Healthcare Payment Integrity

Proven business results. Deep industry
expertise. Technology-driven insights.

We combine multiple data source and proprietary technologies with extensive industry expertise and a nationwide footprint to help health plans identify and recover more overpayments while minimizing both provider and member abrasion.

Conduent’s Payment Integrity Services offer
health plans an integrated solution to:

  • Identify and recover payer inaccurate payments

  • Ensure accurate and timely payments

  • Provide a single-source for all cost containment efforts

  • Avoid member abrasion

  • Reduce total cost of recovery

  • Strengthen provider relationships

Payment Integrity Services​

Coordination of Benefits (COB) Services

Tailored to your organizations’ needs, Conduent’s COB solution provides health plans the flexibility to focus on all or one line of business (i.e. commercial, Medicare, Medicaid) to optimize your current performance and resources.

Credit Balance Services

Leveraging our extensive provider relationships, as well as our coding and claim expertise, we maximize overpayment recoveries by becoming an extension of the healthcare provider’s business office. ​

Subrogation Services

Whether you are in need of a total outsourced subrogation model, supplemental investigation efforts, or legal assistance, our subrogation services ensure the proper liable party is paying for applicable healthcare costs linked to medical and disability expenses related to accidents and other injuries.

Pharmacy Audit and Compliance Services

Whether added on to an existing audit program or used as a stand-alone service, Conduent’s pharmacy audit and compliance services serve an important role in monitoring retail pharmacy operations by containing spiraling pharmacy expenses, returning overpayment money, and providing aggressive oversight and deterrence against fraud and abuse. ​

Payment Integrity Services

With more than 30 years in this business, we understand the impact that recovery of inaccurate claim payments has for your medical spend. To learn more about Conduent’s extensive Payment Integrity Services, download the brochure and see how we can help your health plan.

Download Brochure

See how Conduent can help improve your health plan’s operations, reduce costs and significantly increase annual recoveries.

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