Andovia

What Andovia does

Andovia is a privately-held healthcare data technology company that operates a four-product portfolio—VeriAct, ca360, m360, and ai360—designed to identify, prevent, recover, and govern healthcare spend. The platform's primary customer is the self-insured employer health plan seeking independent fiduciary oversight under ERISA §404(a)(1), with secondary segments including health plans operating complex value-based-care and incentive contracts, organizations consolidating data across multiple point solutions, and healthcare finance, benefits, clinical, and operations teams. Andovia positions its solutions against an estimated 8-12% leak in healthcare spend driven by billing errors, inefficiencies, utilization issues, and contract terms that do not serve sponsor interests.

The platform is architected around a dimensional, append-only data warehouse built specifically for healthcare data, supporting identity resolution, normalization, rationalization, validation, and reconciliation across eligibility, claims, clinical, pharmacy, lab, risk score, contract, and payment sources. Andovia cites a decade of claim-level audit history across commercial and Medicare populations and enforces 99.99% data quality across sources. Proprietary components include a contract adjudication engine that codifies MSAs and sub-agreements into executable rules adjudicating every transaction against tiers, caps, exclusions, minimums, bundles, multipliers, eligibility, and rolling contract windows, and a vendor-agnostic data abstraction layer that retains ownership of the longitudinal record with the customer. The same warehouse runs both traditional BI reports and AI queries, ensuring numerical consistency and providing source lineage on every AI-generated answer.

Andovia runs a sales-led, enterprise go-to-market targeting self-insured employer health plans, with products sold on subscription contracts—VeriAct on a fixed annual fee tiered by plan size (no PEPM, no gainshare, no percent of savings), and ca360, m360, and ai360 on subscription terms tied to the contract or warehouse scope. Engagement begins with discovery calls, ROI calculators, demo requests, and the offer of a first governance finding within 30 days of data receipt. The company is SOC 2 Type II certified, HIPAA-compliant, and pursuing HITRUST i1 certification across its portfolio. Revenue, funding, headcount, ownership, leadership, and operating geographies are not publicly disclosed.

Name

Andovia

Website

https://andovia.com

Company type

Private

Founded year

2009

Operating status

Operating

Headcount range

1–10 employees

Short description

Andovia is a private healthcare data company offering four products—VeriAct, ca360, m360, and ai360—that help self-insured employer health plans identify billing errors, adjudicate contracts, maintain longitudinal member records, and run AI queries against private healthcare data.

Ownership category

akta.pro rank

Product category

Healthcare Data Analytics Software

NAICS

Software Publishers (5132), Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Services-Computer Programming, Data Processing, Etc. (7370)

akta.pro primary industry

Claims Administration & Payment Integrity (Medical/Dental/Vision) (HLAEALAD)

akta.pro secondary industries

De-identification, Tokenization & Privacy-Preserving Data Platforms (HLACAIAK), Self-Funded (ASO) Group Health Plans & Stop-Loss (FSAIAFAB), Eligibility, Coverage Verification & Policy Administration Support (BPAAAFAC)

Keywords

• Healthcare data analytics
• Health plan governance
• Contract adjudication software
• Longitudinal member record
• Healthcare spend management

Headquarters

HQ city

Woburn

HQ country

United States

HQ region

North America

Markets served

GTM type

B2B

Offering type

Software

Cost components

Personnel, Technology or R&D, Operations, Infrastructure, Marketing or Sales

Revenue model

1. VeriAct - Health Plan Governance: Fixed annual fee, tiered by plan size. No percent of savings, no gainshare, no PEPM (per employee per month) structure. One annual fee provides continuous monthly claim-level review, vendor-attributed findings, and Advocate Services support.
2. ca360 - Contract Adjudication: Subscription-based contract adjudication. Andovia supports implementation and each billing cycle, with ca360 running daily or monthly based on the contract. Start with one contract approach to prove rules, outputs, and audit trail.
3. m360 - Longitudinal Member Record: Subscription-based data layer. Andovia manages ingestion, validation, reconciliation, and refresh schedule across vendor sources. Record lives in customer warehouse on customer terms.
4. ai360 - Private Healthcare AI: Warehouse layer subscription. BI and AI run on same healthcare data. Existing BI keeps running while AI runs on same data so numbers never disagree.

Pricing tiers

Go-to-market motion2 records

Distribution channels1 record

Marketing channels4 records

Core offering

Andovia sells a portfolio of four subscription software products — VeriAct (independent health plan governance), ca360 (contract adjudication), m360 (longitudinal member record), and ai360 (private healthcare AI) — built on a proprietary append-only data warehouse that ingests claims, eligibility, pharmacy, clinical, risk-score, and contract data directly from TPAs, networks, PBMs, and benefits administrators. The products are sold to self-insured employer health plans seeking fiduciary-grade oversight and 8–12% spend recovery through vendor-attributed findings, executable contract adjudication, normalized member records, and plain-English AI queries.

Product overview

Andovia offers a portfolio of four integrated healthcare data and AI products that identify, prevent, recover, and govern healthcare spend. The platform consists of: VeriAct for independent health plan governance providing claim-level oversight and fiduciary-grade documentation; ca360 for contract adjudication converting contract terms into executable rules against real-world activity and payment data; m360 as the longitudinal member record creating a normalized, person-centric record across all vendor sources; and ai360 as the AI warehouse layer enabling plain English querying against the same data that powers BI reporting. Together, these products address cost reduction, contract compliance, data quality, and AI-enabled insights across healthcare finance, benefits, clinical, and operations teams.

Differentiator

Problem solved

Functional benefit

Brands

• VeriAct: Independent health plan governance software that identifies billing errors, inefficiencies, and contract terms that do not serve sponsor interests.
• ca360
• m360
• ai360

Products and services

• VeriAct

Quantifiable outcome

• Reduce healthcare spend by 8-12%
• +2 more outcomes

Segments4 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

AI capability4 records

Feature4 records

Scale indicators3 records

Recent moves5 records

Expansion highlights3 records

Broad incumbents

• Optum: Optum (UnitedHealth Group) is the largest incumbent in healthcare analytics, data, and care management; its broad portfolio overlaps with every layer of Andovia's stack but at much greater scale and with deeper payer-side vertical integration.

Direct peers

• Health Catalyst: Health Catalyst operates a healthcare data and analytics platform with data warehousing and AI capabilities, sharing Andovia's underlying thesis of operating on a unified enterprise healthcare warehouse.
• Arcadia: Arcadia is a healthcare data platform that aggregates clinical, claims, and utilization data for analytics and AI, comparable to Andovia's m360 + ai360 combination for payers and providers.
• Zelis: Zelis provides healthcare cost management, payment integrity, and network solutions for payers and employers, closely mirroring Andovia's targeting of self-insured plans with claim-level optimization.
• Cotiviti: Cotiviti specializes in payment integrity and claims accuracy for health plans and retailers, directly overlapping with Andovia's VeriAct claim-level governance and ca360 contract adjudication capabilities.
• Datavant: Datavant focuses on healthcare data connectivity, de-identification, and longitudinal record linkage — closely aligned with Andovia's identity resolution and longitudinal member record capabilities in m360.
• Clarify Health: Clarify Health delivers healthcare analytics and value-based care performance measurement using longitudinal claims and clinical data, comparable to Andovia's analytics and incentive-contract evaluation capabilities.
• MultiPlan: MultiPlan is a healthcare cost-containment vendor providing network and claim cost-management services to payers and self-funded employers, comparable to Andovia's claim oversight and contract enforcement.
• Komodo Health: Komodo Health provides healthcare analytics and longitudinal patient-level data for payers, providers, and life sciences, sharing Andovia's approach to enterprise-scale healthcare data and AI.
• Innovaccer: Innovaccer offers a healthcare data platform with AI and analytics capabilities for payers, providers, and self-insured employers, overlapping with Andovia's unified warehouse + AI architecture.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks6 records

Key highlights7 records

Customer concentration

Compliance3 records

Revenue estimate

Valuation estimate

Number of profiles

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Andovia