JSON twin: https://www.healthaidb.com/software/alaffia-health.json
Alaffia
https://www.alaffia.ai/auto-agents
Alaffia Health provides Autodor, an AI‑powered claims workflow platform that automates medical record digitization, clinical evaluation, and transparent recommendations to accelerate health plan claims, appeals, utilization management, and payment integrity reviews.
Autodor uses AI Agents to OCR and extract data from PDFs/scanned records, apply clinical reasoning against policies and guidelines, surface citations and rationales, triage and pre‑process claims, and enable human clinician validation. Offered with enterprise security controls (SOC2, HIPAA, HITRUST) and customizable agents for prior authorization, DRG validation, appeals, utilization management, and payment accuracy.
unknown
2020
Customer-dedicated cloud environment; specific region options not specified
P0079
2025-09-07
commercial / proprietary
Contact vendor for pricing and demo; enterprise contracts and custom deployments.
enterprise_quote
2022
Cloud-hosted, customer-dedicated tenant; no public on-prem OS/DB requirements listed
product
1.0
{
"company_name": "Alaffia",
"company_url": "https://www.alaffia.ai",
"company_offices": [
"United States"
],
"company_founding": "2020",
"product_url": "https://www.alaffia.ai/auto-agents",
"categories": [
"administrative",
"payment integrity",
"claims management",
"utilization management",
"appeals",
"AI/ML",
"clinical decision support"
],
"market_segment": [
"enterprise",
"health plans",
"payer"
],
"links": [
"https://www.alaffia.ai/",
"https://www.alaffia.ai/auto-agents",
"https://www.alaffia.ai/about",
"https://www.alaffia.ai/security",
"https://www.alaffia.ai/blog/alaffia-health-raises-10m-to-supercharge-health-plan-operations-with-generative-ai",
"https://www.alaffiahealth.com/blog/everest-group-recognizes-alaffia-as-a-major-contender-in-payment-integrity-solutions",
"https://www.linkedin.com/company/alaffia-health",
"https://www.crunchbase.com/organization/alaffia-e8a5",
"https://www.prnewswire.com/news-releases/alaffia-health-raises-10m-to-supercharge-health-plan-operations-with-generative-ai-302126072.html"
],
"summary": "Alaffia Health provides Autodor, an AI‑powered claims workflow platform that automates medical record digitization, clinical evaluation, and transparent recommendations to accelerate health plan claims, appeals, utilization management, and payment integrity reviews.",
"description": "Autodor uses AI Agents to OCR and extract data from PDFs/scanned records, apply clinical reasoning against policies and guidelines, surface citations and rationales, triage and pre‑process claims, and enable human clinician validation. Offered with enterprise security controls (SOC2, HIPAA, HITRUST) and customizable agents for prior authorization, DRG validation, appeals, utilization management, and payment accuracy.",
"target_users": [
"health plan clinicians",
"payment integrity teams",
"utilization management teams",
"appeals teams",
"case managers",
"operations/admins"
],
"specialties": [
"payment integrity",
"utilization management",
"appeals management",
"prior authorization",
"DRG clinical validation (sepsis, cardiovascular, respiratory)",
"specialty pharmacy / high-cost drug review",
"readmission and short-stay review"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Contact vendor for pricing and demo; enterprise contracts and custom deployments.",
"license": "commercial / proprietary",
"deployment_model": [
"SaaS",
"dedicated cloud (customer-specific tenant)"
],
"os_platforms": [
"Web"
],
"features": [
"Document digitization / OCR for PDFs and scanned images",
"Automated clinical reasoning against medical records",
"Policy and guideline cross-referencing",
"Transparent recommendations with citations",
"Pre-processing and triage of claims",
"Custom Auto Agents tuned to plan policies",
"Human validation workflow (clinician review and override)",
"Prioritization and smart triage",
"Case-level rationales and auditability",
"Support for utilization management, payment integrity, and appeals workflows"
],
"optional_modules": [
"Custom Auto Agent development / fine-tuning",
"Managed services for deployment and governance"
],
"integrations": [],
"data_standards": [],
"api_available": "unknown",
"system_requirements": "Cloud-hosted, customer-dedicated tenant; no public on-prem OS/DB requirements listed",
"compliance": [
"HIPAA",
"SOC II (AICPA) Type II",
"HITRUST"
],
"certifications": [
"SOC II Type II",
"HITRUST"
],
"security_features": [
"Encryption in transit and at rest (256-bit stated)",
"Role-based access control (RBAC)",
"Multi-factor authentication (MFA/2FA)",
"Human oversight / auditability of AI recommendations"
],
"privacy_features": [
"Data processed in customer-dedicated environment (not used to train external models)",
"HIPAA protections / BAA implied (data privacy-first posture)"
],
"data_residency": "Customer-dedicated cloud environment; specific region options not specified",
"customers": [
"Johns Hopkins Health Plans"
],
"user_reviews": [],
"ratings": [
"ITQlick: 5/5"
],
"support_channels": [],
"training_options": [
"documentation"
],
"release_year": "2022",
"integration_partners": [
"Johns Hopkins Health Plans"
],
"id": "P0079",
"slug": "alaffia-health",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/alaffia-health.json"
}
}