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Payment Integrity Program – Streamline Claims Management to Reduce Administrative Costs

From changing the way payers pursue claims overpayments to helping them undercover a wide range of waste and errors in claims processing, Inniti is helping payers boost efficiency and reduce costs.

According to Tom Barnard, Client Operations Director at Inniti Alliance - “We are pleased to be identified as one of the leading providers of payment integrity solutions. It is a confirmation of the value we put into our methodology and approach for detection and prevention of payment for fraudulent activities in the healthcare sector.”

Every year, payment integrity issues in the US healthcare industry result in a staggering $800 billion in healthcare losses. This is one of the main reasons why payers are moving from the pay-and-chase model to a different approach of identifying errors and waste throughout the claims process.

By opting for Inniti’s payment integrity solutions, a growing number of insurance companies in the US are finding it easy to spot fraud and billing issues earlier in the cycle. It is enabling them to stop losses before they occur, thereby reducing their administrative costs.

Payment Integrity Solutions Becoming a Necessity

Payers are facing challenges in ensuring that dollars are spent appropriately. They are trying to achieve this while navigating new and complex payment models. They are not only under the pressure to ensure advanced and flexible solutions for reimbursement but also the need to innovate and contain administrative costs.

“Payment integrity solutions have become a necessity for healthcare organizations. Since the ACA (Affordable Care Act) was passed in 2012, a number of strict regulations were imposed on insurance companies to reduce costs and price plans in a way that customers are satisfied. As a leading claims management partner, we wanted to help our clients contain their costs and therefore, we introduced our Payment Integrity Program” – said Tom Barnard, Client Operations Director at Inniti Alliance.

Inniti’s Payment Integrity Approach
Inniti has developed an approach that helps insurers take a deep dive analysis of a health plan’s integrity across multiple areas, including claims review and audits. By looking at the plan’s payment integrity from an enterprise perspective, clients have been able to find ways of saving and recovering more money through effective capturing and sharing of data and investment in the right technology.

“Our Payment Integrity Program includes various metrics, improved technologies and reporting and analytics, helping our clients see dramatic results in saving dollars and improving recovery and cost avoidance. Tom Barnard also added that the program by Inniti solves payment integrity issues from the root, presenting a roadmap towards achieving the desired goals. It is only through optimized payment integrity solutions that payers can harness the rising cost of healthcare that has become a burden for everyone in the industry.

With a team of skilled claims managers or claims adjudicators, Inniti has been able to deliver premium solutions to some of the best clients in the industry. Besides payment integrity, they also provide solutions for managing the claims process, helping clients cut down backlogs and enhance their service levels.

About Inniti Alliance
Inniti Alliance acts as a partner for insurance and healthcare companies, offering a spectrum of top-notch services, including claims management, business intelligence and analytics and business process management. With 14 offices across the globe, Inniti has been driving quality results for clients in the insurance and healthcare industry, helping them grow and boost their ROI.

For More Information You Can Contact Inniti Alliance



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News Release: Payment Integrity Program – Streamline Claims Management to Reduce Administrative Costs
Submitted on: December 21, 2016 11:05:06 AM
Submitted by: Harshal K
On behalf of: