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Feature ARTICLE

The Dirty Dozen: 12 Most Common Upcoding Errors

With a lack of standardized criteria for identifying specific codes, there’s often a disconnect between providers and health plans, allowing providers to take advantage and force incorrect payments. We’ve identified the top 12 common coding errors or, as we’re calling them, the Dirty Dozen.

Feature article

4 Times to Never Use AI in Healthcare 

We have a saying in the operating room, “just because you can, doesn't mean you should.” We have microscopic graspers, robots, and laser-guided navigation at our disposal, yet there’s still a doctor behind those tools, making sure everything is running smoothly.

Feature article

What is Payment Integrity?

If you’ve ever been on the receiving end of a medical bill or an “explanation of benefits,” you know that, behind the scenes, there's a complex, multilayered system at work. This system ensures healthcare providers are compensated fairly while also preventing unnecessary or fraudulent payments. One crucial aspect of this system is payment integrity. 

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My team loves Machinify! Their AI capabilities have increased recoveries by over 30% and reduced our dependence on PI vendors. Even more, as a leader of a large PI organization, Machinify multiplied reviewer productivity while eliminating false positives.

VP of Payment Integrity at Leading Medicare Health Plan

Working with Machinify has been a uniquely positive experience. Machinify helped us identify opportunities that were previously missing and continues to serve as valuable thought partners.

AVP of Claims Operations at Leading US Health Plan

Machinify is very flexible and has clearly demonstrated a track record with our payment integrity team. We couldn't ask for better partners. Internally, there is a high level of respect and trust in Machinify and when you say something, you do it.

AVP of Data Science at Leading US Health Plan