Predict, prevent, protect and preserve
CGI ProperPay is a data-driven solution used to predict, identify, manage and recover on claims that have been improperly paid. It is configurable to an organization’s specific business rules and reimbursement methodologies. Its predictive analytics, workflow management, rules management, and global best practices provide both flexibility and scale. Our solution includes:
- Advanced algorithms unearth hidden patterns and anomalies within the entire claims data universe to identify claims with high potential for recovery.
- Analytics provide the framework to prevent fraudulent activity and keep patients safer by allowing staff to easily identify patterns and research claims as well as audit data through a series of views and dashboards.
- Protecting client data is important in any industry, but is critical when dealing with protected health information. CGI ProperPay implements rigorous data security measures.
- We bring depth of knowledge of modern technology to identify, stop and recover improper payments to preserve healthcare funds and revenue. Balancing modern technological tools with years of clinical and auditing expertise generates a greater number of improper payment recoveries and makes funds available to improve patient care. Business user-friendly features also free up valuable IT resources for other priorities.
We also provide expert recovery audit and payment services covering all provider types, focusing on payment issues with a high rate of error and yield a return on investment. Our specialized healthcare professionals bring over 25 years of experience in analyzing and auditing medical claims data.
Read more in our CGI ProperPay factsheet.