Payers
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Payers

Ingenix unites the brightest minds to transform and improve health care through information and technology. Organizations rely on Ingenix innovation to improve the delivery and operations of their business and to increase the quality of care by systematically identifying and eliminating duplication, waste, and inefficiency in critical functional areas.

Categories:


Care and Health Management
By providing decision support and links between analytic methods, Ingenix helps you arrive at consistent answers, deeper insight, and more effective cost control initiatives. Health plans can improve health by targeting the right members at the right time with the right interventions across the entire health continuum.
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Claim Adjudication & Reimbursement Management
Achieve a consistent and reliable claims review process with claim adjudication, compliance, and reimbursement products from Ingenix.
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Claims Management & Fraud Prevention
Enable prospective claims analysis and retrospective investigation and recovery by detecting and deterring fraudulent, erroneous, and abusive claims.
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Clinical Assessment Solutions
Helps Medicare Advantage organizations optimize revenues, ensure regulatory compliance, and provide the highest quality care to members.
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Consumer Tools
Drive better consumer financial and medical decisions with innovative tools and services.
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Electronic Data Interchange (EDI) Solutions
Ingenix delivers measurable savings today with the next generation of out-sourced or self-managed electronic data interchange solutions. By implementing our solutions, payers benefit from accelerated revenue cycles; reduced costs and errors; simplified connectivity with all your trading partners; optimized administrative and clinical transaction management; and improved compliance assurance.
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Electronic Payments & Statements
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Medical & Financial Management
Ingenix products included in this category help you measure, analyze, and control health care costs while increasing the quality of care provided to your members.
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Network & Credentialing
Take a truly sophisticated approach to building your provider network—while improving quality and reducing costs. We offer intelligent technology and advanced strategic techniques that help you optimize your network’s efficiency and competitiveness.
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Pharma Benefit Management
Reduce your pharmacy cost and trend, maintain appropriate utilization, and improve outcomes through benefit design strategies.
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Underwriting & Actuarial
Ingenix offers a range of solutions designed to facilitate and streamline the day-to-day workflow of underwriters and actuaries
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