2024 Partners

Machinify

Website: https://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.

Alivia Analytics

Website: https://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: https://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: https://www.penstockgroup.com/

Penstock is a payment integrity partner purpose-built for health plans and integrated health systems. As consolidation reshapes the industry, many vendors have shifted focus toward volume and automation. Penstock takes a different approach—delivering the attention, accuracy, and innovation today’s health plans deserve.

Our team of industry veterans brings decades of clinical, coding, and regulatory expertise—backed by proprietary technology that empowers smarter, faster, and more transparent audits. From first-pass to deep, multi-pass reviews, we uncover savings others miss while helping reduce provider abrasion.

Our internal platform, ClearBridge, was developed by auditors, for auditors—enabling real-time logic visibility, streamlined workflows, and smarter outcomes at every stage of review.

Recognized as one of the fastest-growing companies in payment integrity and Best Place to Work, Penstock is powered by people who love what they do—and it shows in the results we deliver.