Amid rising medical loss ratios, administrative cost pressures, and increased competition, health plans are under pressure to deliver high-performing payment integrity programs. But when choosing between a software-only payment integrity vendor versus a full-service partner, health plans have many factors to consider when it comes to their prepay claim review, DRG validation, coordination of benefits, and data mining programs. On the third episode of our Payment Integrity Insights podcast, Cotiviti’s payment integrity leaders discuss: The dimensions of payment integrity value that go beyond medical cost savings The benefits of pairing clinical expertise with advanced technology The value of consultative expertise including benchmarking and analytics

View Entire Post