Payment Integrity

The Power of Measurement and Pilot Programs in Payment Integrity In the world of healthcare payments, accuracy is everything. Lost revenue due to errors and improper claims can significantly impact an organization’s financial health. That’s why building a strong payment integrity program is crucial, and a key element of that program is measurement. As a […]

In the dynamic landscape of healthcare operations, the pursuit of payment integrity stands as a crucial imperative. At the heart of this endeavor lies the strategic utilization of internal resources, whose expertise and advocacy can significantly accelerate progress. In this article I detail how leveraging internal assets can drive success in payment integrity initiatives within

In healthcare operations and finance, establishing a robust Payment Integrity (PI) program is imperative for optimizing financial health and ensuring quality care delivery. However, embarking on this journey requires a clear roadmap and execution focus to navigate the complexities effectively. Drawing from insights learned from my article “Navigating the Landscape: 10 Lessons Learned while Implementing

WEBINAR RECAP Unraveling Payment Integrity Challenges: Tactics for Sustainable Success Speakers: Chad Roswick, VP Healthcare Consulting, Curate Partners Dennis Rossi, Data & Analytics Solutions Partner, Curate Insights Emily O’Brien, VP Healthcare Solution, Curate Partners Healthcare costs are a major concern, and health plans are constantly seeking ways to optimize their spending. Payment integrity (PI) programs

In my experience navigating the intricate world of healthcare operations and finance, I’ve come to recognize a crucial aspect that can make or break Payment Integrity (PI) initiatives: the need for dedicated support. Let me share why expecting claims leaders to manage PI efforts alongside their existing responsibilities can hinder progress rather than propel it

Embarking on the journey to establish a robust Payment Integrity (PI) program within healthcare operations often entails addressing initial skepticism and misconceptions. In my two decades in healthcare, I’ve encountered a spectrum of comments reflecting initial skepticism when introducing PI initiatives: “What is PI, and why do we need it?” “We already have a quality

Leading the Way: The Crucial Role of Executive Leadership in Payment Integrity In the complex landscape of healthcare operations, one principle stands out above all: Payment Integrity (PI) starts at the top. At the helm of every successful PI initiative lies the unwavering commitment and strategic vision of executive leadership. As highlighted in a recent

In the complex world of healthcare, maintaining payment integrity is of utmost importance for payers. Understanding what healthcare payment integrity entails and why it is essential allows payers to navigate the challenges and ensure accurate and efficient payment processes. What is Healthcare Payment Integrity? Healthcare payment integrity refers to the accuracy, efficiency, and compliance of

Navigating the Landscape: 10 Lessons Learned while Implementing a Payment Integrity Office in Healthcare Operations In the dynamic realm of healthcare operations, the successful implementation of a Payment Integrity Office is crucial for financial stability and operational efficiency. Navigating the payment integrity journey can prove challenging due to factors such as ever-changing regulatory requirements, data