Revolutionizing healthcare for Risk-Bearing Providers: The Allymar Advantage

Our ability for multi-faceted wins across your organization allows for providers to earn more money, save time and cost, and allows their care teams to focus on the work they love: improving patient outcomes.

Increased revenue

Improve risk revenue 10-15% + streamline coding efficiency*

Improved care delivery

Improved care delivery and coordination of care for each patient

Increased compliance

Compliance focus strengthening navigation of CMS and State regulations

Achieve quality metrics

Achieve quality metrics across your ACO with Allymar Health AI

Increased vendor governance

Streamlined vendor governance from many-to-one

How Allymar Health works with Risk-Bearing Providers

Allymar brings expert advisory services, owned technology and BPaaS offerings and pairs these with industry leading Medicare Advantage technology in one centralized platform. Our health risk-bearing providers benefit from:

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.

Impact for Risk-Bearing Providers

Ability to earn bonus payment, this occurs by improving from a 4 Star to a 5 Star Health Plan.

Up to 10 to 15% increase in risk accuracy revenue*
Ability to earn bonus payment, 5% increase in NAAS by move from 4-5 Star Health Plan

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 markets.

*These numbers are based on previous work engagements, and each work engagement will have varying results based on partner and their specific population.

Empowering Clinicians at the point of care with recommendations and detailed reports and insights directly in their EMR

Take unstructured data from all sources and have that pulled into coding recommendations, care gap opportunities and next steps for patients.

Our approach

Specifically tailored for risk-bearing providers, the Allymar Health Platform ensures market-leading security and efficiency, all at a price that caters to small and mid-sized health plans.

Unprecedented compliance

Benefit from a fully auditable, traceable system, ensuring maximum compliance with all federal and state regulations.

Member-centric approach

Allymar Health empowers providers and Accountable Care Organizations to prioritize members, ensuring healthy patient outcomes and consistent growth.

How the Allymar Health AI Platform works



Understanding the Patient

  • Ingest various structured & unstructured data into the Risk Al Platform.
  • EHR, Claims, Labs, Supplemental Data, etc.

Recapture/Suspect HCCs and Quality Gaps in Care

  • Risk & Quality Reporting Suite
  • 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

  • Provider sees patient in the office and is notified of recapture suspect dx + quality gaps within EHR and captures the diagnoses.

EHR Chart Retrieval

  • EHR Retrieval
  • Fax, Mail, Call Center, Onsite as Needed

Al-Assisted Risk + HEDIS Coding

  • Code charts using Al-assisted coders on the Risk and HEDIS AI Platform.
  • Concurrent Review

Encounter Submissions & Fallout Analysis

  • Submit at 95%+ accuracy with insights into encounter and dx fallout

Financial Projections

  • Estimate incremental financial impact based on payment year
  • RAF accruals & revenue forecasting

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.