Things don't always have to be done the old way...

The provider network has been reinvented

Built for healthcare

The Apaly Health solution has compliance and security embedded in its fabric, and has been tailored to deliver significant benefits with minimal behavioral change.

HIPAA compliance

We've designed the platform to help app developers/operators stay HIPAA compliant. SSO secure authentication with verified patient record access authorization, designed to address regulatory requirements.

Automated smart contracts

Streamlining efficiency and trust between parties through smart contract automation and execution. Removing subjectivity, reducing errors, improving efficiency and lowering cost.

Identity verification

Apaly Health's security framework uses individual identity verifications to verify that each individual is who they claim to be. This functionality serves as the foundation for all other compliance.

Employee-focused

This is not your old "No-Contract Reference Based Pricing (RBP)" model. Apaly believes in upfront, transparent pricing. No more patients being turned away by providers or receiving collection notices and credit report marks.

Dynamic network

An elegant solution to easily create and control a provider network built on quality and performance that serves as the foundation for cost savings, employee satisfaction, and enhanced health and wellness.

White labeled option

White label your own network and call it whatever you want. Offer it only to your clients or to others, and even monetize it. Gain a competitive edge and add a new revenue stream.

Innovative direct contracting and transacting

Designed to make your experience seamless and simple.

Direct contracting at scale

A scalable solution to facilitate an unlimited number of direct relationships between employers and providers, each having the ability to define their own acceptable rates of payment or reimbursement.

One account - many connections

The days of one-to-one contracts are over. A single account on the platform creates relationships between many other employers or providers.

Name your price

Employers and providers enter their desired rates. Proprietary algorithms then show how much of the market you can expect to capture, based on the rates you enter.

Price matching

Apaly Health pairs providers with employers, establishing matched providers as in-network to plan members. If a specific provider is excluded through price matching, employers have the ability to refine their pricing to include this desired match.

White labeled networks

Create a custom provider network, name it, market it as your own, and monetize it however you want.  Use it to expand your service offering and delivery footprint, and gain a competitive advantage.

Network filtering

Providers in your network can be filtered and sorted based on cost, quality, utilization, outcomes, and more. We've partnered with data sources to help you facilitate this functionality.

Digital payments

Apaly Health makes paying for services simple and efficient. Based on the agreed upon contracted rates, payment can be automated or employers (or an independent TPA on the employer's behalf) can pay the provider for services delivered electronically.

Bundled services

Apaly Health makes it easy for providers and employers to engage in pre-negotiated, bundled rates for any service. Bundles can be defined to a very granular level (i.e. DRG, CPT, HCPC, etc.) and the rate for a bundle can be based on a flat fee or percentage of Medicare.

Dynamic provider directory

Apaly Health enables employees to find the right provider based on many factors: specialty, location, outcomes, experience, patient feedback, geolocation, and more. We are taking the provider directory to a whole new level.

Automated eligibility and prior authorization

Accessed directly through the provider's practice management/billing system, or directly through our provider web portal, smart contract eligibility and prior authorization delivers a real time confirmation of member coverage eligibility and service authorization.

Automated escrow

This is a key component of eligibility and prior authorizaton functionality, and helps to eliminate non-payment risk for providers by ensuring that the appropriate funds are available and released when services are delivered.

Automated claim repricing

A proprietary, smart contract based solution for claims repricing that utilizes the agreed upon contractual rates that were individually set by each party and ensures that claim charges and reimbursement are accurate.  

Automated provider credentialing

Smart contracts enable a provider controlled repository of personal credentialing information to dynamically facilitate a yes/no credentialing determination based on terms defined between the employer and provider.

Online claim viewer

Full transparency and visibility into all medical billing claims for employers, employees, providers, benefits advisors, and TPAs through access to all medical billing claim information with appropriate authorization.

Sales support tools

Tools to help benefits advisors and TPAs demonstrate the benefits of the solution to their clients including provider geographic coverage reports and cost savings analysis. Apaly Health can help you become a benefits hero!