Alaffia Raises $55M Series B to Tackle Healthcare's $570B Waste Problem. Read More.

Cut wasted spending with AI you can trust

Every year, health plans lose billions to improper payments and administrative waste. We’re using expert clinicians and transparent AI to change that.

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Alaffia Dashboard

Trusted across the entire claims lifecycle

Special Investigations
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Appeals
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Utilization Management
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Payment Integrity
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Case Management
Inspection icon
Special Investigations
Cluster icon
Appeals
Approval icon
Utilization Management
Shield icon
Payment Integrity
File box icon
Case Management
Inspection icon

Supercharge your claims operations

Purpose-built for health plans, our AI platform delivers deeper insights, smarter automation, and consistently better outcomes.

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With alaffia's AI Solutions, you can:
Automate routine clinical case reviews with AI agents
Empower your team to work at the top of their license
Get results with unmatched accuracy and defensibility
01

Configuration

Our agents are configured to meet your clinical needs. Your plan’s specific data, policies, and processes are integrated into our AI platform to create bespoke workflows and outputs.

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02
Data extraction

Comprehensive medical records are normalized into pre-built clinical facts to flexibly service your clinical decisioning needs, then annotated by our clinicians for accuracy.

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03
Clinical analysis and triage

Your agent cross-references your medical records against clinical criteria and policy guidelines, automating routine cases and prioritizing the most valuable claims for human review.

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04
Human validation

Every recommendation includes a clear clinical rationale and traceable citations for unmatched defensibility. Human clinicians are always at the helm for overview and signoff.

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Simple to implement.
Secure by design.
HIPAA shield

HIPAA Compliant

SOC AICPA

SOC-II
TYPE II

HITRUST

HITRUST

Seamless integration

We get up and running in just 30 days, with immediate ROI. Integration into your current systems is seamless, with no disruption to your operations or changes to your workflows.

Enterprise-grade security

We uphold the strictest enterprise-grade security standards to keep member and payer data private and secure. We adhere to SOC-II Type II, HIPAA, and HITRUST security standards.

Our customer impact by the numbers

20x

increase in throughput

97
%+

accuracy rate

5x

ROI

What our health plan partners are saying

See how other health plan leaders are using Alaffia’s AI solutions to transform their workflows.

"Alaffia is streamlining how medical claims are processed and reviewed. They're applying AI and machine learning in new ways that will reduce burden and lower costs across the industry, which will free up resources to more equitably care for patients."
Dr. Andrey Ostrovsky
Former CMO, US Medicaid
“Alaffia has some of the best AI technology we’ve come across in the market. It's amazing.”
Director of Payment Integrity
National Health Plan
"Agentic AI is the future and Alaffia is on the forefront with their best in class technology."
VP of Payment Integrity
Regional Health Plan
"We're excited about using Alaffia's generative AI solutions to streamline our medical claim reviews. We anticipate significant improvements in productivity that will allow each auditor to focus on our highest value work."
Head of Payment Integrity
Regional Health Plan
“Alaffia has some of the best AI technology we’ve come across in the market. It's amazing.”
Director of Payment Integrity
National Health Plan
"Alaffia is streamlining how medical claims are processed and reviewed. They're applying AI and machine learning in new ways that will reduce burden and lower costs across the industry, which will free up resources to more equitably care for patients."
Dr. Andrey Ostrovsky
Former CMO, US Medicaid

Drive health plan affordability with Alaffia

Discover how our clinical review platform drives real savings for your plan.

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