For risk bearers
MA financial intelligence
A defensible financial picture of every Medicare Advantage contract
The challenge
Your numbers are only as good as the file they came from.
Organizations holding Medicare Advantage risk live downstream of payer extracts: claims, eligibility, premium, pharmacy, and quality files, each in its own format, each arriving with its own defects. Build the analysis on a broken file and everything after it is wrong with confidence.
The Ariv approach
The defensible number is the product.
Medicare Advantage analytics usually start by assuming the feed is right. Ariv starts by proving it. Every figure traces from the feed version it was computed on, through the forensic findings and the ratified rulebook, to the computation that produced it, so you can defend it to a payer, an auditor, or a board.
When a feed needs deeper human forensics, the same team behind the product is available as an engagement through our actuarial services.
How it works
Ingest
Ingest and verify
Each payer feed mapped, profiled, and graded before anything is computed from it.
Rule
Apply the rulebook
Ratified corrections applied consistently, with every version stamped on every result.
Report
Report with confidence
Contract economics, cost drivers, and risk, current and reproducible.
What you get
Four modules, one consistent view.
Intelligent claims ingestion
Every arriving feed gets a trust verdict before it touches an analytic, with guided mapping for each payer's format.
Claims forensics built in
Truncated files, repeated paid amounts, and duplicate adjudication versions are caught automatically, not discovered in a board meeting.
A rulings-based rulebook
Every correction is recorded once as a ruling, applied consistently, and versioned, so the number is reproducible months later.
Contract analytics
Per-member costs, utilization per thousand, total cost of care, medical expense ratio, revenue and risk, and quality gaps, per contract.