With many payers making the move to value-based care reimbursement models, the need for efficient and continuous  data sharing between systems has never been greater. Advalent offers a complete, end-to-end solution that can replace the multitude of vendors currently being used with one, flexible, easy-to-use platform. Or, it can simply help bridge the gap between the disparate systems that make healthcare reimbursement so challenging.

No matter what your reimbursement model,
line of business (Medicare, Medicaid or Commercial)
or payer type (Health Plan, TPA, ACO or Physician Group),
Advalent has you covered!

A complete suite of modular tools to manage your entire business

Core Claims Administration

Control your payment and adjudication processes with flexible claims technology that supports the latest trends in value-based reimbursement.

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Member Management

Enhance member engagement and experience with connected tools that drive delightful experiences at every member touchpoint.

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Risk Adjustment

Improve risk score and payment accuracy through integrated suspect analytics, retrospective coding, prospective interventions and risk submissions (RAPS, EDPS, EDGE, APCD & Medicaid).

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Medical Management

Drive meaningful clinical interventions that drive financial performance with turnkey analytics and modern care management.

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Clinical Quality

Close gaps in care and improve quality and compliance through advanced HEDIS and STARS measurement and advanced analytics.

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Provider Management

Support providers in the move towards value-based care with rules-based contracts that drive transparency and enable shared risk.

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Why Advalent is better
Truly configurable and SMAART technology that grows with you

Interoperable with Existing Solutions

Use Advalent on its own or in conjunction with existing claims administration, risk adjustment, member management, and care management solutions

Painless Implementations

Handle a multitude of business environments and integrations with configurable choices that are as easy as flipping a switch

Rules Based and Flexible

Administer any new plan type from traditional fee-for-service and complex value-based models—error free and in real-time