CGI ProperPay is a medical claim analytics solution enabling healthcare payers to easily and securely identify, predict and prevent improper payments of inpatient, outpatient and professional claims.
Advanced algorithms are used to identify hidden patterns and anomalies within a payer’s entire claims universe to indicate which incoming claims should be suspended or rejected from payment to a provider, and which paid claims have high potential for recovery.
CGI ProperPay analyzes claims using industry standard, CGI proprietary, and client configured edits to generate information such as:
CGI ProperPay does the heavy lifting so payers can realize these benefits without affecting business users, and free up valuable IT resources for other priorities.