Alivia, a leading AI-based healthcare payment integrity platform for fraud, waste, and abuse (FWA) has acquired SourcEdge, a national provider of claims systems modernization services serving over 25 health plans. Together, the capabilities empower healthcare payers with an end-to-end claims solution.
Alivia and SourcEdge have worked collaboratively for more than two years, resulting in a solution combining expert professional services with purpose-built healthcare technology. The combined entity will operate under the Alivia brand.
“Our platform and its modules are even more effective when our clients’ claims and business systems are optimized to achieve financial and operational returns, says Michael Taylor, MD, Alivia CEO. “We are thrilled to incorporate this exceptional, well-respected team of experts we know and trust.”
SourcEdge brings unique expertise to assist health plan CIOs and VPs in modernizing and maintaining their critical healthcare claim systems. This includes protected health information (PHI) security, value-based care strategy accelerators, and claims payment data consolidation.
“Alivia’s SaaS platform combined with SourcEdge’s data transformation services provides a unique combination for end-to-end claims management,” adds Mark McAdoo, SourcEdge CEO who will become President of Alivia and member of the Board of Directors. “Combining products and services demonstrates the efficiency of modern healthcare technology and digital transformation.”
Fusing these capabilities also includes the formation of a tech-enabled services practice that uses the platform to provide outsourced SIU / investigative resources, pre-pay clinical reviews, post-pay recovery audits, and end-stage renal disease (ESRD) premium protection.
Bill Lucia, former Chairman, President & CEO of HMS (NASDAQ: HMSY) and Alivia Board Member, comments, “Finding solutions to improve the effectiveness of our nation’s healthcare system will continue to dominate headlines and remain top-of-mind for policymakers and regulators. Embracing technologies that truly unlock this potential through use of advanced artificial intelligence are critical tools in addressing healthcare challenges and will improve affordability and change the status quo for patients, providers, and payors.”
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