Healthcare payers are under pressure to modernize claims operations while handling rising volumes, compliance demands, and member expectations. Success depends on more than technology: it requires a foundation of operational excellence built on three pillars: training, productivity, and quality.

Imagenet’s Digital Mailroom has earned HITRUST i1 Certification, validating that it meets rigorous security standards to protect sensitive healthcare data and mitigate cybersecurity threats.

Many health plans mishandle CMS MSP & COB data—leading to compliance issues, payment delays, and member dissatisfaction. Learn how to get it right.

Inaccurate enrollment data can put health plans at compliance risk. Learn how operational governance and timely reconciliation safeguard member trust.

CMS made key updates and issued 12 corrections to 2026 ANOC/EOC models. Learn what changed and how health plans can adapt workflows and reduce risk ahead of the next cycle.

Discover 4 costly CMS reconciliation pitfalls health plans face in MSP and COB processes—from data delays to audit risk—and how automation can solve them.

Imagenet announces Sesha Mudunuri, Chief Operating Officer, and Julie Kendall Hughes, Chief Compliance and Consultancy Officer, will take the stage at the Fourth Annual Medicare Advantage Leadership Innovations East event.

What are health plans really asking for in 2025? At AHIP this year, leaders across the industry shared unfiltered insights on the challenges they’re facing and what they expect from vendors. From digital operations and AI skepticism to the evolving complexity of member experience, here are three conversations that reveal what payers actually want—and how solution partners can rise to meet the moment.

Imagenet announces Malcolm Smith as Vice President of Claims, strengthening its leadership in fast, accurate, and cost-efficient claims processing for healthcare payers.

CMS is dramatically expanding its Risk Adjustment Data Validation (RADV) audits—scaling from 60 plans per year to over 550. With tighter timelines, AI-driven scrutiny, and larger record samples, here’s how health plans should prepare.

Claims processing may not always make headlines, but its impact on a payer’s bottom line, compliance posture, and reputation with members and providers is massive. Billions are lost each year due to denials, rework, and delayed reimbursements. How can payers mitigate these risks?

Digital mailroom isn’t just about going paperless. It’s about making smarter, faster, and more compliant decisions at every stage of operations.

How Imagenet helped a public, not-for-profit health plan reduce paper claims turnaround from 5+ days to 48 hours.

How Imagenet transformed a not-for-profit health plan’s contact center to scale operations & cut wait times by 10x.

How Imagenet helped a channel partner solve a major claims challenge for a government payer.

How Imagenet helped a Pacific Northwest health plan streamline print and fulfillment workflows—ensuring CMS compliance and enhancing member experience.

How Imagenet helped a leading Puerto Rico-based health plan serving 117,000+ Medicare Advantage members streamline benefits communications and reduce compliance risk.

How Imagenet helped a major public health plan scale claims processing by 12.5x.

CMS data reconciliation is more than a technical process—it’s a strategic necessity for Medicare and Medi-Cal plans. Learn how to reduce audit risk, recover revenue, and protect the member experience.

A visual guide to how digital mailrooms capture, classify, and route incoming mail for faster, more efficient processing. Learn how intelligent document processing replaces manual mail handling with speed and accuracy.