Payment integrity solutions membership

The Payment Integrity Solutions Membership provides comprehensive support for all aspects of healthcare payer claims management accuracy and efficiency. Through extensive research and market insights, we assist enterprises in optimizing processes through claims editing, itemized bill review, clinical reviews, coordination of benefits, subrogation, data mining, and more. 

The membership also provides deep analysis of service providers, competitive intelligence, and guidance on pricing, technology prioritization, and market trends. This membership is designed to help enterprises and service providers optimize performance, enhance decision-making, and chart the best path to success.

Everest Group’s methodology leverages extensive primary research, including:

  • Regular feedback from 50+ healthcare payers
  • Holistic assessments of service provider performance (strengths and areas for improvement)
  • In-depth interviews and surveys covering:
    • Key factors in outsourcing decisions
    • Insights on decision-making for current deals
    • Expectations from vendors
    • Pain points in outsourcing
    • Service scope and scale
    • Buyer satisfaction on key parameters tracked in a payment integrity contract 

Everest Group works with multiple vendors in the payment integrity market

To support enterprises’ sourcing decisions, Everest Group collaborates with over 25 payment integrity solutions providers, tracking key metrics like revenue, client growth, and technology solutions. Our proprietary database offers insights into provider portfolios, pricing models, and deployment methods. Additionally, we conduct briefings to gather inputs on strategy, performance, and emerging investment areas.

Who is our payment integrity solutions membership for?

Want to learn more about our payment integrity solutions? Contact us today

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