Abacus Insights and CoverSelf recently announced a strategic integration to enhance Payment Integrity (PI) for the U.S. Health Plans. This collaboration combines configurable claims editing with a HITRUST-certified data foundation. Together, they aim to help payers reduce improper payments across commercial and government lines. Consequently, the integrated solution modernizes how insurers manage Payment Integrity (PI) for the U.S. Health Plans.
The partnership leverages Abacus Insights’ structured and unstructured data assets for clinical records. By utilizing this data usability platform, health plans gain a single, governed environment. This clean data foundation then allows CoverSelf to surface cost containment opportunities earlier. Therefore, the joint effort improves the accuracy of Payment Integrity (PI) for the U.S. Health Plans.
Modernizing Healthcare Payer Workflows
The new unified approach supports a proactive, in-house payment integrity strategy. It provides full transparency into every rule and audit result. Furthermore, the partnership removes friction from how payer data is governed and structured. Both companies believe this will eliminate black-box vendor dependency for health plans.
“Payment integrity is only as effective as the data foundation behind it,” said Minal Patel, Chief Executive Officer at Abacus Insights. “We are helping payers future-proof their payment integrity strategy and deliver greater ROI.”
The integrated solution is now available to help plans catch billing anomalies before payment. It utilizes CoverSelf’s SmartEdit concept library and CodeSense coding intelligence. These tools help prevent improper payments at scale for 65 million members. This partnership highlights the importance of robust data ecosystems in the payer market.
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News Source: Businesswire.com
