Medicare Advantage Suite
Allymar brings expert advisory services, owned technology, and BPaaS offerings and pairs these with industry-leading Medicare Advantage technology in one centralized platform. Our customers benefit from the following products and services within the Allymar Health platform:
Check our features
Risk Adjustment & Quality Services
Core Administration
Health Management and Risk & HEDIS
Integration Architecture provided by
CORE ADMIN
Our BPaaS Service Layer Benefit
Enrollment
- Customer service
- Translation services
Billing
- Member portal & Provider portal
- Core claims engine
Claims & Payments
- Health management
- Grievances
Member Portal
- Survey
- Submission
Provider Portal
- Customer service
- Translation services
How Allymar Health works with Risk-Bearing Providers and Health Plans
Allymar Health’s AI Risk Adjustment & Quality Solutions combine our expertise in Medicare Advantage and our leading AI technology platform to deliver a modular and configurable solution for both payers and risk-bearing providers.
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.
Take unstructured data from all sources and have that pulled into coding recommendations, care gap opportunities and next steps for patients.
Allymar Health’s Risk Adjustment & Quality & HEDIS AI increases coding accuracy and RAF scores by ~10 to 15%+* and achieves 4+ Star Ratings.
Allymar Health is designed for mid-market plans and providers. We enable them to compete with their larger counterparts by bringing premier talent and technology to their stack at an affordable price.
Our Medicare Advantage Platform
Allymar Health provides a BPaaS, Medicare Advantage Suite consisting of an end-to-end turnkey AI powered platform supported by a robust suite of services that enables mid-market health plans to access market-leading capabilities, compliance-driven solutions and differentiated value.
MA Advisory Services
Specialized advisory and diagnostic services powered by AI and analytics to pinpoint and capture trapped value.
BPaaS Services
Comprehensive suite of Core Admin, Risk & Quality, and Health Management services delivered by an experienced team.
Medicare Advantage Platform
An end-to-end future tech ready, multi-tenant Medicare Advantage platform, tailored to the unique needs of growth-oriented plans and risk-bearing providers.
What Benefits We Offer
Allymar Health offers multiple benefits and impacts for risk bearing providers.
Our ability for multi-faceted wins across your organization allows for providers to earn more money, save time and costs, and their care teams to focus on the work they love: improving patient outcomes.
Increased revenue
Improve risk revenue 15-30% + streamline coding efficiency*
Improved care delivery
Improved care delivery and coordination of care for each patient
Decreased OpEx
Improved efficiencies and focus of the care team
Achieve quality metrics
Achieve quality metrics across your ACO
Increased compliance
Compliance focus strengthening navigation of CMS and State regulations
Increased vendor governance
Streamlined vendor governance from many-to-one with Allymar Health
Allymar Health enables growth-oriented MA plans to compete and outperform in the middle market by providing an integrated fabric of Core Admin and Care Management solutions to power their operations.
Increased profitability
Our Core Admin solution has a defined value and return on investment. This results in up to a 20% reduction in PMPM
Improved risk and quality score
Improve risk and quality score accuracy by up to 20% via AI solution*
Decreased OpEx
Improved efficiencies and focus of the care team
Improvements in accuracy and transparency
Compliance focus strengthening navigation of CMS and State regulations. Improvements in accuracy and transparent
Innovation tied to value outcomes
Our commitment to innovation means we will continue to drive value across each and every member
Single point of accountability
Streamlined vendor governance from many-to-one with Allymar Health
Allymar Health enables mid-market health plans and risk-bearing providers to access market-leading capabilities, compliance-driven solutions and differentiated value.
Future-ready, end-to-end Medicare Advantage platform
Integrated vendor platform
Designed for small to mid-sized health plans
We will take care of everything else
Allymar Health's Medicare Advantage Suite
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Health Management
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Utilization Management
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Care Management
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Clinical Insights & Diagnostics
Risk Adjustment & Quality Services
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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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In-Home Assessments
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Member And Provider Outreach Services
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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
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
*Performance is based on that of the partner and their population and therefore performance may vary