Root Cause to Corrective Action.
Algorithms, predefined rules and post-pay audits will only take you so far. Payment Integrity and Cost Containment is finding the payment error before payment is released. Each Cost Containment and Recovery opportunity in our platform comes from your data – your calls, your errors, your contracts, your plan configuration changes. Our tools support your unique needs — identifying, capturing, auditing, prioritizing, routing and tracking. Prepay Process, not Pay and Chase Analytics.
“Now we manage with audit workflows and alerts to problem issues. I can easily see what’ problems we have in provider and plan config and how much that costs us. I have the data to get Leadership’s support for corrective actions needed. “
John G. – Vice President, National Health Plan