Release Notes

Introducing the new actAVA Workforce Agent Library for Payor Operations

Health plans are running some of the most operationally complex organizations in healthcare — and doing it under the most demanding regulatory scrutiny in the industry's history. CMS-0057 FHIR prior authorization mandates, MHPAEA Non-Quantitative Treatment Limitation analyses, No Surprises Act network adequacy obligations, NCQA credentialing standards, and 834/270/271 eligibility workflows must all execute correctly, simultaneously, at the scale of millions of members and thousands of in-network providers. actAVA's Payer Operations Workflow Library introduces 10 purpose-built agents across six domains — Provider Network & Credentialing, Plan Configuration & Adjudication Rules, Member Operations, Utilization Management, Regulatory Compliance, and VBC Contract Design — each built for the compliance architecture that payer operations require and the audit trail that regulators demand.