Meet the Partners joining Chicago

AMS Intelligent Analytics

Website: http://www.amspredict.com/

 Advanced Medical Strategies (AMS) is the premier provider of payment integrity, risk management, and business intelligence solutions to identify and address excessive claims, prevent and recoup overpayments, and effectively manage the risks associated with high-cost claimants and group health underwriting.

4L Data Intelligence

Website: https://4ldata.com/

4L Data Intelligence™ is leading the way in a new era of healthcare program and payment integrity using the patented power of Integr8 AI Risk Detection™ technology to find, fight and prevent FWA in near real-time. Integr8 AI™, coupled with our continuously credentialed provider database, creates a revolutionary provider-centric capability to dynamically detect FWA you cannot see with stacks of traditional claims data-centric editing and analytics solutions.

The 4L FWA Prevention™ solution rapidly detects and prevents FWA at five points across the claims management workflow including pre pre-payment, pre-payment and post-payment positions. At each point, patented Integr8 AI technology dynamically and continuously detects provider behaviors, relationships and outliers without the limitations of rules-based and claim data-centric solutions. In short, it enables you to see what providers are doing individually, in relationship with all other providers, and in relationship to all other claims on each-and-every claim submitted.

4L FWA Prevention pre-payment and post-payment detection and prevention results are continuously delivered in four complementary modules. These are:

• Provider Integrity Edits
• Adaptive Claims Edits
• Billing Behaviors Analysis
• Provider Schemes Analysis.

For SIU teams, the new 4L SIU Hub™ packages the expanded range of Integr8 AI powered FWA detection behaviors and schemes into easy to use views with comprehensive investigation and lead management tools. This new capability increases FWA detection, reduces complexity and increases speed-to-decision on lead triage and investigation. All so you can Find, Fight and Prevent FWA Fast™.

Alivia Analytics

Website: https://www.aliviaanalytics.com/

Your most expansive Payment Integrity and FWA partner for medical, pharmacy, vision, and dental claims. This features our powerful, configurable Alivia 360™ Platform that provides pre- and post-payment flexibility and considerable cost savings across the healthcare claims management process. It seamlessly transitions between FWA detection and Payment Integrity solutions including clinical and non-clinical audit scenarios, first- and second-pass claims editing, and COB/TPL. Alivia 360™ not only ensures comprehensive financial oversight but full adaptability to operational needs. Alivia integrates AI as an assistant, not a replacement, prioritizing ethical use, human oversight, and compliance with industry standards. Our solutions are offered as SaaS or tech-enabled services that build strong cases against inappropriate billing practices, identify new recoveries missed by legacy vendors, deliver actionable analytics, and offer automated corrections. Alivia enables healthcare payers to streamline vendor management, improving control and strategic decision-making. Schedule a discovery meeting and demo.

Ceris Health

Website: https://www.ceris.com/

CERIS has 30 years of prepay and post pay claim review and repricing experience with a 97% client retention rate. Our solutions are deep, consistent, and defensible reviews, which make CERIS the partner of choice for health plans, Medicare and Medicaid plans, and third-party administrators. CERIS’ longstanding review services and clinical expertise offer incremental value and are grounded in a sincere dedication to our valued partners. CERIS' mission is to continue to grow and deliver long term Payment Integrity services for our partners and to help them save.

Cohere Health

Website: https://coherehealth.com/

Cohere Health is a clinical intelligence company delivering AI-powered intelligent prior authorization solutions, which streamline patients’ access to quality care by aligning their physicians and health plans for improved collaboration, transparency, and care coordination. Cohere works with nearly 600,000 providers and processes more than 12 million prior authorization requests annually, using AI to auto-approve up to 90% of requests for millions of health plan members around the country. The company was recognized in the Gartner® Hype Cycle™ for U.S. Healthcare Payers in 2024 and 2025, is a Top 5 LinkedIn™ Startup for 2023 & 2024, and is a three-time KLAS Points of Light award recipient.

Magical

Website: https://www.getmagical.com/

Magical helps to securely transfer patient data between systems. Autofill forms and databases in your EHR system or on insurance portals without expensive integrations or APIs. Magical’s no-code solution allows teams to connect and move information between different systems and apps—instantly.

Optum

Website: https://business.optum.com/en/operations-technology/payment-integrity.html

Optum is a leading information and technology-enabled health services business dedicated to helping health plans achieve payment accuracy and improve cost savings across the claim lifecycle.

Rialtic

Website: https://www.rialtic.io/

Rialtic is a next-generation platform that equips and enables players with the technology to take control of and execute their payment accuracy strategy. Rialtic’s first solution on the platform is a comprehensive code editing capability that combines the scope of editing typically found with both primary and secondary editors and merges it into a single platform supported by a modern user experience for managing policies, deviations, reporting, and provider inquiries. Our solution champions transparency — enabling greater understanding and control of your payment accuracy program and empowering payment accuracy teams to collaborate more effectively within their organization and with provider partners and employer groups.

Trend Health Partners

Website: https://www.trendhealthpartners.com/

TREND Health Partners is on a mission to revolutionize healthcare financial management. By combining innovative technology, transparent collaboration, and a relentless commitment to operational excellence, TREND helps payers and providers eliminate waste, recover overpayments, and prevent future errors. TREND creates shared visibility, streamlines workflows, and delivers AI-powered insights that drive measurable results. The outcome: stronger alignment, lower administrative costs, and a smarter, more accurate payment system

Nokomis

Website: https://nokomishealth.com/

Nokomis Health is a privately‑owned, Minneapolis‑based leader in Pre-payment Payment Integrity.

Founded in 2013, they leverage their proprietary ClaimWise™ platform alongside over 650 years of combined industry expertise to review every professional and facility claim—before payment—with next‑business‑day turnaround 

They deliver an average of 9% incremental savings, uncovering coding errors, upcoding, and fraud that others miss—all at no upfront cost. 

With a <2% appeal rate and <0.5% overturn rate, Nokomis ensures minimal provider friction 

Their contingency‑based model aligns incentives and frees up critical funds for member programs and quality initiatives.