Gartner Report

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

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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."