Payment Integrity
Maximizing claims cost savings by uncovering and reducing provider errors, waste and abuse.
We combine leading-edge, machine learning-enabled technology with superior clinical expertise and integrate network, claims and payments data to generate insights that drive actions that maximize claims cost savings.
We maximize claims cost savings by finding and reducing provider errors, waste and abuse using our proprietary claims editing, specialty clinical audits, dialysis savings, hospital bill review and audit and out-of-network solutions.


Hospital Bill Review
Reduce improper payments through precise & flexible prepayment review of medical claims.
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Specialty Clinical Audits
Review of specialty Rx, complex spinal & biologic implants & air ambulance claims.
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Dialysis Savings & Support
Maximizing savings for high cost dialysis claims through a comprehensive program.
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Out-Of-Network Services
A multi-layered, balanced approach dynamically delivering the highest level of claim savings.
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Reference Based Pricing
Delivers sustainable cost management that goes beyond cost shifting.
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