Successfully managing payment integrity programs is getting more challenging. Rising medical loss ratios (MLR), administrative pressure to keep costs low, and plan-wide pressure to build and maintain a satisfied, engaged network combine for a complex balancing act. Add the fact that many payment integrity vendors offer limited support options for their solutions, and health plans might be feeling overwhelmed.
To go above and beyond in their payment integrity program, payers need to look at the big picture to satisfy members, keep costs low, and onboard reliable partners. They need to implement programs and solutions that balance price with net medical cost savings, taking time to consider the value of services models that offer more benefits and that take on more administrative burden. This not only enables health plans to get long-term value but can even improve relations and engagement with members. Better payment integrity can help contribute to lower costs and better help for members, ensure more accurate health records, and bolster trust by showing a plan’s commitment to accuracy, transparency, and accountability.
Discover how to get better long-term value out of payment integrity efforts in our latest eBook, Total Value: How to build a better payment integrity program. Read the eBook to unlock the ways that health plans can get the best cost benefits from their payment integrity programs in three areas:
- Dimensions of value beyond medical cost savings
- Meaningful innovation
- True consultative partnership
Don’t miss this opportunity to learn how your plan can evolve from looking at siloed claims to unearthing larger billing patterns, combine prepay and postpay efforts for a complete continuum, and find the right partner to make the most out of your initiatives.
