Automating and optimizing accuracy of claims payments

Cost pressures on healthcare payers have been strong for years. Now they are coupled with the rise of complex payment systems and, with health reform, the addition of millions of beneficiaries who are likely to choose plans that reimburse at the lowest rates. These pressures create complex claims reimbursement challenges for health plan executives - challenges that McKesson can help manage.

McKesson’s payment integrity solutions enhance the capabilities of core claims processing systems by enabling them to automate payment to providers for different risk-sharing arrangements and complex benefit design. They utilize the McKesson Total Payment™ platform advanced technology framework and intelligent rules engine, unmatched clinical editing rule content, neural analytics, and a full-service consultative approach. The result is more accurate and automated claims payment no matter how complex the payment and medical policies; provider contract terms; or fraud, waste and abuse issues.

McKesson Total Payment optimizes payment comprehensively by:

  • Providing unparalleled accuracy and consistency in claims reimbursement
  • Controlling medical spending and increases accuracy of payment
  • Optimizing payment policies
  • Simplifying the management of medical policies
  • Preventing payment of wasteful and abusive claims and can quickly detect new patterns of fraud
  • Enabling automation of bundled payments and episode of care programs via the McKesson Episode Management solution

With Total Payment, you can go beyond managing your medical spend to impacting your administrative overhead, giving you greater control of the entire business.