The future of claims management: How payers can maximize payment integrity

Recent statistics show that 7 to 10 cents of every dollar spent on healthcare goes toward paying for fraudulent claims. Meanwhile, the rise of value-based care and new technologies like AI have many payers exploring new strategies to deal with a changing reimbursement landscape. The previous focus on fraud detection and provider audit is shifting to include the unification of other payment integrity functions that were previously siloed, allowing payers to move operations from reactive to predictive.

Health plans that take a comprehensive approach to payment integrity can reduce overall costs while minimizing low-value activity and stakeholder abrasion. This whitepaper details how payers can begin to make that shift, along with trends in the industry and considerations going forward.

You'll learn how to:
  • Increase claims accuracy, enhance coordination of benefits and refine audits
  • Move past traditional data handling processes to get actionable insights
  • Use AI and machine learning to reduce billing errors and fraud

Please fill out the form to download the whitepaper.