Payment Integrity

Carewise Health uniquely integrates technology, analytics, nurse auditors and case managers to provide the only holistic payment integrity solution.

Program Overview


Changes ignited by healthcare reform have precipitated a new approach to Payment Integrity. Carewise Health uniquely integrates technology, analytics, nurse auditors and case managers to provide a holistic payment integrity solution.

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Clinical Staff


Our nurses make the difference. When cases have been identified as having a high probability of being improperly paid, incorrectly coded, or being unnecessary or inappropriate, our nationwide team of experienced nurse auditors steps in.

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Market Segments


Our primary focus is serving health plans. We use nurse auditors supported by proprietary analytics to identify, audit and recover on behalf of health plans over-payments to providers

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