2024 Partners

Machinify

Website: www.machinify.com

Machinify is the healthcare intelligence company helping health plans improve payment accuracy and efficiency across pre- and post-pay. Deployed by 85+ plans and representing 270M+ lives, Machinify's platform operating system combines AI with clinical, coding, and policy expertise to make better decisions at scale. We support COB, subrogation, itemized bill review, DRG audits, pharmacy, and data mining across commercial and government programs. 

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. 

Penstock

Website: www.penstockgroup.com

Penstock is a high-performance payment integrity partner built for health plans that expect more—from their vendors, their audit programs, and their financial outcomes. We partner with national and regional health plans to deliver rigorous, transparent, and strategically aligned payment integrity programs that improve payment accuracy, uncover meaningful savings opportunities, and drive long-term operational value.

Our tech-enabled, human-led, auditor-controlled model combines deep payment integrity expertise with advanced data mining to uncover what others overlook and strong pre-pa chart review to pay the claim accurately from the start. 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 avoided and 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 consistently generate 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 consolidation across the payment integrity industry continues to reduce transparency and slow innovation, leading 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.