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Our latest healthcare insights and perspectives
FRAUD, WASTE, AND ABUSE
Case study: Highmark Wholecare prevents FWA with Claim Pattern ReviewNov 6, 2024
CONSUMER ENGAGEMENT
Case study: Engaging members to apply for the Low-Income Subsidy (LIS)Oct 30, 2024
Feb 8, 2024
May 14, 2024
Feb 28, 2024
Feb 6, 2024
CONSUMER ENGAGEMENT
Proactive member engagement strategies to close gaps in Medicare AdvantageOct 17, 2024
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching outlier behaviors in physical therapy claimsAug 8, 2024
PAYMENT INTEGRITY
FRAUD, WASTE, AND ABUSE
Video: Navigating new frontiers in FWA and payment integrityJul 16, 2024
PAYMENT INTEGRITY
White paper: Getting self-insured employer groups on board with payment integrityJun 13, 2024
PAYMENT INTEGRITY
Case study: Protecting financial integrity with prepay review solutionsJun 5, 2024
ENTERPRISE DATA ANALYTICS
Navigating new frontiers in healthcare: 3 takeaways from CCC24May 29, 2024
CONSUMER ENGAGEMENT
5 steps for proactive member engagement following Medicaid redeterminationsMay 23, 2024
QUALITY AND STARS
RISK ADJUSTMENT
White Paper: Executing high-performing interoperability programs to enable clinical dataMay 2, 2024
QUALITY AND STARS
Webinar: Implications of the 2025 CMS Final Rate Announcement for quality programsApr 11, 2024
PAYMENT INTEGRITY
Case study: Coordination of benefits (COB) results soar for large national planApr 9, 2024
FRAUD, WASTE, AND ABUSE
Case study: Integrated prepay and FWA solutions deliver improved claim accuracyJan 24, 2024
FRAUD, WASTE, AND ABUSE
Preparing for 2024 trends in healthcare FWA: CPT code updates and beyondJan 17, 2024
PAYMENT INTEGRITY
Case study: Data mining for errors yields more accurate pharmacy paymentsNov 16, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Flagging suspicious activity related to COVID-19 testingNov 8, 2023
CONSUMER ENGAGEMENT
Video: Reducing disparities in care during Global Health Equity WeekOct 26, 2023
PAYMENT INTEGRITY
Savings spotlight: Dental claim review expertise nets significant savingsSep 13, 2023
FRAUD, WASTE, AND ABUSE
Webinar: Finding new schemes with AI and investigative techniquesSep 11, 2023
QUALITY AND STARS
Podcast: Enhancing interoperability for better risk and quality outcomesSep 6, 2023
QUALITY AND STARS
Closing the Gap: Maintaining healthy cholesterol and improving medication adherenceAug 31, 2023
PAYMENT INTEGRITY
Video: A new approach to prepay coordination of benefits (COB) validationAug 14, 2023
FRAUD, WASTE, AND ABUSE
FWA Insights: Catching schemes related to Ozempic, Wegovy, and semaglutidesAug 2, 2023
QUALITY AND STARS
Navigating changes in Star Ratings programs: Enhancing success with four key stepsJul 24, 2023
PAYMENT INTEGRITY
4 strategies to curb medical cost increases as healthcare utilization reboundsJul 10, 2023
