Our technology partners
Our Medicare Advantage Platform
Allymar provides 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
Offers specialized advisory services including diagnostic services to pinpoint, and capture trapped value powered by AI and analytics
BPaaS Services
Comprehensive set up Core Admin, Risk and Quality and Health Management service delivered by an experience team.
Medicare Advantage Platform
An end-to-end future tech ready Medicare Advantage platform, that is multi-tenant and tailored to the unique needs of growth-oriented plans and risk-bearing providers.
Allymar’s Medicare Advantage Suite
Call center & core operations
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Customer service
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Translation services
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Document control
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Paint/ content creation
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OCR/ scanning
Core admin
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Member portal & Provider portal
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Core claims engine
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Membership & billing
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Payment integrity & Gateway
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Payment disbursement
Health management
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Health management
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Grievances
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HRA
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Credentialing
Risk & HEDIS
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Survey
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Submission
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HEDIS
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Provide data MGMT
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 AI 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
Eliminate duplicative costs from multiple IT implementations and conversions.
Streamlined vendor governance from many-to-one with Allymar Health AI.
Improve risk revenue 15-30% + streamline coding efficiency.
Improved care delivery and coordination of care for each patient.
Achieve quality metrics across your ACO.
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.
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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 to allow 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
Costs and Expenses decreased as well as the time of the care team is refocused.
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 Helth AI
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 score
Improve risk score accuracy by up to 20% via AI solution
Decreased OpEx
Costs and Expenses decreased as well as the time of the care team is refocused
Increased compliance
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 every member
Single point of accountability
Streamlined vendor governance from many-to-one with Allymar Health AI
Our approach
Allymar 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 and risk-bearing providers.
Market leading, secure services at scale and at a price point specifically designed for small to mid-sized health plans and providers.
Fully auditable, traceable solution to maximize compliance with federal and state regulations.
The Allymar Health AI platform allows health plans to focus on healthy patient outcomes.
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