Advalent is a purpose-built, cloud-based payer solution supporting health plans, third party administrators (TPAs) accountable care organizations (ACOs), independent physician associations, and other large at risk managed care organizations. Designed to automate and integrate core administration, population health, and medical management under one easy-to-use rules based, data driven platform, Advalent enables health care organizations to minimize the total cost of maintaining traditional Commercial, Medicare, Medicaid and Exchange lines of business while helping them transition to value-based payment models. And, with implementations that take days rather than months, Advalent not only gets you online and more efficient sooner, but also has the added benefit of making life a little easier on your IT departments.

Take a look at the payers we support:
  • Health Plans – Whether you’re a traditional health plan or a new, provider-sponsored (“payvider”) plan, moving quickly to a value-based payment model, Advalent has you covered. We can handle all your Medicare, Medicaid, Commercial, Supplemental and Exchange requirements with our out-of-the box 360 solutions designed specifically for each line of business, in one platform with rich functionality for portals, broker commission, enrollment, premium billing, claims administration, revenue management, submissions, risk adjustment and quality management. Advalent can also help plans identify opportunities for value-based contracting and payment modeling within their network of providers.
  • Third Party Administrators – We understand that TPA’s have a unique set of requirements for their technology, including the flexibility to meet the needs of each of their individual employer groups. Advalent can help you provide the highest level of services with a single UI, from self-service portals for brokers, employer groups and employees, to enrollment, claims, billing, to utilization and care management. Advalent provides TPAs with all the tools to reduce costs and improve overall services along with robust business intelligence, analytic tools and more.
  • Accountable Care Organizations – We know that ACO’s require a great deal of coordination between providers, hospitals and health plan administration to deliver high-quality, cost-effective care to their at-risk patients. Advalent simplifies communications across the patient care continuum and keeps everyone up to date with provider performance analytics, contracts administration, claims adjudication, care management, risk adjustment, quality and more.
  • Independent Physician Associations – We know that physician groups don’t always have the same capacity as their plan partners to administer assigned populations. That’s where Advalent can help. With our provider performance analytics, your group can easily manage the risk and quality requirements assigned to you by your plan partner, maintain control over costs, and achieve your value-based targets for at risk populations—all while maintaining the focus where it matters most—on your patients.