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If you are concerned about improper payments, we can help.

It’s no secret that improper payments plague our healthcare system. Whether you are a state, federal or commercial payer, 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.

 

 Who We Serve

 

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Commercial Payers


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.

 

For more detailed capabilities, please see our services page or let’s talk.


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Government Payers


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.

DUNS #081047546

NAICS

  • 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

 

Need a partner with program integrity expertise? We can help.