Your systems manage transactions.
We manage revenue, risk, and continuity.
Alphiniti Continuum combines three intelligence platforms: Continuum RM™, which recovers revenue and automates care management for providers; Continuum RiskFlow™, which gives self-insured employers and brokers real-time visibility into claims exposure, stop-loss risk, and emerging high-cost claimants; and Alphiniti Dental Continuity™, which unifies oral health, medical history, benefits intelligence, and treatment planning into a longitudinal care experience that improves patient outcomes and practice production.
Revenue Intelligence for Providers
Stop-Loss Exposure Intelligence for Self-Insured Employers & Brokers
Medical-Dental Continuity Intelligence for Practices and Patients
One ecosystem. Three platforms.
Zero gaps in continuity.
Alphiniti Continuum unifies revenue intelligence, stop-loss exposure intelligence, and medical-dental continuity into a single ecosystem that recovers revenue, reduces risk, and improves patient outcomes.
Continuum RM™
Provider Revenue Intelligence
12 modules that recover $180K–$400K in annual CMS reimbursement by automating CCM, RPM, AWV, and TCM documentation, billing, and attestation.
Continuum RiskFlow™
Stop-Loss Exposure Intelligence
Real-time visibility into claims exposure, high-cost claimants, and aggregate corridor burn — plus a full intervention suite that detects risk, routes it to the right clinical team, and validates the savings. 8–15% potential renewal savings.
Alphiniti Dental Continuity™
Medical-Dental Continuity Intelligence
Unifies oral health with medical history, manages MA dental benefits, and automates surgical clearance. $400K+ potential annual practice value creation.
From early detection to
defensible, validated savings
The newest intelligence engines across Continuum RiskFlow™ and Dental Continuity™ — every alert is detectable, actionable, provable, and governed.
Continuum RiskFlow™ Intelligence Suite
13 new engines — detect, act, prove
Detect
Stratifies every member into risk cohorts with drill-down funnels from population to individual.
Outside-network care encounters detected in near-real-time, Risk Twins updated, care teams alerted.
Orchestrates the full admission → discharge → ED/SNF/home-health lifecycle with med reconciliation and follow-up tracking.
Tracks clinical episodes and flags deviations from evidence-based care pathways.
Surfaces care-continuity opportunities and ranks providers on cost, quality, and outcomes.
Act
Scores every savings opportunity on 7 dimensions — from clinical appropriateness to confidence.
Clinically reviewed workflows, AI-adapted to each member, with triggers, owners, and SLAs.
Routes interventions to the right clinical role with automated task assignment, SLAs, escalation, and audit trails.
Prove
Counterfactual measurement of predicted vs. actual trajectories with 4-tier, clinically validated savings.
Views the same savings through Employer, Hospital, ACO, Health Plan, and Stop-Loss carrier lenses.
Every flag carries its full audit chain: input evidence, contributing factors, human decision, and measured outcome.
HIPAA-aligned authorization — role, organization, purpose, contract, and consent evaluated before any data access.
Alphiniti Dental Continuity™ Capabilities
Medical-dental continuity, end to end
Periodontal disease → diabetes, abscess → cardiac risk, xerostomia → medication review — clinical alerts fired in real time.
Pre-populated clearance packets routed to PCP, cardiologist, or endocrinologist with 48-hour turnaround.
Benefit utilization tracking, non-utilizer identification, and STAR measure campaigns across the MA panel.
Composite risk score combining periodontal, diabetes, medication, behavioral, and access factors.
Utilization, risk-tier distribution, STAR performance, and outreach conversion across the member panel.
Auto-identifies anticoagulants, bisphosphonates, and immunosuppressants that affect dental treatment before procedures.
How clients actually use
each platform
Not feature lists — real workflows that practices, employers, and dental teams run every day to recover revenue, reduce risk, and close care gaps.
Continuum RM™
Provider Revenue Intelligence
Chronic Care Management at Scale
Automate CCM enrollment, care plan documentation, and 20-minute monthly time tracking for 200+ Medicare patients without adding staff.
Remote Patient Monitoring
Enroll hypertensive and diabetic patients into RPM, auto-capture device readings, and bill 99453–99457 without manual data entry.
Annual Wellness Visit Capture
Identify AWV-eligible patients, pre-populate HRA data, and complete G0438/G0439 visits with one-click documentation and billing.
Transitional Care Management
Auto-detect hospital discharges, generate 14-day outreach tasks, and capture TCM 99495–99496 reimbursement before the 30-day window closes.
Continuum RiskFlow™
Stop-Loss Exposure Intelligence
Emerging High-Cost Claimant Detection
Catch the member trending toward a $250K+ claim 90 days before they hit the specific deductible, with clinical and pharmacy risk drivers explained.
Stop-Loss Renewal Negotiation
Walk into renewal with portfolio loss-ratio data, projected corridor burn, and intervention ROI evidence — negotiate 8–15% lower premiums.
Specialty Pharmacy Spend Control
Flag new oncology therapies, biologics, and gene-cell treatments within 48 hours of the first fill, with pharmacist review and site-of-care alternatives.
Multi-Employer Portfolio Oversight
Brokers and TPAs monitor aggregate corridor burn across all groups, drill into any member, and route interventions to the right clinical team.
Alphiniti Dental Continuity™
Medical-Dental Continuity Intelligence
Medical-Dental Cross-Condition Management
Link HbA1c trends to periodontal risk, flag patients whose uncontrolled diabetes is worsening oral outcomes, and coordinate care between medical and dental providers.
Surgical Clearance Automation
Generate pre-operative clearance packets with medical history, medication reconciliation, and physician sign-off — no more faxed forms or 3-day delays.
Risk-Based Recall Scheduling
Stratify patients into standard, moderate, and high-risk recall intervals, automate outreach, and fill chairs with the patients who need care most.
Medicare Advantage Dental Benefit Management
Track MA dental benefit utilization, ensure preventive services are delivered, and document for Star rating and risk-adjustment submission.
The cost of doing nothing
is higher than you think
For every platform, there's a gap between what you're capturing today and what's available. Here's what that gap costs — and what closes it.
Continuum RM™
For Healthcare Practices & Providers
Without it
CMS reimburses $180K–$400K per year for CCM, RPM, AWV, and TCM — but 70% of practices never bill it because documentation takes too long.
With Continuum RM™
Automated time-tracking, one-click care plans, and attestation-ready notes mean you capture every eligible minute.
Without it
Staff spend 6+ hours per week on manual enrollment, chart review, and form completion for care management programs.
With Continuum RM™
Pre-visit briefs, auto-populated intake forms, and AI-generated care plans cut documentation time by 80%.
Without it
Hospital discharges slip through the cracks — the 30-day TCM window closes before anyone makes the outreach call.
With Continuum RM™
Auto-detection of admissions and discharge feeds, with 14-day outreach tasks generated automatically.
Continuum RiskFlow™
For Self-Insured Employers, Brokers & TPAs
Without it
You find out about a $300K claimant when the monthly report arrives — 60 days after they already hit the specific deductible.
With Continuum RiskFlow™
Real-time detection flags emerging high-cost claimants 90 days before attachment, with clinical and pharmacy drivers explained.
Without it
At renewal, the carrier raises your premium 18% and you have no data to push back — no loss-ratio evidence, no intervention ROI.
With Continuum RiskFlow™
Walk into renewal with portfolio analytics, projected corridor burn, and documented savings from interventions you actually ran.
Without it
Specialty pharmacy spend spikes 40% year-over-year and nobody sees it until the pharmacy benefit manager sends a quarterly report.
With Continuum RiskFlow™
New oncology therapies, biologics, and gene-cell treatments are flagged within 48 hours of the first fill, with pharmacist review and site-of-care alternatives.
Alphiniti Dental Continuity™
For Dental Practices & MA Plans
Without it
A patient with uncontrolled diabetes (HbA1c 9.2) keeps getting deep cleanings that fail — but the dental team has no idea the medical condition is driving the periodontal breakdown.
With Alphiniti Dental Continuity™
Medical-dental cross-condition intelligence links HbA1c trends to periodontal risk and flags the patient for medical-dental coordinated care.
Without it
Surgical clearance takes 3–5 days of faxed forms, phone tag, and manual medical history gathering — delaying treatment and losing revenue.
With Alphiniti Dental Continuity™
Automated clearance packets pull medical history, medication reconciliation, and physician sign-off into one workflow — ready in hours, not days.
Without it
MA dental benefits go underutilized — patients don't know they have coverage, and the practice misses preventive service revenue.
With Alphiniti Dental Continuity™
Benefit intelligence identifies eligible patients, automates recall outreach, and documents utilization for Star ratings and risk adjustment.
Visualize Your Practice's
Revenue Potential
See the estimated annual revenue impact across all Continuum RM engines, including the new DentalSync modules.
- CCM
- RPM
- AWV
- TCM
- Dental
Your practice is leaving this much on the table
Adjust your patient count and Medicare mix to see your estimated annual value