Prospective Payment Integrity for Enterprise Transformation

The Source platform offers the ability for clients to unlock transformation at the reimbursement, payment integrity, and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial and Government lines of business. Payment Integrity Transformation includes rich editing libraries with history-based capabilities, easy development of customized edits, and improved transparency to reduce vendor dependency and increase control. As a complete solution, clients can achieve Enterprise Transformation, where root-cause issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence.

Ppi systems overview

The Source Solution Suite

“By investing in a prospective payment integrity solution that highlights inaccuracies before the payment is made, you can stop the costly retroactive repayment process that negatively impacts your providers and members through administrative costs”

– Gartner®, Inc. U.S. Healthcare Payer CIOs Must Invest in Prospective Payment Integrity to Improve Member Experience, Austynn Eubank and Mandi Bishop, 24 March 2023. GARTNER is a registered trademark and service mark of Gartner, Inc. and/or its affiliates in the U.S. and internationally and is used herein with permission. All rights reserved.

Source Medicare Reimbursement

Delivers, manages and maintains CMS pricing data for comprehensive payment accuracy.

Source Medicaid Reimbursement

Pay Medicaid claims accurately, quickly and comprehensively – the first time.

Source Commercial Reimbursement

A dynamic solution that simplifies contract configuration and provides accurate modeling.

Source Editing

Comprehensive support to handle complex policies automatically across all lines of business.

Source Platform Access

Enabling payers to gain control of their IT ecosystem through radical transparency.


Additional Offerings

Source Analytics

Our Business Intelligence capabilities enable enterprise-wide decision support for setting medical policy, renegotiating provider contracts, and identifying and remediating billing and utilization trends within your provider network.

Source Professional Services

Our Source experts are stewards of our solution, with a mission to equip your internal teams with the knowledge and support required to optimize your business.

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Source Third-Party Integrations

Incorporate third-party solutions and their data into a cohesive workflow for true interoperability of normally disjointed solutions. 

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“When it comes to building and managing claims, I never want to go back to anything else.”

Director of Policy & Editing, Large Southeast Payer

"All of our pricing and editing is a one stop shop"

Melissa Rusk, Vice President of Operations, SummaCare
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