“Listen with curiosity. Speak with honesty. Act with integrity.”
— Roy Bennett
“If you want different results, do not do the same things.”
— Albert Einstein
It’s no secret that improper payments plague our healthcare system. Whether you are a payer or technology solution provider, our understanding of the challenges you face, as well as our expertise with trends in healthcare fraud, waste and abuse (FWA) makes us a strong strategic partner for your organization.
We understand the delicate balance that payers face when dealing with improper payments resulting from fraud, waste and abuse, while still maintaining a relationship with providers to meet the needs of your members. Commercial payers with Medicaid, Medicare, Federal Employee Health Benefits, and other lines of business benefit from our expertise in building, maintaining and supporting an effective program to identify, investigate and prevent FWA.
Our support includes:
Outsourced investigative and medical review services
New case development and data analysis
FWA program development
In-depth assessments of SIU operations with executable action plans
Compliance and regulatory support
Education and training
There are so many nuances to being a health payer. Trust the experts who know your business to help you.
Our unique perspective of state and Federal program integrity efforts gives us an edge. Partnering with Integrity Advantage in pursuing these opportunities allows you to leverage our knowledge and expertise in solutioning, development and execution for a variety of opportunities. Connect with us to see how our expertise in program integrity can support application development, analytics, investigations, medical review and other program integrity opportunities.
541611 - Administrative Management and General Management Consulting Services
541990 - All Other Professional, Scientific and Technical Services
561611 - Investigation Services
611430 - Other Management Consulting Services
541618 - Professional and Management Development Training
It’s no secret that technology solutions improve efficiency for FWA and payment integrity efforts. But payers still struggle to find value and improve ROI. Bridging the gap between your solution and what your customer needs is essential for success. That’s where we can help. We are the voice of the customer. Integrity Advantage provides an array of support that, when coupled with your solution, helps your clients recognize increased value from your solution. Our services include:
Prioritization of industry needs and wants
Support for creation of scheme detection models
Position assessments
Validation of analytic findings
Support in operationalizing new solutions
User-centric design assistance
Case generation, investigative support and clinical review
Let’s not forget the value of support during proof of concept (POC) and implementation phases. Whatever your challenge, we offer flexible options to fit your needs.
