Healthcare Payment Integrity Resources
Explore Machinify's healthcare payment integrity resources, including expert analysis on AI, audit strategy, and claims accuracy.
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 Report
You Don’t Need to Start Over to Improve Claims Payment Accuracy. Just Start Here.
Discover the questions to ask, the case for pre-pay as a workflow extension rather than a system overhaul, and a practical framework for improving claims payment accuracy without starting from scratch.
June 04, 2026 Blog
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Pharmacy spend is leaking through outdated eligibility and COB processes.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 Blog
Pre-pay Review in Healthcare: What It Gets Right, and What It’s Been Missing
Pre-pay review promises better payment accuracy, but results vary. Learn why intelligence, not rules, is the missing capability in pre-pay review.
May 21, 2026 Blog
Prepayment Review Isn’t New, So Why Has It Been So Hard to Operationalize?
Prepayment review promises better payment accuracy, but execution has lagged. Here’s why, and what’s finally changed.
May 07, 2026 Blog
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 Blog
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 Blog
The 20% Problem: Why Most Healthcare Recoveries Never Happen
Explore why health payers routinely miss at least 20% of recoverable dollars—and often underperform on the opportunities they do identify—due to structural blind spots in measurement, timing, and execution. See where value is lost and the operational, legal, and strategic shifts needed to close the gap and maximize healthcare recoveries.
April 14, 2026 Blog
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 Blog
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 Blog
Why AI in Healthcare Operations Fails Without Experience
AI is valuable for healthcare operations, so it needs to be applied thoughtfully and with humans in the loop. Here's why experience matters more than algorithms, and how to apply both meaningfully.
March 26, 2026 Blog
How Payment Integrity Strengthens Provider Relationships
Payment integrity hasn’t always strengthened provider relationships. The difference between friction and trust often comes down to timing. Explore how proactive payment integrity strategies are changing the equation.
March 24, 2026 Blog