18 min

A Vision for Payment Integrity Payment Integrity Perspectives: how health plans innovate

    • Technologies

This season, as we have followed L.A. Care Health Plan's journey building a payment integrity function from the ground up, we've seen them go from a few thousand in unsolicited recoveries to $131 million in overpayment avoidance and recoveries in just a few short years. That's a triumph by any measure. But if you've learned anything from the L.A. Care team, you might have guessed that isn't the pinnacle of their ambition. As they look back on how far they've come and look forward to their next challenge, they still have their focus firmly planted on a vision for a fully mature payment integrity function.

In this episode, Shonnie Davis, Gladys Oswell and Erik Chase tell of how they’re incorporating more of the organization and sharing their insights in order to shift more to overpayment prevention.

Joined by Yaw Agyemang, Jeff McNeese, Dana Ryan and Andrew Walters of ClarisHealth who discuss the value of partnership, focused goals and starting small to achieve big gains.

Guests: 

L.A. Care Health Plan: Shonnie Davis, Gladys Oswell, Erik Chase

ClarisHealth: Yaw Agyemang, Jeff McNeese, Dana Ryan, Andrew Walters


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Send in a voice message: https://podcasters.spotify.com/pod/show/payment-integrity-podcast/message

This season, as we have followed L.A. Care Health Plan's journey building a payment integrity function from the ground up, we've seen them go from a few thousand in unsolicited recoveries to $131 million in overpayment avoidance and recoveries in just a few short years. That's a triumph by any measure. But if you've learned anything from the L.A. Care team, you might have guessed that isn't the pinnacle of their ambition. As they look back on how far they've come and look forward to their next challenge, they still have their focus firmly planted on a vision for a fully mature payment integrity function.

In this episode, Shonnie Davis, Gladys Oswell and Erik Chase tell of how they’re incorporating more of the organization and sharing their insights in order to shift more to overpayment prevention.

Joined by Yaw Agyemang, Jeff McNeese, Dana Ryan and Andrew Walters of ClarisHealth who discuss the value of partnership, focused goals and starting small to achieve big gains.

Guests: 

L.A. Care Health Plan: Shonnie Davis, Gladys Oswell, Erik Chase

ClarisHealth: Yaw Agyemang, Jeff McNeese, Dana Ryan, Andrew Walters


---

Send in a voice message: https://podcasters.spotify.com/pod/show/payment-integrity-podcast/message

18 min

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