Healthcare Administration Solutions

Alivi provides healthcare consulting and outsourcing solutions aimed at helping health plans streamline operational efficiencies while overcome their day-to-day challenges efficiently, to save resources and increase revenue. By means of implementing industry-proven best practices, payer-tailored technology, outsourced services, or other strategic advisements, we help our clients to thrive in today’s healthcare landscape.

Payer Solutions to Meet Every Need

Strategic Analysis & Insights

Turn raw data into actionable reports and insights that can help your bottom line.

Operational Performance

Identify how you can optimize performance by adopting innovative strategies.

Regulatory Compliance Advisement

Keep up with evolving regulations and market changes to correct and prevent deficiencies.

Payer Contracting

Receive help with analyzing your value proposition, building proposals and negotiating rates.

Revenue Optimization

Learn how you can increase processing accuracy while reducing turnaround time.

Provider Network Development

Credentialing Verification Outsourcing (CVO)

Provider Management

Member Management

Claims Processing

Analytics and Reporting

Revenue Health Optimization

Quality Assurance

EDI Services

FW&A Protection

Risk Management

Eligibility Services

Insights

Detailed analytics that meet regulatory guidelines and SLA requirements and give plans the ability to report on outcomes. We analyze the aggregated trends and provide additional insights to help you stretch your dollars further while providing better care.

Utilization

Our UM department works in a 14-day or 72-hour escalation window backed by a staff of medical directors and trained UM coordinators to remove friction between members and appropriate care. Using the InterQual Medical Necessity platform, we add an extra layer of security against FWA losses while streamlining the process for providers.

Claims Processing

Our adjudication service combines automation with our claims coordinators for an average claim accuracy rate of 98%. Between analysis and payment, we add a level of human expertise to examine claims where appropriate to reduce Fraud, Waste, and Abuse.

Credentialing

We offer provider credentialing and re-credentialing with demographic updates and yearly maintenance along with ongoing oversight and automated alerts when violations are found.

Connect With A Managed Care Expert

Discover innovative solutions for some of your organization’s biggest pain points. Schedule a call to learn how we can help you reach your quality and performance goals.