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

You Don’t Need Rules to Mitigate Healthcare FWA

Health plan SIUs find deep learning models for fraud detection provide advantages over rules-based tools.   The onset of the novel coronavirus pandemic highlighted a glaring weakness in ...

3 Ways MCOs Can Prevent Fraud, Waste and Abuse

A robust fraud, waste and abuse program at MCOs and MAOs includes three key areas: Technology, Clinical Audit and Investigative capability. As your health plan grows its fraud, waste and abuse ...

6 Steps to a Successful Prepay Strategy

Health plans can take control of their own prospective provider audits instead of over-relying on services vendors with the help of advanced technology and access to proven ...

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