Payment Integrity
Capture more revenue to reduce inappropriate claims payment
Maximise Revenue With Proven Toolsets
In today’s complex health plan environment, you must analyse huge data loads, coordinate payments to multiple carriers and manage a wide range of health plans across government and commercial clients. This makes payment integrity issues, including fraud, waste and abuse (FWA), more common. FWA leads to higher costs for you – and higher co-payments and premiums for members. NTT DATA can help. Along with our strategic partners, we deliver solutions that use workflow automation and dashboards to help you proactively detect and investigate non-payable claims.
We can help you capture more revenue and automate payment authorisations with proven toolsets for screening, scoring and coordinating benefits. Our solutions allow you to improve pre-pay screening and scoring for direct savings and scan for programme irregularities and billing anomalies. Plus, you can use advanced analytics to improve audit and recovery results and increase referrals using provider risk scorecards. Let’s get started.
Reduce Inappropriate Claims Payments Before They Happen
Our approach to health plan payment integrity solutions helps you proactively detect fraudulent claims with proven toolsets for screening, scoring and coordinating benefits so you can improve payment integrity.
SIMPLIFY
Automate coordination of benefits with other carriers to verify eligibility, coverage, coding
COMPLY
Keep on top of changing federal and state regulatory mandates
RESPOND
Dynamic reporting of multiple performance indicators through automated workflow, dashboards
PROTECT
Implement effective detection, investigation, recovery services
