Improper payments cost billions. Discover how smarter tools uncover hidden waste and protect healthcare dollars.
With President Trump expected to announce a Medicare pilot program that enables Medicare CBD reimbursement for certain cannabidiol (CBD) treatments, we raise and track the questions that impact payers the most.
DRG errors are costing payers millions, but the shift to AI-supported validation is rewriting what accuracy and scale can look like. Discover how modern DRG review programs can protect financial integrity while smoothing provider relationships.
With soaring utilization costs and claims volume, healthcare payers face an unsustainable challenge. Through candid conversations with payers and industry experts, the Machinify OS/AI Summit unlocked insights to make healthcare payments more transparent, efficient, accurate, and compliant.
Spending on skin substitutes has soared, often without clear clinical evidence. Discover how Machinify helped one national payer to improve accuracy, consistency, and cost control in its skin substitutes review process.
Time is wasted correcting data, money is spent resolving preventable disputes, and trust is diminished between payers, providers, and patients.
With rising medical expenses and increased scrutiny of billing inaccuracies, payers are turning to IBR to address the nuances of billing at the line-item level.
Coordination of Benefits (COB) is used to establish the order in which a health insurance plan pays claims when an individual has more than one insurance carrier.
At Machinify, we’re always looking for new ways to bring clarity to complex payment integrity challenges—and pharmacy is no exception. Chris Powers, VP of National Sales, sat down with Derek McMahan, SVP of Pharmacy to answer the industry’s most pressing questions.
In the complex world of healthcare reimbursement and oversight, few acronyms carry as much weight for Medicare Part D payers as PDE—Prescription Drug Event.
Health plans are increasingly moving upstream in the claims adjudication lifecycle—a strategic pivot known as the “shift left” in payment integrity.
Quiz your payment integrity program's performance and review timelines to uncover opportunities for operational and financial improvement.