Total Prepayment Command for Your Health Plan

Give your team the tools they deserve. The Paytegrity Unified Defense System is a modern, agile, closed-loop Payment Integrity Ecosystem, providing total transparency and robust protection. Built to complement your existing infrastructure, our easy to deploy specialized overlay delivers AI-Powered workflows and a comprehensive Rules Engine that covers 80% of medical spending.

Total Transparency

For too long, payers have outsourced their intelligence. Paytegrity changes that—allowing you to own and manage your own Payment Integrity infrastructure. Deploy in days to catch errors and emerging trends in real-time. We’re not reinventing the wheel. We’re handing you next-generation velocity, insourced intelligence, total ownership, and a true force-multiplier solution.

Tectonic Shift In Payment Integrity

Legacy vendors have made significant contributions over the last two decade, offering undeniable value that addresses administrative complexities, abuse and waste. But just as legacy automakers recognize a tectonic shift towards EVs, healthcare payers face a similar realization in a world of high-velocity AI billing. While traditional PI was “necessary work” for its time, the new era requires AI-to-AI defense to maintain a sustainable Medical Loss Ratio (MLR). Our ecosystem empowers your team of specialized leaders with the playbooks and frameworks needed to stop leakage real-time.

Paytegrity PayRight Solutions – The Undeniable PI Choice

Paytegrity’s agile, modern, high-velocity platform is a non-intrusive, intelligent data layer that stops leaks in real-time before the claim is paid. The integrated ecosystem empowers Payer teams with transparency on every rule and clinical rationale. Our dynamic rule engines covers nearly 40 claim types, settings, and pricing methods, providing a truly comprehensive, unified defense.

Prepayment initiatives are on the move and rightfully so. With hospital spending hitting over $1.6 trillion and high-severity stays increasing by 20%, the pressure to validate claims upstream is the new requirement. Our light-weight, power-house, Interactive MS-DRG Opportunity Analyzer sets up in minutes to give you the visual intelligence and protection you need. Empower your team today and drive Prepayment Excellence. Engineered to pay for itself within the first 1–10 claims identified.