--- title: "Who We Serve: Health Plans, Employers, Stop-Loss | Avandé" url: "https://avande.net/who-we-serve" description: "Physician-led review for health plans, TPAs, self-funded employers, stop-loss carriers, providers and legal teams. Every determination by a specialist." last_updated: 2026-10-09 --- Who we serve # Built for the people who pay for care. Avandé serves five kinds of buyers with one standard: a board-certified, specialty-matched physician makes every determination. 1. [01 Health plans & TPAs](https://avande.net/#health-plans) 2. [02 Employers](https://avande.net/#employers) 3. [03 Stop-loss & reinsurance](https://avande.net/#stop-loss) 4. [04 Providers & ACOs](https://avande.net/#providers) 5. [05 Legal & compliance](https://avande.net/#legal) 01 · PAYERS ## Health plans & TPAs Claims and utilization review that holds up on appeal. Avandé gives health plans and TPAs physician-led prior authorization, claims and utilization review, with cited criteria and a full audit trail on every case. ![Two health plan analysts at a desk reviewing a claims dashboard on a monitor, one pointing at the charts.](https://avande.net/_astro/serve-health-plans.BT3E1lDX_ZfkF2J.webp) ### Relevant services - [Care Assurance Care reviewed before it happens.](https://avande.net/what-we-do/care-assurance) - [Forensic Claims Validation Full-record review of high-cost claims.](https://avande.net/what-we-do/forensic-claims-validation) - [Clinical Surveillance Ongoing outlier detection.](https://avande.net/what-we-do/clinical-surveillance) - [Healthcare IT Services FHIR and X12 EDI integration.](https://avande.net/what-we-do/healthcare-it-services) 02 · SELF-FUNDED PLANS ## Employers Lower self-funded plan costs, same networks. Avandé helps self-funded employers lower plan costs by reviewing high-cost care before and after service, without changing networks. ![Two benefits leaders at a conference table going over printed plan cost reports beside a laptop.](https://avande.net/_astro/serve-employers.BD9GiDS9_Z1vUwD7.webp) ### Relevant services - [Care Assurance Right care approved before it happens.](https://avande.net/what-we-do/care-assurance) - [Forensic Claims Validation Pay only for care the record supports.](https://avande.net/what-we-do/forensic-claims-validation) - [Clinical Surveillance Spot cost trends before renewal.](https://avande.net/what-we-do/clinical-surveillance) 03 · RISK ## Stop-loss & reinsurance Large-claim review and risk mitigation. Avandé reviews large claims in the full medical record, so stop-loss carriers and reinsurers pay only for supported care. ![A risk analyst at a standing desk studying large-claim trend charts across two monitors, with one claim flagged.](https://avande.net/_astro/serve-stop-loss.BOqR1hbF_1nIYcg.webp) ### Relevant services - [Forensic Claims Validation Physician review of every large claim.](https://avande.net/what-we-do/forensic-claims-validation) - [Clinical Surveillance Early warning on high-risk members.](https://avande.net/what-we-do/clinical-surveillance) 04 · PROVIDERS ## Providers & ACOs Clear, fast determinations. Avandé gives providers and ACOs clear prior authorization determinations, made by a physician in the same specialty. ![A physician in a white coat at his office desk annotating a patient chart.](https://avande.net/_astro/serve-providers.BWa2Iczg_Z1aPeTF.webp) ### Relevant services - [Care Assurance Specialty-matched, peer-to-peer ready.](https://avande.net/what-we-do/care-assurance) - [Healthcare IT Services Connect EHRs over FHIR.](https://avande.net/what-we-do/healthcare-it-services) 05 · LEGAL & COMPLIANCE ## Legal & compliance Expert medical record review. Avandé physicians review medical records for legal and compliance teams, trained in legal, regulatory and financial healthcare matters. ![An attorney in a law library office reviewing a medical record, with scales of justice on the desk.](https://avande.net/_astro/serve-legal.cDHguslE_xj5hH.webp) ### Relevant services - [Forensic Claims Validation Findings documented in the full record.](https://avande.net/what-we-do/forensic-claims-validation) FAQ ## Is Avandé right for us? ### Who does Avandé work with? Avandé works with organizations that pay for healthcare: health plans and TPAs, self-funded employers, stop-loss carriers and reinsurers, providers and ACOs, and legal and compliance teams. ### Do we have to change networks or vendors? No. Avandé reviews care and claims alongside your current networks, TPA and systems. ### Who makes the determinations? Board-certified, specialty-matched physicians make every determination. Our platform prepares the evidence and keeps the audit trail. ### How often are decisions overturned? Rarely. 3 out of 10,000 cases (0.0003%) are overturned on appeal. ### How do we get started? Send a few sentences through the contact form or call 1-833-328-2633. Our team reads every message. Don't see yourself here? ## Tell us what you're reviewing. A few sentences are enough. [Let's Talk](https://avande.net/contact) or call **1-833-328-2633**