Abstract

This IDC Perspective highlights how payer payment integrity is becoming more predictive and integrated. Payers and providers are working diligently to make accurate payments to providers in a single pass with precise audit trails and embedded business intelligence to facilitate better relationships with providers, reduce waste, and improve financial performance.

"Payment integrity suites that provide a single solution for both pricing and editing, handling all lines of business, connecting all core claims platforms, handling both fee-for-service and fee-for-value contracts will become the enterprise standard for payers over the next three years. Payers that can overcome organizational fragmentation with common, integrated, transparent technology will benefit greatly," says Jeff Rivkin, research director for Payer IT Strategies for IDC Health Insights.

Coverage