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.
Behavioral health is no longer an afterthought in healthcare—it’s central to how people heal, how systems function, and how payers drive value.
A real-world study of how one of the nation's largest payers transformed their payment integrity program and realized more than $1 billion in cost avoidance.
Explore our simple, transparent payment integrity solutions to see what we can do for your organization.
When it comes to DRG payment integrity, there’s a massive shift underway—towards smarter, faster, more cost-effective pre-pay solutions.
Machinify was able to to reveal maximum cost savings while reducing payment timelines with the fastest speed to pay on prepayment reviews.