks, reducing improper payments and streamlining early case review. Leverages an Edit Engine that validates claims as a primary, secondary, and/or post-payment editor backed by industry experts and advanced technology.
Post-Pay Recovery Analytics that surfaces hidden leads, accelerates SIU investigations, and manages case workflows—supported by Clinical Audits and Data Mining to validate medical necessity, policy compliance, and uncover overlooked savings. Outsourced SIU is available when you have limited resources.
Data & IT Transformation centralizes fragmented claims data, converting and consolidating it into standardized, analytics-ready formats. Our IT services modernize legacy systems, optimize claims platforms, and safeguard PHI across environments.

One Platform

unifies solutions and shares insight and actions at any point in the claims lifecycle.

Pre-Pay FWA Preventive Analytics

Post-Pay FWA Recovery Analytics

Data Transformation Services

VALIDATED BY EDITS, AUDITS & MODELING

Keynote Session

Blurring the Lines: Navigating the Gray Zone Between Payment Integrity and FWA

THR 9/11, 10:55 AM – 11:20 AM

Alivia’s Matt Perryman will lead an exclusive panel to include Scott Hirschbrunner, Director of Payment Integrity, Nebraska Blue and a panelist TBA.

As health plans continue to evolve their strategies around medical cost containment, the distinction between payment integrity and fraud, waste, and abuse is becoming increasingly nuanced. This session explores the “gray zone” where wasteful or abusive billing practices don’t clearly qualify as fraud, but still pose significant financial and ethical risks.

How payment integrity and SIU teams can effectively collaborate
Where the hand-off should occur between routine overpayment detection and deeper investigation
Real-world examples where waste tipped into abuse, and how it was handled
How health plans can build workflows that enable earlier intervention before issues escalate
The operational and cultural gaps between PI and SIU and how to bridge them