Healthcare Payment Integrity
Proven business results. Deep industry
expertise. Technology-driven insights.
Our healthcare payment accuracy solutions combine multiple data source and proprietary technologies with extensive industry expertise and a nationwide footprint to help health plans identify and recover more overpayments while minimizing both provider and member abrasion.
Conduent’s Healthcare Payment Integrity Solutions offer health plans an integrated solution to:
Payment Integrity Services
Coordination of Benefits (COB) Services
Tailored to your organizations’ needs, Conduent’s COB solution provides health plans the flexibility to focus on all or one line of business (i.e. commercial, Medicare, Medicaid) to optimize your current performance and resources.
Credit Balance Services
Leveraging our extensive provider relationships, as well as our coding and claim expertise, we maximize overpayment recoveries by becoming an extension of the healthcare provider’s business office.
Subrogation Services
Whether you are in need of a total outsourced subrogation model, supplemental investigation efforts, or legal assistance, our subrogation services ensure the proper liable party is paying for applicable healthcare costs linked to medical and disability expenses related to accidents and other injuries.
Pharmacy Audit and Compliance Services
Whether added on to an existing audit program or used as a stand-alone service, Conduent’s pharmacy audit and compliance services serve an important role in monitoring retail pharmacy operations by containing spiraling pharmacy expenses, returning overpayment money, and providing aggressive oversight and deterrence against fraud and abuse.
