Alaffia Health provides AI-powered solutions to automate pre-payment claim reviews for healthcare payers and cost-containment firms.

Alaffia Health

Alaffia Health is a healthtech company that uses AI to reduce claim spending and operational costs for healthcare payers and cost containment firms. We provide our clients Autodor, our integrated claim review SaaS platform, to help them most efficiently ingest, review, and process healthcare claims. Please visit our website to learn more and schedule a demo. 

(ERA) Entrepreneurs Roundtable Accelerator

Tau Ventures

Twine Ventures

1984 Ventures

Anthemis

Aperture Venture Capital

Remarkable Ventures

Plug and Play

🎉 Please join us in welcoming Eric Reeves, our new Vice President of Sales, to the Alaffia team! Eric brings a wealth of knowledge about the challenges facing health plans today, and we're excited to have him support our clients with advanced software solutions.

#healthplans #artificialintelligence #costcontainment

Understanding hospital facility fees and staying ahead of legislative changes can ensure accurate billing and reduce errors. Our article provides the latest updates on hospital facility fees and helps you understand their impact on your medical claims reviews.
#Healthcare #MedicalBilling #FacilityFees #AI #Legislation #HealthcareInnovation #AlaffiaHealth

Have you ever wondered whether your healthcare payer organization is in compliance with the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) for mental health claims? Our article provides essential updates on a recent ruling that could affect your mental health claims processes.

In the 2024 Ryan S. v. UnitedHealth Group, Inc. case, the Ninth Circuit U.S. Court of Appeals expanded the pleading standard for MHPAEA violation allegations. The ruling stated that using stricter review processes for mental health claims compared to medical claims, even without outright denial, could still violate the Mental Health Parity Act. 

This means that even legitimate denials could be an issue if the process for reviewing mental health claims is tougher than for other types of claims. Keep reading to learn more!

#parityact #MHPAEA #classactionlawsuit #integrity #professionals #ai #future #artificialintelligence #mentalhealth #compliance #regulatorycompliance #alaffiahealth

Imagine cutting your claim costs in half overnight. That happened when Alaffia Health's AI platform detected an unusual charge in an inpatient hospital claim, saving a health plan over $16,000. Learn more about it in our latest bill review spotlight.

#HealthcareInnovation #AIinHealthcare #OperationalEfficiency #MedicalClaims #CostSavings #InsuranceTech #HealthcareAI

Check out our article highlighting shocking telemedicine fraud cases, recent congressional actions to extend telemedicine benefits, and how to use technology to guard against telemedicine fraud in your healthcare payer organization.

As law enforcement investigates and prosecutes telemedicine fraud cases amounting to billions, healthcare payers must implement vigilant monitoring and prevention measures as lawmakers further efforts to extend benefits set to expire at the end of 2024.  

#TelemedicineFraud #Telemedicine #CongressionalAction #HealthTech #FraudWasteAbuse #FWA #HealthcareFraud #HealthcarePayers #AIPowered #AlaffiaHealth

Check out our latest article that discusses recent CMS guidance on ensuring AI's ethical and compliant use in Medicare Advantage claims processing. 

Healthcare payers must carefully balance AI use with responsible decision-making to avoid legal issues highlighted by recent lawsuits. 

Alaffia Health assists payers in understanding and complying with these regulations to ensure ethical and compliant AI use.

#HealthcareAI #MedicareAdvantage #CMSGuidance #EthicalAI #AICompliance #HealthcareInnovation #ClaimsProcessing #HealthTech #LegalCompliance #PatientCare #AlaffiaHealth #MedicalClaims #HealthcareRegulations #HealthInsurance

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Alaffia Health