--- title: "Avande (Avandé) | Physician-Led Healthcare Cost Management" url: "https://avande.net/" description: "Board-certified physicians review prior authorizations, claims and utilization for health plans, TPAs and employers. Decisions that cut cost, not care." last_updated: 2026-10-09 --- Physician-led healthcare decisions # Decisions that cut cost, not care. Board-certified physicians review prior authorizations, claims and utilization, so health plans and employers pay for the right care, faster. [Talk to a physician-led team](https://avande.net/contact) - BOARD-CERTIFIED PHYSICIANS - 46% AVERAGE SAVINGS - $0 BALANCE BILLING > Avandé is a physician-led healthcare cost management company: board-certified, specialty-matched physicians review prior authorizations, claims and utilization on the Ansera Portal platform, and have delivered $500M+ in cost savings. - 100% Of claims scanned daily for billing errors - 0.5% Of claims, at minimum, flagged for physician review - 62% Of flagged claims generate measurable savings - 40% Estimated average savings on flagged claims Our approach ## We don't replace your vendors. We add the layer they miss. Most vendors review the claim. Avandé reviews the care behind it. A 50% discount on an inappropriate claim is still an inappropriate payment. \+ AVANDÉ Physician review of the care 46% - PPO discounts - Reference-based pricing - Coding edits - Payment integrity tools - Prior authorization vendors YOUR EXISTING COST CONTAINMENT What we do ## Four ways we cut cost without cutting care. - PRE-SERVICE ### Care Assurance Specialty-matched physicians review care before it happens, against current evidence-based guidelines. 0.0003% OVERTURNED Explore [Care Assurance](https://avande.net/what-we-do/care-assurance) - POST-SERVICE ### Forensic Claims Validation Physicians read the full medical record to find what automated edits miss: miscoding, unsupported stays and excess services. 46% AVG. SAVINGS Explore [Forensic Claims Validation](https://avande.net/what-we-do/forensic-claims-validation) - ONGOING ### Clinical Surveillance Ongoing monitoring of utilization flags outliers early, and physicians review each flag before action. 62% GENERATE SAVINGS Explore [Clinical Surveillance](https://avande.net/what-we-do/clinical-surveillance) - TECHNOLOGY ### Healthcare IT Services Custom development, legacy modernization and FHIR and X12 EDI integration, supported 24/7/365. FHIR + X12 EDI Explore [Healthcare IT Services](https://avande.net/what-we-do/healthcare-it-services) Case studies ## What automated review missed. CS-01 · FORENSIC CLAIMS VALIDATION Determined ### Trauma DRG miscoding A clean claim every scrubber would have paid. CASE Trauma admission billed as DRG 003 PROBLEM One trach kit charge, no supporting care RESOLUTION Corrected to DRG 957 Original payment $468K Final payment $238K Total savings $230K CS-02 · CARE ASSURANCE Determined ### Notes vs. objective testing Approved by another vendor. Caught by Avandé physicians. CASE Carotid and vertebral catheter placement PROBLEM 80% obstruction claimed RESOLUTION Records showed 15% and 55% Claimed 80% Required 70% Total savings $388K How Avandé works ## Measure. Manage. Improve. Avandé turns utilization data into physician decisions, and physician decisions into measurable savings. 1. ACT 01 ### Measure Avandé analyzes utilization data to show where cost and risk concentrate. 100% OF CLAIMS SCANNED DAILY 2. ACT 02 ### Manage Board-certified physicians lead clinical, legal and financial review of every flagged case. PHYSICIAN DETERMINATION 3. ACT 03 ### Improve Decisions lower cost and risk while protecting patient safety and outcomes. $500M+ SAVED Who we serve ## Built for the people who pay for care. [See who we serve](https://avande.net/who-we-serve) - ### Health plans & TPAs Claims and utilization review that holds up on appeal. [Health plans & TPAs](https://avande.net/who-we-serve#health-plans) - ### Employers Lower self-funded plan costs, same networks. [Employers](https://avande.net/who-we-serve#employers) - ### Stop-loss & reinsurance Large-claim review and risk mitigation. [Stop-loss & reinsurance](https://avande.net/who-we-serve#stop-loss) - ### Providers & ACOs Clear, fast determinations. [Providers & ACOs](https://avande.net/who-we-serve#providers) - ### Legal & compliance Expert medical record review. [Legal & compliance](https://avande.net/who-we-serve#legal) Why Avandé ## Physicians decide. Technology accelerates. ![An Avandé physician reviewing a case checklist on screen](https://avande.net/_astro/physician-review.Bo4HB5lK_YciWt.webp) 1. ### Physicians decide, AI assists Board-certified, specialty-matched physicians make every call. 2. ### Defensible decisions Cited criteria and a full audit trail on every case. 3. ### Avandé technology Physicians and engineers under one roof, building Ansera Portal. 4. ### 30+ years of results $500M+ in savings delivered. - SOC 2 Type II - HIPAA - PHI Protection - PII Safeguards HITRUST certification in progress. FAQ ## Straight answers. ### What is Avandé? Avandé is a physician-led healthcare cost management company. Board-certified, specialty-matched physicians review prior authorizations, claims and utilization on the Ansera Portal platform for health plans, TPAs, employers, stop-loss carriers, providers and legal teams. ### Do physicians or AI make the clinical decisions? Physicians do. The Ansera Portal platform prepares the evidence and keeps the audit trail; it never replaces clinical judgment. ### How often are Avandé decisions overturned? Rarely. 3 out of 10,000 cases (0.0003%) are overturned on appeal. ### What does forensic claims validation find that automated edits miss? Unsupported admissions, DRG miscoding, excessive services, misrepresented findings, inappropriate treatment pathways and fraudulent billing, found in the full medical record. ### Is Avandé HIPAA compliant? Yes. Avandé is SOC 2 Type II and HIPAA compliant, signs a BAA for client PHI, and uses AES-256, TLS 1.2+, MFA and US data residency. HITRUST certification is in progress. ### How do we get started? Send a few sentences through the form or call 1-833-328-2633. Our team reads every message. Talk to a physician-led team ## Tell us what you're reviewing. A few sentences are enough. [Let's Talk](https://avande.net/contact) or call **1-833-328-2633**