Case Study: a regional healthcare payer achieves $21M in savings with Alaffia Health

Regional Healthcare Payer realizes $21M in savings with Alaffia Health

A regional healthcare payer faced the challenge of maintaining payment integrity across a large volume of high-dollar hospital claims. Their previous vendor's traditional review services left critical gaps, leading to arduous workflows and limited accommodation of their specific requirements. They partnered with Alaffia Health to upgrade their claim review process.

Alaffia implemented its AI-powered platform to put complex claim reviews on autopilot. The solution was customized to the payer's specific policies and workflows, meticulously uncovering billing discrepancies. This resulted in $21M in realized savings, a 20% savings rate, and an appeal rate of under 2%, all while giving valuable time back to the claims processing team.