Ingenix Payment Integrity Platform

Ingenix provides a full suite of advanced detection software, comprehensive investigation and recovery services, and advisory services that fortify all steps of the payment process to help you pay the right claims accurately the first time—we can help you secure payment integrity.

Core competencies

• Claims editing—professional and facility
• Advanced analysis of code-to-code relationships
• Prospective and retrospective fraud, error, and abuse detection

An anti-fraud program that saves even 1 percent of medical expense can increase the profitability of a typical health plan by up to 16.7 percent.

—Reden & Anders, an Ingenix company

Ingenix can help increase your business by 220 basis points by attacking error, fraud, and abuse in three ways: Breadth of Rules—Ingenix Detection Software reviews professional and facility claims, increasing average coverage of paid claims from 32 to 82 percent; Depth of Rules—Ingenix Detection Software can increase the analysis of code-to-code relationships from 1 to 9 million, and; Threshold and Yield—By combining our Detection Software with Investigation and Recovery Services, we can decrease the threshold for subrogation from $500 to $300 and can decrease the threshold for fraud recovery from $25,000 to $0.

To learn more, download the Ingenix Payment Integrity Executive Briefing