Transforming Payment Recovery Processes and Elevating ROI through Innovative Data Analysis

Summary:

A health insurance company needed to improve its payment integrity efficiencies with a primary goal of increasing payment recovery. They engaged Alivia Analytics and used the FWA Finder™.

Results:

  • Increased their ROI by 11x in the first 7 months of going live by running a pharmacy initiative that recovered $2,700,000.
  • Performed 2 years of work in 4 months.
  • Reduced time-to-recover from 12 months to 3 months.
  • Reduced the false positive rate to under 1%.