Hospitals are facing unprecedented financial strain driven by insurers who delay, deny, downcode, and underpay claims. These tactics directly weaken hospital margins, threaten service lines, and limit the resources needed to deliver high-acuity care around the clock.
Allia Group specializes in litigation funding for hospitals, helping to recover substantial revenue tied to in and out of network underpayments, using a combination of legal solutions. These healthcare legal finance solutions transform disputed claims into revenue recovery opportunities for hospitals, providing an innovative pathway to recover full payment for services rendered.
Our team does the heavy lifting so your hospital can focus on what’s important: caring for patients and organizational growth.
Since 2000, hospitals have provided almost $745 billion in uncompensated care. Narrow networks and contract terminations are accelerating the problem as insurers increasingly anchor reimbursements rates toward the median in-network rate — known as the Qualifying Payment Amount or QPA. Allia Group identifies and pursues the underpayments hospitals are rightfully owed — restoring dollars that directly support your mission.
Successful recovery against major insurers requires specialized legal strategy, precise data analysis, and an understanding of state-specific laws and rules. Allia brings over 14 years of experience litigating and arbitrating against more than 50 regional and national carriers.
Hospitals do not have to manage the lift involved with the proceedings of litigation. Allia takes on these responsibilities through highly automated workflows and specialized legal expertise.
Allia identifies and pursues commercial underpayments across emergency, inpatient, outpatient, and ancillary services. By analyzing EOBs and historical claims data, we pinpoint high-value recoverable revenue and challenge insurers more effectively.
Hospitals face growing financial pressure from chronic underpayment, downcoding, and network manipulation. Allia holds insurers accountable and works to correct payers’ systemic reimbursement behaviors that erode hospital margins.
Allia’s Bundled Case model aggregates large volumes of hospital claims across health systems to increase leverage, strengthen legal positioning, and make recovery economically feasible at scale. This unified approach helps hospitals address widespread payer underpayment patterns far more effectively than isolated litigation or appeals.
Success through IDR and litigation helps hospitals enter negotiations with leverage. With rich market data analysis of reasonable rates, hospitals can negotiate from a position of strength and set themselves up for fair, sustainable agreements and strong long-term financial posture going forward.
We analyze your hospital’s historical and ongoing claims data — including 835/837 files, EOBs, billing records, and detailed history with individual payers — to pinpoint underpayments with the highest recovery potential.
Allia develops a tailored recovery plan using litigation, Direct Insurance Resolution (DIR), and IDR as appropriate. We purchase underpaid claims, assuming responsibility when pursuing litigation or arbitration and shielding hospitals from the role of a plaintiff.
Supported by automation, data intelligence, and over 14 years of experience litigating healthcare reimbursement disputes s, our team manages the organization of thorough claims lists, negotiations, arbitration materials, engaging experts and payer interactions from start to finish.
Upon case resolution, Allia oversees all settlements and accounting of expenses and distributes recovered funds back to the hospital. This approach creates long-term security for your hospital’s financial health and allows your team to focus wholly on improving patient care.
Underpayment is a structural issue in commercial reimbursement for hospitals. Litigation holds insurers accountable and recovers revenue needed to sustain hospital operations.
Minimal involvement is required. Allia handles data analysis, filings, payer communication, arbitration support, and payment follow-through.
Yes. Allia’s managed IDR service provides full-service dispute preparation, data-driven batching, arbitration briefs, offer calculation, and payment enforcement, helping hospitals navigate a resource-intensive process.
No. Since Allia serves as the plaintiff, hospitals can preserve their payor relationships while leaning on Allia to resolve chronic underpayments.
Underpayment is not a cost of doing business — it’s an avoidable loss that strains hospital operations. Allia Group helps hospitals recover what insurers should have paid in the first place and strengthens long-term financial stability.
Contact us today to learn how Allia Group can support your hospital’s revenue recovery efforts.