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Implementing prospective payment accuracy solutions is more important than ever as payers look for every opportunity to contain costs and improve financial performance.

Learn why Gartner recommends that payers “kick-start 2018 financial performance by transforming the way your organization manages payment integrity in two simple steps.” 

We think you will gain the following insights from this research report: 
  • Why it is urgent that payers shift focus to pre-pay solutions now 
  • What capabilities you should evaluate within your own organization, and how an experienced vendor with mature prospective solutions can add value
  • Why issuing an RFP now is vital to your ability to address improper payments for every reason, beginning before a claim is every submitted for payment, and continuing after a claim has been paid 
 
Complete the form on the right to learn why Gartner recommends that payers “Ask vendors about their core competencies in pre-emptive, prospective and retrospective payment integrity processes in areas such as diagnosis-related group (DRG) audits, high dollar audits, coordination of benefits, subrogation, claims edits, data mining and reporting dashboards."
 
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1Gartner, “U.S. Healthcare Payer CIOs Must Adopt Prospective Payment Integrity to Thwart Improper Claims Payment and Fraud,” by Bryan Cole and Mandi Bishop, February 13, 2018.

Gartner does not endorse any vendor, product or service depicted in its research publications, and does not advise technology users to select only those vendors with the highest ratings or other designation. Gartner research publications consist of the opinions of Gartner's research organization and should not be construed as statements of fact. Gartner disclaims all warranties, expressed or implied, with respect to this research, including any warranties of merchantability or fitness for a particular purpose. 

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Access Report