Aria is the first RPA cloud platform designed specifically for healthcare. It was built to automate the industries of healthcare that are most in need of transformation—payer and PBM. Aria takes RPA to the next level by integrating machine learning (ML) and artificial intelligence (AI), delivering actionable intelligence to all stakeholders across the administrative and care continuums.
It’s also modular, meaning it can be used as an all-in-one solution, or the modules below can ‘plug and play’ into existing plan sponsor systems.
National Full-Service PBM
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Avoidable Drug-Impacted Medical Cost Management
Convert “Buy & Bill” to “Value-Based & Outcome-Driven”
Extract and consolidate information across all departments of the PBM, providing plan sponsors with a 360° patient view that enhances critical health/financial decision-making and results in best outcomes.
Model, design, and manage custom drug formularies to maximize clinical and financial outcomes.
Customize and automate utilization management programs across prior authorization, step therapy, quantity limits, and more to yield the optimal balance of clinical efficacy and cost management.
Model, design, and manage custom pharmacy networks, while simplifying pharmacy contracting and credentialling.
Adjudicate pharmacy claims in real-time across all lines of business.
Automate creation and submission of encounters and PDEs.
Empower plan sponsor staff, pharmacists, and prescribers with the needed tools to work collaboratively to produce low cost and high-quality MTM outcomes.
Model, design, and manage pharmaceutical rebate contracting processes to optimally balance clinical efficacy and financial outcomes.
Deliver actionable intelligence to the point-of-care and point-of-sale to improve health and financial outcomes without disrupting professional workflows.
Integrate pharmacy, medical, and lab data to provide market-leading reporting and analytics.
Manage the most unmanaged portion of managed care by creating a hospital-like care setting at home.
Convert “buy & bill” to a value-based and outcomes-driven specialty management model.
Provide comprehensive actionable intelligence and transaction information to members, providers, pharmacists, and other care constituents through apps and portals.
Build and manage the product, plan, benefits, and pricing lifecycle.
Automate all possible sales channels from quote-to-card and quote-to-contract.
Automate eligibility, enrollment, and membership reconciliation for all lines of business.
Price, bill, receive payment, reconcile multiple payment buckets, and pay commissions to brokers and agents.
Cloud-native platform to administer medical and behavioral health claims adjudication for all lines of business.
Compute statistically valid cost, quality, and utilization performance of physicians, hospitals, and networks.
Identify top-tier physicians and hospitals, contract with them, help to manage the risk collaboratively, and manage financial reconciliation.
Optimize preventive, episodic, and chronic care and manage the overall disease burden.
Integrate the data universe, including claims data (medical claims, behavioral health, pharmacy claims, lab claims), contractual data (physician contract pricing terms, hospital contract pricing terms, network/repricing terms), pricing data (drug pricing, medical services pricing, bundling/unbundling, premium), and operational data (enrollment, actuarial, risk score).
Prospectively manage quality scores and tie quality scores to outcomes and incentive payments.
Create a platform-driven hospital-like care setting at home to reduce hospital visits and manage the managed portion of the managed care population (5-7%).
Collaborative enterprise-wide service integration to optimize first call resolution for members, employers, brokers, prescribers, pharmacists, and other care constituents.
Provide comprehensive actionable intelligence and transaction information to members, employers, brokers, providers, pharmacists, and other care constituents through apps and portals.