Payment Accuracy & Integrity Solutions 2023: Financial Outcomes Top of Mind

Payers take on financial risk for members and pay for healthcare expenditures based on various plans and reimbursement types. Due to the complexity of reimbursement contracts, many factors (e.g., coding and billing errors, fraud, waste) can contribute to payers sometimes underpaying or overpaying provider organizations. Payment accuracy and integrity solutions help payers make accurate payments and recover losses when overpayments and fraud occur. This report-KLAS' first on this market-aims to identify the main capabilities these solutions provide and show early findings on customer satisfaction with vendors' performance.