Payment Integrity

We've saved clients over $1.1 Billion in fraud, waste, and abuse costs since 2015. See how Highmark protects your bottom line.

Fantastic results

We have a proven track record of saving businesses and members money and a lot of headaches. Here are just a few of the things our industry leading payment integrity systems can do:

  • $7.5 million in fraud, waste and abuse prevented related to COVID-19 in 2020.
  • Outpaces the industry and saves 10% of medical claims spend annually.
  • May save up to 33% per member per year compared to competitors.

13 Steps to better security

As much as 7% of every health care dollar spent is lost to fraud, abuse, or waste.* From claims verification and medical record reviews in the prepayment phase to audits and remediation during postpayment, our 13-step process leads the industry in ensuring the integrity of every claim

Get the protection you and your team deserve

To find out more about our payment integrity program and other ways that Highmark helps protect you and your team, talk to a client manager today.

* Harvard Business Review: How the U.S. Can Reduce Waste in Health Care Spending by $1Trillion, 2015.