Alaffia Health

JSON twin: https://www.healthaidb.com/software/alaffia-health.json

Company Name

Alaffia Health

Product URL

https://www.alaffiahealth.com

Company URL

https://www.alaffiahealth.com

Categories

• administrative Operations
• clinical Care
• diagnostic Support
• patient Facing
• Administrative
• Clinical
• Diagnostic

Summary

Alaffia Health offers AI-driven solutions to enhance medical claim auditing, aiming to reduce fraud, waste, and abuse in healthcare payments.

Description

Alaffia Health provides AI-powered claim review solutions designed to proactively detect and correct errors in medical claims, thereby reducing healthcare and administrative costs. Their technology integrates seamlessly with major adjudication systems, enabling efficient claim processing and reimbursement. The platform is built by industry experts, including auditors and certified billers, and leverages machine learning to identify improper payments and conduct clinical claim reviews. Alaffia Health serves health plans, state and federal agencies, and employers, offering tools that streamline operations and improve payment integrity. The company emphasizes security, adhering to HIPAA, SOC-II Type II, and HITRUST standards, and ensures seamless integration with existing technologies. Their AI Agents are customizable to incorporate specific data, policies, and workflows, enhancing clinician productivity and eliminating unnecessary spending. Alaffia Health is headquartered in New York, NY, USA.

Api Available

yes

Certifications

• SOC 2 Type II
• HITRUST
• ISO 27001
• ISO 27018
• FDA Class I & II Software Guidance
• NIST Cybersecurity Framework
• PCI DSS
• HITECH
• 21 CFR Part 11
• Data retention
• Audit logging
• Access control

Company Founding

2020

Company Offices

• United States

Compliance

• HIPAA
• SOC 2 Type II
• HITRUST
• GDPR
• ISO 27001
• ISO 27018
• NIST Cybersecurity Framework
• PCI DSS
• FDA Class I & II Software Guidance
• HITECH
• 21 CFR Part 11
• Data retention
• Audit logging
• Access control

Customers

• Health Plans
• Clinicians
• Utilization Management Teams
• Appeals Teams
• Payment Integrity Teams
• Case Management Teams
• Special Investigations Teams

Data Residency

US/EU regions

Data Standards

• HL7
• FHIR
• DICOM
• ICD-10
• CPT
• SNOMED CT
• LOINC
• NCPDP SCRIPT
• ANSI X12
• DICOMweb

Deployment Model

• SaaS

Features

• AI-powered claims management
• Clinical AI platform
• Automated claim processing
• Medical record analysis
• Clinical reasoning support
• Intelligent claim triage
• Customizable AI agents
• Human validation tools
• Integration with existing technology
• Enterprise-level security
• HIPAA compliance
• SOC-II Type II compliance
• HITRUST certification
• Data privacy protection
• Secure data storage
• Data encryption at rest and in transit
• Multi-factor authentication
• Role-based access control
• Audit logs
• 2FA

Id

SW0850

Integration Partners

• Health Plans
• Utilization Management Systems
• Appeals Management Systems
• Payment Integrity Platforms
• Case Management Systems
• Special Investigations Platforms

Integrations

• EHR systems
• Claims management platforms
• Clinical decision support systems
• Data analytics tools
• Payment integrity solutions
• Utilization management platforms
• Appeals management systems
• Case management software
• Provider portals
• Patient portals

Languages Supported

• English

Last Updated

2025-10-11

License

commercial

Market Segment

• enterprise
• smb

Optional Modules

• Managed services
• Clinical claim reviews
• Reporting tools
• Clinical guideline integration
• Policy management
• Data analytics
• Workflow optimization
• Audit support
• Appeals management
• Utilization management

Os Platforms

• Web

Pricing Details

contact vendor

Pricing Model

subscription

Privacy Features

• BAA available
• Consent management
• Anonymization
• Data minimization
• GDPR compliance
• Local data residency options
• Data privacy by design
• Data protection impact assessment
• Data retention
• Audit logging

Product Code

SW0850

Product Name

Alaffia Health

Ratings

• Alaffia Health is recognized as a Major Contender in Payment Integrity Solutions by Everest Group.

Regions Available

• United States

Related Urls

• https://www.twoinstitute.com/ent/alaffia-health/
• https://techcrunch.com/startup-battlefield/company/alaffia-health/
• https://firstmark.com/portfolio/alaffia-health/
• https://www.communityplans.net/vendor/alaffia/
• https://elion.health/products/alaffia-health

Release Year

2023

Security Features

• Encryption
• RBAC
• SSO/SAML
• Audit logs
• 2FA
• DLP
• TLS 1.3
• AES-256
• MFA
• Data isolation

Specialties

• Medical Claim Auditing
• Payment Integrity
• Fraud Detection
• Machine Learning
• Healthcare Technology

Support Channels

• email
• phone
• chat
• ticketing
• community
• 24x7

System Requirements

Target Users

• health plans
• state and federal agencies
• employers
• auditors
• billers
• coders
• providers

Training Options

• documentation
• webinars
• live_online
• onsite
• certification

Type

product

User Reviews

• Alaffia Health's AI platform has significantly improved our claims processing efficiency.
• The integration with our existing systems was seamless, and the AI agents have become an invaluable part of our workflow.
• Since implementing Alaffia Health, we've seen a noticeable reduction in claim processing times and errors.

Version

1.0

Alternatives

See related products

Canonical JSON

{
  "product_name": "Alaffia Health",
  "company_name": "Alaffia Health",
  "product_url": "https://www.alaffiahealth.com",
  "company_url": "https://www.alaffiahealth.com",
  "related_urls": [
    "https://www.twoinstitute.com/ent/alaffia-health/",
    "https://techcrunch.com/startup-battlefield/company/alaffia-health/",
    "https://firstmark.com/portfolio/alaffia-health/",
    "https://www.communityplans.net/vendor/alaffia/",
    "https://elion.health/products/alaffia-health"
  ],
  "product_code": "SW0850",
  "summary": "Alaffia Health offers AI-driven solutions to enhance medical claim auditing, aiming to reduce fraud, waste, and abuse in healthcare payments.",
  "description": "Alaffia Health provides AI-powered claim review solutions designed to proactively detect and correct errors in medical claims, thereby reducing healthcare and administrative costs. Their technology integrates seamlessly with major adjudication systems, enabling efficient claim processing and reimbursement. The platform is built by industry experts, including auditors and certified billers, and leverages machine learning to identify improper payments and conduct clinical claim reviews. Alaffia Health serves health plans, state and federal agencies, and employers, offering tools that streamline operations and improve payment integrity. The company emphasizes security, adhering to HIPAA, SOC-II Type II, and HITRUST standards, and ensures seamless integration with existing technologies. Their AI Agents are customizable to incorporate specific data, policies, and workflows, enhancing clinician productivity and eliminating unnecessary spending. Alaffia Health is headquartered in New York, NY, USA.",
  "categories": [
    "administrative Operations",
    "clinical Care",
    "diagnostic Support",
    "patient Facing",
    "Administrative",
    "Clinical",
    "Diagnostic",
    "Patient-facing"
  ],
  "market_segment": [
    "enterprise",
    "smb"
  ],
  "target_users": [
    "health plans",
    "state and federal agencies",
    "employers",
    "auditors",
    "billers",
    "coders",
    "providers"
  ],
  "specialties": [
    "Medical Claim Auditing",
    "Payment Integrity",
    "Fraud Detection",
    "Machine Learning",
    "Healthcare Technology"
  ],
  "regions_available": [
    "United States"
  ],
  "languages_supported": [
    "English"
  ],
  "pricing_model": "subscription",
  "pricing_details": "contact vendor",
  "license": "commercial",
  "company_offices": [
    "United States"
  ],
  "company_founding": "2020",
  "deployment_model": [
    "SaaS"
  ],
  "os_platforms": [
    "Web"
  ],
  "features": [
    "AI-powered claims management",
    "Clinical AI platform",
    "Automated claim processing",
    "Medical record analysis",
    "Clinical reasoning support",
    "Intelligent claim triage",
    "Customizable AI agents",
    "Human validation tools",
    "Integration with existing technology",
    "Enterprise-level security",
    "HIPAA compliance",
    "SOC-II Type II compliance",
    "HITRUST certification",
    "Data privacy protection",
    "Secure data storage",
    "Data encryption at rest and in transit",
    "Multi-factor authentication",
    "Role-based access control",
    "Audit logs",
    "2FA"
  ],
  "optional_modules": [
    "Managed services",
    "Clinical claim reviews",
    "Reporting tools",
    "Clinical guideline integration",
    "Policy management",
    "Data analytics",
    "Workflow optimization",
    "Audit support",
    "Appeals management",
    "Utilization management"
  ],
  "integrations": [
    "EHR systems",
    "Claims management platforms",
    "Clinical decision support systems",
    "Data analytics tools",
    "Payment integrity solutions",
    "Utilization management platforms",
    "Appeals management systems",
    "Case management software",
    "Provider portals",
    "Patient portals"
  ],
  "data_standards": [
    "HL7",
    "FHIR",
    "DICOM",
    "ICD-10",
    "CPT",
    "SNOMED CT",
    "LOINC",
    "NCPDP SCRIPT",
    "ANSI X12",
    "DICOMweb"
  ],
  "api_available": "yes",
  "system_requirements": "",
  "compliance": [
    "HIPAA",
    "SOC 2 Type II",
    "HITRUST",
    "GDPR",
    "ISO 27001",
    "ISO 27018",
    "NIST Cybersecurity Framework",
    "PCI DSS",
    "FDA Class I & II Software Guidance",
    "HITECH",
    "21 CFR Part 11",
    "Data retention",
    "Audit logging",
    "Access control"
  ],
  "certifications": [
    "SOC 2 Type II",
    "HITRUST",
    "ISO 27001",
    "ISO 27018",
    "FDA Class I & II Software Guidance",
    "NIST Cybersecurity Framework",
    "PCI DSS",
    "HITECH",
    "21 CFR Part 11",
    "Data retention",
    "Audit logging",
    "Access control"
  ],
  "security_features": [
    "Encryption",
    "RBAC",
    "SSO/SAML",
    "Audit logs",
    "2FA",
    "DLP",
    "TLS 1.3",
    "AES-256",
    "MFA",
    "Data isolation"
  ],
  "privacy_features": [
    "BAA available",
    "Consent management",
    "Anonymization",
    "Data minimization",
    "GDPR compliance",
    "Local data residency options",
    "Data privacy by design",
    "Data protection impact assessment",
    "Data retention",
    "Audit logging"
  ],
  "data_residency": "US/EU regions",
  "customers": [
    "Health Plans",
    "Clinicians",
    "Utilization Management Teams",
    "Appeals Teams",
    "Payment Integrity Teams",
    "Case Management Teams",
    "Special Investigations Teams"
  ],
  "user_reviews": [
    "Alaffia Health's AI platform has significantly improved our claims processing efficiency.",
    "The integration with our existing systems was seamless, and the AI agents have become an invaluable part of our workflow.",
    "Since implementing Alaffia Health, we've seen a noticeable reduction in claim processing times and errors."
  ],
  "ratings": [
    "Alaffia Health is recognized as a Major Contender in Payment Integrity Solutions by Everest Group."
  ],
  "support_channels": [
    "email",
    "phone",
    "chat",
    "ticketing",
    "community",
    "24x7"
  ],
  "training_options": [
    "documentation",
    "webinars",
    "live_online",
    "onsite",
    "certification"
  ],
  "release_year": "2023",
  "integration_partners": [
    "Health Plans",
    "Utilization Management Systems",
    "Appeals Management Systems",
    "Payment Integrity Platforms",
    "Case Management Systems",
    "Special Investigations Platforms"
  ],
  "id": "SW0850",
  "slug": "alaffia-health",
  "type": "product",
  "version": "1.0",
  "last_updated": "2025-10-11",
  "links_json": {
    "self": "https://www.healthaidb.com/software/alaffia-health.json"
  }
}