2024 PARTNERS
Headline
AMS Intelligent Analytics
Website: www.amspredict.com
Advanced Medical Strategies (AMS) is the premier provider of payment integrity, risk management, and business intelligence solutions to identify and address excessive claims, prevent and recoup overpayments, and effectively manage the risks associated with high-cost claimants and group health underwriting.
Find out more: https://pricetransparency.com/
PLATINUM PARTNER
Machinify
Website: www.machinify.com
Machinify is redefining payment integrity with AI-powered solutions designed to be frictionless, intelligent, and future-ready. Trusted by over 60 health plans, Machinify simplifies the complexity of healthcare claims with a platform that coordinates, validates, and pays claims with precision. Backed by cutting-edge technology and healthcare expertise, Machinify delivers cost savings, operational clarity, and strategic insight—empowering payers to take full control of their payment operations.
Machinify Solutions
Machinify offers a unified platform for payment integrity, combining pre-pay and post-pay solutions to detect, prevent, and resolve improper payments across the claim lifecycle.
- Pre-Pay Adjudication & Accuracy: Automatically identify potential errors or duplications before claims are paid, reducing downstream recovery efforts.
- Post-Pay Analytics & Recovery: Leverage advanced AI to uncover patterns, prioritize audits, and streamline recovery with high accuracy and minimal friction.
- Audit & SIU Support: Equip Special Investigation Units and audit teams with AI-enhanced tools to detect fraud, waste, and abuse faster and more effectively.
- Configurable, Modular Platform: Tailored to integrate into existing workflows with flexibility and speed, enabling rapid value without disruption.
Machinify’s intelligent platform unifies fragmented payment integrity processes, empowering payers to reduce costs, increase efficiency, and improve payment accuracy at scale.
NETWORKING PARTNER
GOLD PARTNERS
Alivia Analytics
Website: www.aliviaanalytics.com
Your most expansive Payment Integrity and FWA partner for medical, pharmacy, vision, and dental claims. This features our powerful, configurable Alivia 360™ Platform that provides pre- and post-payment flexibility and considerable cost savings across the healthcare claims management process. It seamlessly transitions between FWA detection and Payment Integrity solutions including clinical and non-clinical audit scenarios, first- and second-pass claims editing, and COB/TPL. Alivia 360™ not only ensures comprehensive financial oversight but full adaptability to operational needs. Alivia integrates AI as an assistant, not a replacement, prioritizing ethical use, human oversight, and compliance with industry standards. Our solutions are offered as SaaS or tech-enabled services that build strong cases against inappropriate billing practices, identify new recoveries missed by legacy vendors, deliver actionable analytics, and offer automated corrections. Alivia enables healthcare payers to streamline vendor management, improving control and strategic decision-making. Schedule a discovery meeting and demo.
Rialtic
Website: www.rialtic.io
Rialtic equips payers with technology to enable payment accuracy capabilities, greater choice of policy options, easier response to a changing environment, and an overall lower administration cost.
SILVER PARTNER
EXHIBITOR
Penstock
Website: www.penstockgroup.com
Penstock is a high-performance payment integrity partner built for health plans that demand more—from their partners and their results. We work with national and regional health plans to restore the depth, attention, and transparency that has been lost in today’s increasingly consolidated payment integrity landscape.
Our human-led, auditor-controlled model combines deep payment integrity expertise with advanced data mining to uncover what others overlook. Every finding is grounded in plan-specific policy, contract language, and defensible logic—designed to hold up under audit, appeal, and regulatory review. The result is real dollars recovered, recurring issues addressed at the source, and sustained improvements in payment accuracy.
Penstock’s post-pay work functions as a plan’s research-and-development engine for pre-pay. Through deep post-pay audits and ongoing data mining, our teams generate 4–6 new claim overpayment concepts each month. By analyzing claims with full context and clinical nuance, we identify not just individual claim overpayments, but the systemic patterns behind them—providing the insights plans need to strengthen pre-pay controls and prevent future leakage.
As payment integrity vendors consolidate and innovation stalls, health plans turn to Penstock for precision, accountability, and results that compound over time. Ranked No. 353 on the 2025 Inc. 5000 list—top 50 in healthcare—and named the fastest-growing private company in the Northeast, Penstock is redefining what defensible, modern payment integrity should look like.