Healthcare Payment Integrity Resources

Learn more about Machinify’s innovative products and solutions designed to transform healthcare operations. Whether you’re interested in AI-powered automation, payment optimization, or efficiency-driving tools, explore how we’re pushing the boundaries of what’s possible.

KLAS First Look | Customers Share Their Machinify Experience

Learn more about what Machinify does and how healthcare leaders rate Machinify’s products, service, and innovation in this First Look report by KLAS. October 01, 2025

The Hidden Pharmacy Waste Payers Can’t Afford to Ignore

Pharmacy spend is leaking through outdated eligibility and COB processes. Learn how payers can close the gap and capture rapid savings. May 28, 2026

What “Shifting Left” Really Means in Subrogation and Why It Matters

Explore how to rethink subrogation by shifting coordination upstream, using prepay insights to identify third-party liability early, reduce costly overpayments, and streamline recovery before dollars go out the door. April 28, 2026

Behavioral Health Claims Recovery and the Out-of-Network Oversight Gap

Out-of-network behavioral health has grown faster than networks, regulations, and oversight models were built to manage. As parity enforcement accelerates and utilization continues to climb, health plans face a structural question: how do you govern a benefit that expanded faster than its controls without restricting access to care? April 16, 2026

Mental Health Parity Compliance: Why Behavioral Health Payment Integrity Is Now Essential for Health Plans

Mental health parity enforcement is accelerating across federal and state jurisdictions. Health plans are under growing pressure to demonstrate comparable oversight across behavioral health and medical benefits. Explore how a thoughtful mental health parity compliance strategy supports compliance, protects access to care, and strengthens financial stewardship. April 09, 2026

Why Every Payer Needs a Compliant Behavioral Health Claims Auditing Program

Behavioral health has become one of the fastest-growing areas of medical spend, yet oversight models have not evolved at the same pace. As parity enforcement expands and utilization remains elevated, payers are reassessing how a behavioral health audit program can support accuracy, financial stewardship, and regulatory alignment simultaneously. April 02, 2026

COB Recovery Explained: How Detection Timing Shapes Financial and Operational Performance

COB recovery performance depends on when primary coverage is identified. Learn how pre-pay, pre-claim, and post-pay approaches impact cash flow, workload, and net value. March 17, 2026

Medical-Benefit Drug Spend: The Hidden Driver of High-Cost Drug Risk

Medical-benefit drug spend carries hidden risk. Learn why discretion, not fraud, drives overpayments and how analytics restore control. March 03, 2026

Rethinking Subrogation Operations to Improve Recovery and Member Outcomes

Up to 60% of subrogation analyst communication effort is wasted, leading to missed recoveries and inflated administrative costs. Streamlining operations could cut workforce needs by up to 30% and transform payer return on investment. February 19, 2026

Understanding DRG Reviews and Their Role in Payment Integrity

DRG errors are costing payers millions, but the shift to AI-supported validation is rewriting what accuracy and scale can look like. Discover how modern DRG review programs can protect financial integrity while smoothing provider relationships. December 10, 2025

Machinify OS/AI Payer Summit 2025: Transforming Healthcare Through Collaboration and Innovation

With soaring utilization costs and claims volume, healthcare payers face an unsustainable challenge. Through candid conversations with payers and industry experts, the Machinify OS/AI Summit unlocked insights to make healthcare payments more transparent, efficient, accurate, and compliant. November 18, 2025

The Growing Cost of Skin Substitutes: How AI Helps Payers Regain Control

Spending on skin substitutes has soared, often without clear clinical evidence. Discover how Machinify helped one national payer to improve accuracy, consistency, and cost control in its skin substitutes review process. October 13, 2025