Boston, June 30, 2021 –Healthcare payers had a favorable year in 2020, as utilization declined due to stay-at-home advisories during the COVID-19 pandemic. But in the normal course of business, when utilization levels are likely to be higher, the emphasis shifts to optimizing internal processes—namely, claims processing and payment operations. Payment integrity tools play an important role in these optimization initiatives. Vendor partners must be in sync with and responsive to the needs of their health plan clients to succeed.
This Impact Report explores the perspectives of clients actively participating in the May 2021 Aite Group Payment Integrity Matrix in healthcare. The report highlights some key drivers for clients seeking vendor solutions as well as various reasons leading to specific vendor selections.
This 31-page Impact Report contains 17 figures and two tables. Clients of Aite Group’s Health Insurance service can download this report, the corresponding charts, and the Executive Impact Deck.
This report mentions Centers for Medicare and Medicaid Services (CMS), CGI Group, Change Healthcare, Claris Health, Codoxo, Cotiviti, EXL Service, OptumInsight, and SAS Institute.