Case Study: a large health plan achieves $1.5+ billion in recoveries with Conduent Payment Integrity Solutions

a large health plan recovers $1.5+ billion with Conduent

A large health plan faced a significant financial challenge, with overpayments to providers impacting its bottom line by billions of dollars across its operations in more than ten states. The plan engaged Conduent and its Payment Integrity Solutions to stop these financial losses and needed an independent third party to manage sensitive provider relationships.

Conduent implemented a targeted solution by leveraging its wide provider network and assigning local experts for on-site reviews. This grew their on-site audit access from 21 to 483 providers, a 2,200% increase. The results for the health plan were substantial, with Conduent delivering over $1.5 billion in recoveries since 2004, surpassing annual goals and consistently recovering over 6,000 overpayments per month.