Improve payment accuracy with next-generation intelligence
Challenges and pressure to reduce healthcare costs, increase recovery rates and avoid overpayments continue to rise. Health plans strive to improve payment integrity capabilities by transforming outdated technology and processes. But most point solutions lack transparency or only provide a one-sided view across business lines, which leads to increased administrative and medical costs. They also rely on retrospective pay-and-chase models with minimal intention to fix the root cause. It’s time to shift from the pay-and-chase model of payment integrity to a model that will enable near real-time accurate payments.
We can help. As a trusted global innovator, we assist health plans in harnessing next-generation intelligence and advanced analytics through our Medical Cost Manager (MCM). We combine advanced data management with Fast Healthcare Interoperability Resources (FHIR) integration for real-time data collection to bring a unified, holistic view of high data value points from claims and membership information. This approach provides a complete view with more transparency and insights to detect and prevent overpayments to improve cost avoidance. See what MCM can do for you.
Medical Cost Manager helps increase overpayment identification, improve accuracy, reduce vendor spend and optimise operations.
PLAY VIDEOAn enterprise-level payment integrity solution
Processes diverse data sources through comprehensive, deep learning and custom rules enabled analytics to provide 360-degree view.
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Comprehensive platform with agility adapts and integrates with systems to respond to changing regulations
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Advanced analytics and machine learning identify gaps and fix the root cause for better cost avoidance
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360-degree member/claim view with capabilities customises and integrates with diverse data sources
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Automation and command centre with workflow reduce administrative costs and vendor spend for streamlined operations
Shift gears
Should you shift to an AI-powered payment integrity (PI) model? Our webinar explores the change in focus from payment platforms to a systemic use of automation to simplify the PI function. Experts from IPsoft and NTT DATA explain how you can leverage a self-driving PI programme to improve provider satisfaction, reduce regulatory risk and achieve cost savings.
ACCESS THE WEBINAR