Revealing Hidden Fraud Schemes and Boosting Case Volume Tenfold Through Advanced Analytics


A Managed Care Organization (MCO) needed to comply with state healthcare payment integrity requirements within its first year of operations. They activated Alivia Analytics FWA Finder™.


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