• Viewpoint
    Sep. 18, 2026

    Payment Integrity (PI) is a key driver for containing medical costs and payment leakage, and is heavily outsourced. In a traditional black-box model, health plans receive findings, savings, reporting, and invoices while the logic, evidence, exceptions,…
  • Provider Compendium
    Oct. 07, 2026

    Pre-payment integrity is gaining momentum as health plans look to shift left with payment accuracy activities, moving from retrospective recovery toward earlier intervention before claims are paid. Rising medical costs, provider abrasion from post-pay recoveries, and…
  • PEAK Matrix®
    March 02, 2023

    Health plans and payer organizations rely on core administration platforms as the foundation of their operations. These platforms facilitate efficient execution of core operational and administrative functions such as benefits administration, claims processing, member enrollment, claims…