The Payment Intelligence® Ida™ workbench goes beyond the simple payment policies approach used by payment integrity vendors. We identify claims recovery opportunities, as well as configuration edits to address errors around member eligibility, covered benefits, contracts, provider data, payment policies and prior authorizations.

Yes, Payment Intelligence® can provide you with transparency into the accuracy of your provider data. With the No Surprises Act requirements, we know this is an area of concern. We validate and verify that configured information matches source documents, including provider-sourced information (such as rosters, ACT files, contracts) and third-party information (such as AArete Intelligence® , NPPES, Google).

If not carefully managed, artificial intelligence can provide a lot of false positives. Our Payment Intelligence ® process relies on machine learning to ensure that findings continue to improve when presented and prepared for each client. This helps to ensure any manual reviews conducted by your team are minimized over time to reflect just the changes with the highest probability of acceptance.