Solutions for integrated program integrity management

CGI has developed a comprehensive package of solutions in our Protect the Payer (PTP) Suite to address program integrity holistically throughout the payer enterprise. Collectively, these solutions leverage cognitive analytics for a highly targeted approach to transaction screening, provider due diligence, preventing fraud and waste, and strengthening cybersecurity.

CGI’s Protect the Payer Suite provides market-leading solutions and services to support the payer, including:

  • Cybersecurity consulting, solution implementation and managed services

  • Transactions screening and provider due diligence through our HotScan filtering software

  • Claims fraud, waste and abuse prevention and recovery with CGI ProperPay

  • Cognitive analytics/machine learning to produce more reliable, repeatable results

  • Big data management and analytics

CGI’s PTP Suite can involve engagements in program management, systems integration, solution implementation, managed services and/or business process outsourcing. But before we begin any PTP engagement, we perform a current state assessment to determine which components of the framework can be applied to quickly deliver benefits to protect the payer.