Payment integrity leaders are operating in one of the most challenging payer environments in over a decade. Margins are tightening. Utilization is rising, driven by specialty drugs and high-acuity ...

For years, payment integrity was built around simple assumptions: errors can be fixed after payment. In today’s environment of rising medical costs and accelerating claims volume, that approach isn’t ...

Affordability has become one of the most discussed topics in modern health care. Medical spend is shifting and health plans are looking for realistic strategies to control costs and maintain financial ...

BURLINGTON, Mass. & DULUTH, Ga.--(BUSINESS WIRE)--HealthEdge® and Codoxo announce a strategic partnership to provide healthcare payers with the industry’s most cutting-edge solutions and services.

In this episode, Jhana Spence, Senior Vice President of Strategy at CERIS, discusses the shift toward proactive payment integrity and what it means to “move left” in the claims lifecycle. She explores ...

Steve Sutherland, Senior Vice President at CERIS, dives into how AI and machine learning are transforming payment integrity in healthcare. He explores the benefits payers can experience, challenges to ...

SALT LAKE CITY--(BUSINESS WIRE)--Cotiviti, a leader in data-driven healthcare solutions, has been named the highest-designated Leader by Everest Group in the Payment Integrity Solutions PEAK Matrix ® ...

EXL, a global data and AI company, has been recognized as a Leader and Star Performer in the Everest Group Payment Integrity Solutions PEAK Matrix® Assessment 2025. This recognition is attributed to ...

Transcarent, the One Place for Health and Care™, today announced the launch of a new payment integrity category in the Transcarent Experience Store, through a partnership with Bluespine. The new ...

The MarketWatch News Department was not involved in the creation of this content. Health plan leaders set to return to Nashville April 14--16, 2026 for three days of peer-led strategy, collaboration, ...