White Papers

White Paper: Position Your Health Plan for Long-Term Success with Payment Integrity

Paper: Compliance with Prior Authorization Mandates Is a Strategic Opportunity for Payers

A strategy to comply with the final rule issued by the U.S. Centers for Medicare & Medicaid Services suggests that payers should unify systems around their core claims and care management platforms...

White Paper: A New Paradigm in Payment Integrity - Taking an Enterprise Approach

Gain insights from a survey of health plan leaders on how to solve payment integrity challenges and achieve enterprise alignment.

White Paper: The Digital Payer Journey to Achieve a Coherent Individual Healthcare Experience

White Paper: Prospective Payment Integrity Moving from Pay and Chase to Predictive

This Spotlight examines payer payment integrity platforms and how payers can aggressively apply analytics and coordinate workflows to move "left" from reactive postpay to proactive, predictive prepay.

White Paper: Prospective Payment Integrity Solution Partner

Traditional multi-vendor payment integrity systems, while well-intentioned, often complicate IT environments with disjointed data sources and inconsistent workflows.

White Paper: Open & Flexible Care Management Systems to Transform Healthcare

In today's rapidly evolving healthcare landscape, traditional IT systems and monolithic care management solutions are becoming obsolete.

White Paper: Secondary Editing Platform

White Paper: Payment Integrity Medicaid

The intricacies and variability of state-by-state Medicaid regulations are presenting significant challenges for health plan executives, who must continually adapt to the latest Medicaid payment...