Enhancing Cost Efficiency With Robust Payment Integrity

Jun 11,2024

Read Time 2 Minutes

Imagine a healthcare world where payment integrity is about more than just stopping financial loss. It's about improving experiences. It's about recognizing that everyone — from members to care providers — wants a more efficient health system.

Roughly 25% of US healthcare spend is wasted so we continue to innovate, using both technology and people skills. Our comprehensive approach has been developed to ensure every insurance dollar goes where it should — to the right patient, for the right care, and to the right provider.


  • Curb financial loss. Our Payment Integrity program directly addresses the rising cost of care. We leverage artificial intelligence (AI) and machine learning capabilities to better manage healthcare costs. This technology combines programs, optimizes return on investment, and enhances the efficiency of every intervention.

  • Optimize value. Using an advanced, data-driven approach, we can actively look for savings and continually adjust priorities based on value. This results in a more efficient system designed to cater to your organization’s specific needs.

  • Enhance healthcare experiences. We’re committed to simplifying processes for members and care providers. Long phone calls and paperwork are becoming things of the past. Instead, we’re using database mining and direct subrogation, which leaves members out of the process and improves their experiences. 


We continually aim to handle the increasing volume and complexity of claims to prevent wrong ones from sneaking in. Even as we use technology to boost efficiency, we remember that healthcare is about people, focusing on building better relationships between payers and providers.


Our program is human-focused and uses automation and AI, but still values human interaction. It's a blend of innovation and human touch that's critical for a good Payment Integrity program. Together, we can reduce waste, boost transparency and better the payment process.


The bottom line? We’re devoted to keeping healthcare as affordable as possible, ensuring you can provide the best for your employees. As your trusted partner, we stay ahead of the curve to deliver a proactive, innovative, and truly comprehensive Payment Integrity program.