Join the next era of payment accuracy
Across the healthcare system, everyone is searching for ways to control costs without compromising care. For health plans, payment integrity has proven to be an effective way to do just that. But yesterday’s approaches are no match for the complexity of today’s challenges. The next generation of PI solutions focuses on preventing errors before claims are paid for greater efficiency, better experiences, and improved costs.
We’re at the forefront of payment integrity, accelerating its evolution. We’ve taken what we’ve learned through decades of experience to offer you new solutions powered by deep data sets, ground-breaking technology, and sophisticated analytics. But our real power comes from our team of approachable experts who understand what true partnership is all about. Our team meets you where you are, making the path to a more effective and efficient payment integrity strategy easier to navigate.
It’s time to get excited about payment integrity
On the surface, the subject of claims payment accuracy may sound a bit dry and technical. We find it fascinating. We see that payment integrity offers incredible potential to tackle one of the biggest challenges for health plans — and our healthcare system: affordability. To achieve this, we break down barriers, partner like never before, and keep humanity at our core. It's this vision, collaboration, and integrity that set us apart.
Expertise
Born out of one of the nation’s largest health plans, we know how critical payment integrity is to your plan. Because we live and breathe healthcare, we design and deliver solutions that maximize results and support your valuable member and provider relationships.
Create clarity in the payment workflow
Powerful technologylytics driven by artificial intelligence and machine learning power our solutions for unmatched accuracy and efficiency. Plus, our next-gen technology is backed by a team of seasoned experts who are there to partner with you every step of the way.
Full transparency
Being able to clearly see how your payment integrity program is performing is critical. That’s why we provide access to easy-to-read dashboards and reports to monitor your program’s progress and provide insights that optimize results.
Data Mining Solution
What if you had a payment integrity partner that could find an increased number of overpayments quickly and accurately without causing undue provider or member abrasion? Our Carelon Data Mining Solution makes that possible. With our finely tuned concepts, and collaborative online workflow tool, we unlock savings others miss and provide value and actionable insights health plans need and want.
Learn more about our Data Mining Solution
Other Party Liability Solutions
Leading health plans seek payment integrity partners that take a comprehensive, proactive approach to payer responsibility. Our Other Party Liability Solutions do just that. We swiftly identify responsible parties and uncover more lead opportunities, maximizing the potential of each lead. Our solutions efficiently and effectively deliver the highest value for our clients, enhancing savings and recoveries to improve their financial health while safeguarding crucial member and provider relationships.
Learn more about our Other Party Liability Solutions
Healthcare sustainability depends on integrity
The health of the healthcare system improves when spending is responsible and accurate. Today, platform technology and advanced analytics are paving the way to make that more efficient and more proactive than ever before.
Learn about the opportunities we see to embed more financial integrity across the healthcare system.
Transformative payment integrity
January 21, 2024
Improving subrogation performance
January 20, 2024
How payment integrity is evolving
January 22, 2024
A health plan’s journey to maximizing health claim recoveries
March 11, 2024
Five questions for payment integrity vendors
June 11, 2024
Working with the right payment integrity partner?
September 04, 2024
Ready to learn more?
We’re here to answer any questions you have about our capabilities.
