Payment Integrity Solutions – Provider Compendium 2025

The payment integrity market is shifting from post-payment recovery to a proactive focus on pre-payment accuracy, aiming to reduce costs and improve efficiencies. AI is enhancing fraud detection, real-time claims validation, and predictive risk modeling. Simultaneously, blockchain is helping boost transparency, while cloud adoption supports automation and operational agility. Collaboration among payers, providers, and regulators is also strengthening, helping develop more integrated and effective ecosystems.

This report assesses 24 payment integrity providers, analyzing key aspects such as revenue scales, client bases, delivery models, value chain coverages, service segmentations, plan sizes and types, notable clients, and proprietary tools. It is designed to help healthcare payers identify the right partners to support operational transformation and gain a competitive edge in a rapidly evolving payment integrity environment.