Everyone involved in health care delivery wants accurate billing and payment. Our team partners with providers, payers and other stakeholders to improve accuracy and transparency.
Our payment integrity solutions can be implemented at any stage. And they integrate with your existing processes.
Payment Integrity Solutions
Accurate, effortless payments at all touchpoints in the claim lifecycle
Prevent, Edit, Price, Assess, Recover, Advise
The Claim Lifecycle
Create, submit, process, adjudicate, pay,
Prevent inaccurate billing. Solutions designed for accuracy before bills reach payers EDI messaging.
Edit inaccurate bills. Solutions designed to enable edits as appropriate during pre-adjudication, mid-adjudication, pre-payment, or post-adjudication.
Claims Edit System
Price bills appropriately. Solutions designed for accuracy pre-payment.
Prospective Payment System
Assess bill details. Accuracy assessed across pre-adjudication, pre-payment, and post-payment processes .
Itemized Bill Review
Coordination of Benefits
Recover overpayments. Solutions designed to increase recovery rates with minimal abrasion and transparency.
Advise on the full payment integrity landscape. A comprehensive design to reduce administrative cost and enhance accuracy across the lifecycle of a claim.
Comprehensive payment integrity
A comprehensive strategy improves savings and relationships and reduces administrative costs. Our experience, data and analytics help health plans develop strategic roadmaps. This helps you identify immediate and long-term opportunities to improve performance.