Allymar Health AI

Allymar Health’s Medicare Advantage Suite is a future-ready, AI-powered platform delivered in a BPaaS service model. We enable health plans and provider groups to access market-leading capabilities, compliance-driven solutions, and differentiated value.

Allymar Health empowers health plans and clinical teams to improve patient care with real-time actionable data provided at point of care. This allows our Health Plan and Provider Partners to:

  • Reduce Administrative Expenses
  • Be Fully Compliant and Secure
  • Improve Quality Performance
  • Increase Revenue Accuracy

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
AI Risk Application
Cohort Browser
Provider Insights
HEDIS Engine
Submission Portal
In Home Assessment
CAHPS Survey
Core Administration
Member Portal
Provider Portal
Core Claims Engine
Payment Integrity
Membership and Billing
Health Management and Risk & HEDIS
Survey Submission
Provider Data Management

Integration Architecture provided by

Explore our Applied Intelligence & Analytics

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

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

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

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

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

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.

Empowering clinicians at the point of care with the ability to:

Attain 99% coding accuracy
See real time data in their EMR
Receive recommendations on closing care gaps
Nudge their patients
Generate insight and understand gaps from aggregated data from multiple sources

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

Health Management
  • Utilization Management
  • Care Management
  • Clinical Insights & Diagnostics
Risk Adjustment & Quality Services
  • Risk Diagnostic
  • AI Chart Review
  • Risk & Quality Analytics
  • In-Home Assessments
  • Member And Provider Outreach Services
  • CAHPS Survey
Core Admin
  • Core Admin Diagnostic
  • Enrollment And Billing
  • Claims And Payments
  • Member Service
  • Customer Service
  • Appeals & Grievances
  • Broker Management and Commission

Applied Intelligence & Analytics

Artificial Intelligence
Artificial Intelligence


Pharmacy STARS Reporting

CMS / HHS Submissions

Member Engagement

Provider Engagement

Analytics & OS

AI / Chart Review

OCR & Workflow

Reporting & Analysis
Reporting & Analysis

Performance Dashboard

Data Warehouse

Data Quality & Standardization


Analytics & Bi

Schedule a Demo

During this 30 minute meeting, a member of our team will explain the opportunities we can offer through a video conference call.

*Performance is based on that of the partner and their population and therefore performance may vary