Using our powerful payment integrity / FWA platform, we support payers by providing outsourced SIU resources, pre-pay clinical reviews, post-pay recovery audits, and end-stage renal disease (ESRD) premium protection.
Where resources are limited, Alivia steps in with experienced investigators and clinical staff to pinpoint potential fraud, waste, and abuse using our FWA Finder and Case Manager platform solutions.
The Pre-pay modules in our platform flag and pause suspect claims in real-time, requesting medical records from providers for a thorough review.
Alivia’s advanced payment accuracy models, developed in FWA Finder™, are pivotal in identifying DRG claim, Medical Necessity, Itemized Bill Review, and Payment Analytics reviews with high probability of inaccuracy.
Alivias analytics uncovers previously unrecognized entitlements to End Stage Renal Disease (ESRD) benefits.