Latest news with #AliviaAnalytics
Yahoo
17 hours ago
- Business
- Yahoo
Alivia Analytics Debuts Alivia 360™ Platform With Early Fraud, Waste, Abuse (FWA) Detection for Healthcare Payers
PHILADELPHIA, June 24, 2025 /PRNewswire/ -- Alivia Analytics, a leader in AI-powered FWA detection and analytics for healthcare payers, today announced the official debut of Alivia 360™, its unified platform for pre- and post-payment fraud, waste, and abuse (FWA) detection. As part of the launch, Alivia is introducing FWA Claims Manager™, a new pre-payment analytics solution that helps health plans and government agencies act earlier to prevent improper payments before they occur. FWA Claims Manager™ focuses on identifying high-risk providers and suspicious billing behavior that fall into the Gray Zone, subtle, often-overlooked activity between error, fraud, waste, and abuse that traditional rules-based systems fail to catch. By flagging these patterns before payment is issued, FWA Claims Manager enables earlier intervention, minimizes downstream effort, and protects plan resources. This advancement complements Alivia's established post-payment suite, where its AI-powered FWA Finder™ and centralized Alivia Case Manager™ continue to deliver value by detecting new leads, accelerating investigations, and streamlining fraud workflows. To further strengthen recovery outcomes, Alivia reinforces its post-pay payment integrity solutions, including Clinical Audits, Data Mining, and Code Editing. These capabilities help validate billing accuracy, medical necessity, and compliance across high-risk claims, driving greater audit precision and improved recoveries. "At a time when healthcare payers are under pressure to reduce losses and act faster, Alivia 360 provides one platform to detect and manage FWA from every angle," said Michael Taylor, MD, CEO of Alivia Analytics. "With the introduction of Early FWA Detection and expanded recovery analytics, we're equipping our clients with the tools to make smarter decisions across the entire claims lifecycle." Alivia 360™ also integrates proprietary data transformation services, enabling the rapid ingestion and standardization of fragmented claims data into analytics-ready formats, accelerating insights and driving operational impact across payer environments. About Alivia Analytics Alivia Analytics helps health plans and government agencies address complex claims challenges, combining AI-powered technology, expert services, and integrated analytics to reduce improper payments and recover more, faster. Our Alivia 360™ platform uncovers what rules-based systems miss, identifying hidden risks in the "Gray Zone" between error, fraud, waste, and abuse to deliver earlier detection and stronger results across the pre- and post-pay spectrum. Backed by data and IT transformation services, we help clients achieve faster results, greater savings, and reduced provider and member abrasion. View original content to download multimedia: SOURCE Alivia Analytics
Yahoo
20-05-2025
- Business
- Yahoo
Dale Carr Joins Alivia Analytics, Former Director of Missouri Medicaid Audit and Compliance
PHILADELPHIA, May 20, 2025 /PRNewswire/ -- Alivia Analytics, a leading AI-powered healthcare data analytics company, announced that Dale Carr has joined the organization as Client Engagement Director for the Government Market. Dale brings more than 40 years of public sector experience across federal, state, and local agencies. He previously served as Director of Missouri Medicaid Audit and Compliance and was a founding member of the division when it launched in 2011. As a former Alivia client, he brings firsthand experience using advanced analytics to prevent and recover financial losses from fraud, waste, abuse (FWA), and overpayments—insights he will now apply to help other government agencies improve payment integrity. His career includes investigative roles with the U.S. Office of Special Counsel, the U.S. Coast Guard Investigative Service, and as a police officer. He is a graduate of Columbia College and the FBI National Academy. Dale is also a former board member of the National Association for Medicaid Program Integrity (NAMPI), where he helped foster cross-state collaboration and continues to be a frequent speaker on program integrity strategies. "Dale brings a rare combination of operational insight and investigative expertise," said Michael Taylor, MD, Chief Executive Officer of Alivia Analytics. "As a former client, he knows exactly how to apply our analytics platform to drive results. We're excited to welcome him to the team." "Alivia's solutions helped me recover millions in improper payments at the state level," added Dale Carr. "I now look forward to helping other states unlock the same level of impact faster and with greater confidence in their data." Outside of work, Dale and his wife care for more than eight horses and enjoy traveling. Alivia will sponsor the NAMPI Conference in St. Louis, August 24-27, 2025, where Dale will share insights on maximizing ROI for government agencies, including during Alivia's product demonstrations. About Alivia Analytics Alivia Analytics helps health plans and government agencies tackle complex claims challenges, from financial losses due to fraud, waste, and abuse (FWA) to missed recoveries, fragmented data, and outdated processes. The Alivia 360™ platform unites revolutionary post-pay FWA detection modules with pre-pay fraud prevention logic to stop high-risk providers at the source, reinforced by payment integrity audits that share actionable insights. Backed by experts, AI-enabled technology, and data and IT transformation services for faster results, greater savings, and reduced provider and member abrasion. Learn more at View original content to download multimedia: SOURCE Alivia Analytics Sign in to access your portfolio
