Adjudicating claims appropriately while minimizing the need to pursue overpayment recovery remains one of the greatest challenges faced by all payers. While many players in the payment integrity space offer software that enables health plans to manage their prepay claim editing of professional and outpatient facility claims, this approach only tackles one aspect of the payer’s entire claim stream and the payment integrity continuum.

Read the new white paper from Cotiviti, a payment integrity partner to more than 100 health plans, as we break down:

• The value of a managed service model versus a software-only approach
• The five critical dimensions of any payment integrity program
• The role of artificial intelligence in payment integrity