The June 2024 report finds the healthcare payment integrity market poised for growth as rising health costs, tighter margins, and demand for accurate payments drive adoption. Vendors are advancing solutions with AI, NLP, OCR, and predictive analytics, with generative AI emerging as a competitive focus. Payers now expect fully automated AI/ML platforms with claims management, analytics, and fraud, waste, and abuse capabilities. Pre-pay integrity is gaining traction, using AI/ML to prevent overpayments and reduce “pay and chase” efforts, signaling a shift from post-payment to proactive cost containment.

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