MAnaged Services
Scale your workforce with our expert clinical team
Hand your claims to Alaffia and we take it from claim to revenue, with minimal lift required on your end. Our AI platform and clinical team review itemized bill, DRG, and complex claims with the speed of automation and the accuracy of human validation. Live in under 30 days. Savings realized within 60 days.
CLAIMS OPERATIONS, ACCELERATED BY AI
Low-lift, high-impact claims operations, fully managed.
Our managed services solution pairs clinical expertise with our AI platform.
Claims and charts are turned into structured clinical facts, triaged by complexity and dollar value, and summarized against your policies in minutes, with every finding confirmed by a clinician or certified coder before it reaches your team.
Streamlined processing of claims and medical records
Smart triage surfaces the claims worth your time
Instant clinical summaries for faster decisions
AI surfaces the findings, clinicians validate them
DESIGNED FOR YOUR HEALTH PLAN
Estimate Savings
See what your health plan could save
Discover the potential savings of partnering with Alaffia to support your health plan's claims review operations.
Potential Savings
$37.5M - $75M
Potential Savings
$37.5M - $75M
Engagements that meet you where you are
When you work with Alaffia, you get a strategic design partner and advisor that acts like an extension of your team.
Insource
Your clinical team, accelerated.
Integrate our AI platform as a core pillar of your existing workflows. Your in-house clinicians and coders review more claims, more consistently, without adding headcount.
Hybrid
Your team, augmented for scale.
Combine intelligent automation with a blend of in-house and Alaffia clinicians to expand your scale, consistency, and output across itemized bill, DRG, and complex claims review.
Outsource
Your claims operation, fully managed by Alaffia.
No clinicians on staff, or need surge capacity fast? Alaffia becomes your clinical team, pairing licensed physicians, nurses, and certified coders with our AI Agents to manage the full review lifecycle, from intake to finding.
Get in touch with our team today to explore which solution is right for you.
Enterprise-level security
We uphold the strictest enterprise-grade security standards to keep member and payer data private and secure.
Why leading health plans partner with Alaffia
“Alaffia opened our eyes to bigger savings and recoveries than we ever thought possible. The dollars they unlock and services they deliver are unlike anything I’ve seen from previous vendors.”
Leading Regional Health Plan
VP of Operations
“Their platform provides a level of visibility we simply didn't have before. It’s transformed how we manage our payment integrity processes across the entire organization.”
Regional Health Plan
VP of Operations
“The speed of implementation and the immediate ROI was impressive. Alaffia's team feels like an extension of our own, dedicated to our success every step of the way.”
Regional Health Plan
Head of Payment Integrity
“Alaffia is setting a new standard for how data and AI can be used to protect Medicaid resources while ensuring patients receive the care they truly need.”
US Medicaid
Dr. Andrey Ostrovsky, Former CMO
Get up and running with Alaffia in just 30 days
No matter which engagement model you choose, integration into your current systems is seamless. Get in touch with our team and start seeing ROI fast.
Identify your savings