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.

The Strategic Approach to Claims Cost Containment

Competing with other health plan functions for technology priority can lead to missed audit claims cost savings potential. An integrated payment integrity strategy breaks down these internal ...

Using A.I. to Unite Fraud and Payment Integrity

Part 1 of our series on how the SIU can use artificial intelligence to overcome common challenges. Bringing together fraud and payment integrity efforts on a single A.I.-powered platform can ...

News

Resources

5 Benefits of Integrating SIU

5 Benefits of Integrating SIU with Payment Integrity A webinar with Mark Isbitts, VP of Program Integrity and Jason Medlin, VP of Marketing and Business Development Recent Posts

L.A. Care Webinar

A free on-demand event for health plan executives How to double your recoveries in 6 months without damaging relationships with providers and members. Created for your busy schedule, join this ...

Case Study: L.A. Care Health Plan

How did the nation’s largest public health plan double their recoveries in just one year? When L.A. Care Health Plan’s membership doubled, their cost containment processes needed to run to catch ...

Recent Podcasts

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 – ...