Gartner Report

U.S. Healthcare Payer CIOs Must Adopt Prospective Payment
Integrity to Thwart Improper Claims Payment and Fraud

Implementing prospective payment accuracy solutions is more important than ever as payers look for every opportunity to contain costs and improve financial performance.

Learn why Gartner recommends that payers “kick-start 2018 financial performance by transforming the way your organization manages payment integrity in two simple steps.”

Access this report to explore the following topics:

  • Why it is urgent that payers shift focus to pre-pay solutions now 
  • What capabilities you should evaluate within your own organization, and how an experienced vendor with mature prospective solutions can add value
  • Why issuing an RFP now is vital to your ability to address improper payments for every reason, beginning before a claim is every submitted for payment, and continuing after a claim has been paid 

Complete the form on the right to learn why Gartner recommends that payers “Ask vendors about their core competencies in pre-emptive, prospective and retrospective payment integrity processes in areas such as diagnosis-related group (DRG) audits, high dollar audits, coordination of benefits, subrogation, claims edits, data mining and reporting dashboards."