The AI billing problem health plans can't afford to ignore.

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.

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.

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.

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.

Simple to implement. Secure by design.

HIPAA Compliant

SOC-II TYPE II

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.

"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.