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.

 

By downloading this content, you agree to Becker's Healthcare terms of service and privacy policy.

I would like to also add the following learning opportunities to my registration:

  • AI is reshaping claims — don't let payers get the upper hand. Learn more: here. - April 22nd at 12:00 PM CT - Learn Now
  • What does it take to scale AI systemwide? Sharp & Guthrie Clinic CIOs break it down here. - April 21st at 12:00 PM CT - Learn Now
  • The top 5 barriers preventing hospitals from improving care access — how to break through them, here. - Read Now
  • Avoid the hidden cost of lab sell-offs. 5 data-driven reasons to keep it, here. - Read Now
  • $10M — what the average healthcare data breach costs. Bolster security here. - Read Now
  • Digital Innovation + Patient Experience + Marketing Virtual Event - Tuesday, August 5th, 2025 - Learn Now