Join the next era of payment accuracy
Across the healthcare system, everyone is searching for ways to control costs without compromising care. For health plans, payment integrity has proven to be an effective way to do just that. But yesterday’s approaches are no match for the complexity of today’s challenges. The next generation of solutions focuses on preventing errors before claims are paid for greater efficiency, better experiences, and improved costs.
We’re at the forefront of payment integrity, accelerating its evolution. We’ve taken what we’ve learned through decades of experience to offer you new solutions powered by deep data sets, ground-breaking technology, and sophisticated analytics. But our real power comes from our team of approachable experts who understand what true partnership is all about. Our team meets you where you are, making the path to a more effective and efficient payment integrity strategy easier to navigate.
It’s time to get excited about payment integrity
On the surface, the subject of claims payment accuracy may sound a bit dry and technical. We find it fascinating. We see that payment integrity offers incredible potential to tackle one of the biggest challenges for health plans — and our healthcare system: affordability. To achieve this, we break down barriers, partner like never before, and keep humanity at our core. It's this vision, collaboration, and integrity that set us apart.
Born out of one of the nation’s largest health plans, we know how critical payment integrity is to your plan. Because we live and breathe healthcare, we design and deliver solutions that maximize results and support your valuable member and provider relationships.
Advanced analytics, artificial intelligence, and machine learning power our solutions for unmatched accuracy and efficiency. Plus, our next-gen technology is backed by a team of seasoned experts who are there to partner with you every step of the way.
Being able to clearly see how your payment integrity program is performing is critical. That’s why we provide access to easy-to-read dashboards and reports to monitor your program’s progress and provide insights that optimize results.
Take payment integrity
to the next level
Our solutions bring together breakthrough technology and human expertise to help speed your ability to drive cost savings and value for your stakeholders.
Coordination of benefits consensus solution
Quickly identify members with multiple coverage and make accurate coverage determinations.
Explore related solutions
Embedding integrity into healthcare payments
We believe that controlling healthcare spending isn’t only possible — it’s essential to creating a healthier health system. Explore our perspectives for our views on tackling one of our industry’s most complex challenges: affordability.
Transformative payment integrity
How payment integrity is evolving
Improving subrogation performance
Ask us about payment integrity
Health plan leaders, contact us to learn more about the possibilities and impact of payment integrity.
Are you a health plan member?
If you’re a health plan member and have a question about your health plan, please call the member services number on the back of your health plan ID card.