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.
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What can your Medicaid MCO do to prepare for this year and beyond?
Medicaid managed care organizations are continually in a balancing act, facing tighter-than-average budgets, political ...
Look out for these 4 elements of payment integrity that may negatively impact provider NPS (net promoter scores) with your network providers.
The Net Promoter Score (NPS) – an established metric ...
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 ...
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 ...
Payment integrity solutions vendors make many claims. Here are the top 14 areas of evaluation to ensure a perfect fit for your health plan.
Virtually every health plan is looking to address ...
Artificial Intelligence is making the leap from much-hyped “trend” for healthcare technology to more widespread adoption. Here’s what A.I. is — and isn’t — and how health plans are proving its ...
Go beyond the basics with a payer-provider portal that drives engagement and decreases costs.
How would you characterize the health of your relationships with network providers? If yours is like ...
Use these tech-enabled tips to comprehensively reduce FWA.
States require MCOs to take proactive measures that reduce not just fraud, but also waste and abuse. But how can you ensure your ...
The 2020 presidential election is upon us, and the debate surrounding healthcare and politics is more contentious than ever. How can your health plan stay ahead of the game, no matter the ...
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Recent Podcasts
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 – ...
Season 1: Bonus Episode - How has Highmark Blue Cross Blue Shield achieved an industry-leading 27:1 ROI on their payment accuracy and FWA operations? Listen as Kurt Spear, VP Financial ...
Season 1: Episode 6 - How your technology solution is delivered, and by whom, is a large factor when considering how successful a technology project will be. In this episode, ClarisHealth ...