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MultiPlan Rolls Out Updated Payment And Revenue Integrity Services; Helping Payors Prevent, Correct, And Recover Throughout Claims Lifecycle

February acquisition fuels expansion of payment and revenue integrity service line

MultiPlan Corporation a leading provider of data analytics and technology-enabled cost management, and payment and revenue integrity solutions to the U.S. healthcare industry, announced  it has completed the branding and service offering update of its Payment and Revenue Integrity services that resulted from the acquisition of Discovery Health Partners in February. The expanded service offering is focused on helping payors convert recoveries into future correction and prevention opportunities throughout the lifecycle of a healthcare claim.

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Paying claims quickly and accurately continues to be a critical priority for MultiPlan’s healthcare payor customers. Even with interventions, payors’ ability to navigate the complex healthcare system is challenged by multiple and legacy technologies, changing regulations, and member churn, resulting in missed opportunities to catch errors within the total lifecycle of a healthcare claim. These factors contribute to incorrectly paid claims, improper reimbursements, or claims that shouldn’t be paid at all.

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MultiPlan’s Payment and Revenue Integrity services analyze eligibility and claims data to ensure claims are paid correctly the first time. MultiPlan combines its award-winning machine learning capabilities with the human intelligence of its seasoned teams to offer the best available solutions to help clients achieve payment integrity success. MultiPlan’s services include:

  • Pre-Payment Clinical Review – Corrects b****** errors before payment and eliminates wasteful claims spending
  • Coordination of Benefits – Identifies instances of other health insurance and determines primacy to maximize recoveries and drive future cost avoidance.
  • Data Mining – Analyzes claims data to identify and resolve incorrectly paid claims, as well as addressing root-cause issues for future error prevention.
  • Post-Payment Clinical Audits – Corrects b****** errors after payment and eliminates wasteful claims spending.
  • Subrogation – Maximizes recoveries from third party liability with improved identification.
  • Revenue Integrity – Finds and restores premium dollars owed for managing Medicare Advantage members

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