Industry Insights & Expertise

Access insights and perspectives from our team of payment integrity and FWA experts. Our podcast ‘Payment Integrity Perspectives’ features innovators and thought leaders who share a common goal to transform health plan engagement.

Articles

Reduce False Positives in Healthcare Fraud Detection

Part 2 of our series on how the SIU can use artificial intelligence to overcome common challenges. A.I. can reduce the fraud false positive rate to make the most of your limited investigator resources.

Resources

A.I. for Healthcare Fraud Detection

In this on-demand webinar, Mark Isbitts, VP of Program Integrity at ClarisHealth discusses how you can use A.I. for healthcare fraud detection to answer SIU questions.

Recent Podcasts

Scaling Payment Integrity to Accelerate ROI

Scaling Payment Integrity to Accelerate ROI

Season 2: Episode 2 - When the L.A. Care Health Plan payment integrity team looks at how far they’ve come in 4 short years, the differences are startling. Their early success made the case for ...
Building Payment Integrity from the Ground Up

Building Payment Integrity from the Ground Up

Season 2: Episode 1 - On their way to achieving an annual $131 million recovery rate, L.A. Care Health Plan had to build their team, onboard and manage vendors, and acquire a technology solution ...
Introducing L.A. Care Health Plan

Introducing L.A. Care Health Plan

Season 2: Trailer - This season, we’re following L.A. Care Health Plan who built a payment integrity function from the ground up – with a little help from advanced technology platform Pareo – and