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Best-in-class technology offerings
Increased risk score accuracy
Decreased OpEx
Increased compliance
Innovation tied to value outcomes
Single point of accountability
How Allymar Health works with Health Plans
Allymar Health brings expert advisory services, owned technology and BPaaS offerings and pairs these with industry leading Medicare Advantage technology in one centralized platform. Our health plans benefit from:
Data Aggregation
We aggregate, normalize, and unify structured, unstructured, and semi-structured data into our common data platform using the latest technology tools and standards such as FHIR and HL7.
Clinical Insights Engine
We identify confidence-adjusted and evidence- based care gap opportunities for every member by leveraging out clinical data repository of over 100M EMR and medical charts.
Patient Data Profiles Integrated into your Workflows
Member and provider level curated data profiles are available in a variety of formats to enable payer and provider workflow integration.
Prospective and Retrospective Services
We offer a full suite of managed services using our AI risk tool to accurately capture documented conditions and identify additional opportunities for prospective provider assessment, including 2-way review and risk mitigation.
Performance Management and KPI Tracking
We provide a self-service and interactive reporting platform that allows your organization to manage RAF performance which includes operational, program/campaign level and financial reporting packages to identify progress towards achieving your RAF objectives.
Access to best-in-class technology offerings
Allymar Health empowers health plans to improve patient care with
real-time actionable data provided at point of care.
This allows our Health Plan Partners to:
Improve RAF accuracy
Be fully compliant and secure
Access the best enterprise technology partners in one simplified platform
Allymar Health offers an unparalleled level of experience and data allowing for better modeling and AI delivery
Allymar Health empowers health plans to improve patient care with real-time actionable data provided at the point of care.
500+ Allymar Healthcare professionals providing products and services***
20,000+ healthcare professionals with 500+ licensed medical professionals
Healthcare management consulting
Health intelligent operations centers
Health customers (through our Partner Network)
Health patent
Enrollment and billing technology
Claims and payments system
Provider portal (through our Partner Network)
AI charts
Clinical records
Take unstructured data from all sources and have it pulled into coding recommendations, care gap opportunities and next steps for patients.
Our Approach
Allymar Health provides a future-tech ready Enterprise Medicare Advantage Platform that offers intelligent, multi-tenant capabilities in Risk Adjustment, Quality, and Core Admin.
Tailored to the unique needs of growth-oriented plans.
Market-leading, secure services at scale designed for small to mid-sized health plans.
Fully auditable, traceable solution to maximize compliance with federal and state regulations.
The Allymar Health platform allows health plans to focus on healthy patient outcomes.
Streamlined vendor governance
Improve coding efficiency up to 99%
Achieve quality metrics across your plan and be fully complaint
Achieve quality metrics across your plan
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Allymar Health's Medicare Advantage Suite
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Call Center & Core Operations
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Risk Diagnostic
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AI Chart Review
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AI HEDIS
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Risk & Quality Analytics
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Member And Provider Outreach Services
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In-Home Assessments
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CAHPS Survey
Core Admin
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Core Admin Diagnostic
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Enrollment And Billing
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Claims And Payments
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Member Service
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Customer Service
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FWA/SIU
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Appeals & Grievances
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Broker Management and Commission
Health Management
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Utilization Management
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Care Management
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Clinical Insights & Diagnostics
Artificial Intelligence
Stars
Pharmacy STARS Reporting
CMS / HHS Submissions
Member Engagement
Provider Engagement
Analytics & OS
AI / Chart Review
OCR & Workflow
Reporting & Analysis
Performance Dashboard
Data Warehouse
Data Quality & Standardization
Operational
Analytics & Bi
How the Allymar Health Platform works
Mrs. Johnson
Understanding the Patient
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Ingest various structured & unstructured data into the Risk Al Platform.
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EHR, Claims, Labs, Supplemental Data, etc.
Recapture/Suspect HCCs and Quality Gaps in Care
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Risk & Quality Reporting Suite
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Risk Al Platform generates suspect diagnoses and gaps based on machine learning algorithms trained on millions of data.
Point of Care HCC and Gap Closure + Phys. Engagement
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Provider sees patient in the office and is notified of recapture suspect dx + quality gaps within EHR and captures the diagnoses.
EHR Chart Retrieval
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EHR Retrieval
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Fax, Mail, Call Center, Onsite as Needed
Al-Assisted Risk + HEDIS Coding
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Code charts using Al-assisted coders on the Risk and HEDIS AI Platform.
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Concurrent Review
Encounter Submissions & Fallout Analysis
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Submit at 95%+ accuracy with insights into encounter and dx fallout
Financial Projections
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Estimate incremental financial impact based on payment year
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RAF accruals & revenue forecasting
Head-to-head competition
In four (4) recent ‘head-to-head’ comparisons with ‘market leading’ competitors, our AI outperformed on accuracy and total value.
We have ‘won’ 100% of the ‘head-to-head’ comparisons in the mid and large market.
*These numbers are based on previous work engagement, and each work engagement will have varying results based on partner and their specific population.
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*Performance is based on that of the partner and their population and therefore performance may vary
*** This includes the Allymar Health team and Allymar Health’s partners.