Highmark and CGI Renew Partnership to Innovate Claim Payment Solutions

Highmark Inc. and CGI Renew Collaboration

In a move set to strengthen the healthcare industry’s payment systems, Highmark Inc. has announced the expansion of its long-standing partnership with CGI, a significant player in technology and professional services. This renewed collaboration follows over a decade of successful teamwork and aims to advance Highmark's goals in payment integrity and innovation through CGI's advanced platform, ProperPay®.

As part of the renewed contract, CGI will enhance Highmark's capabilities in data analytics and recovery audits. These advancements are essential for supporting Highmark's enterprise-wide claims review initiatives, improving operational efficiency while ensuring accuracy in payments. The partnership has already shown substantial success; it boasts continuous year-over-year improvements in recovery rates, reduced false positive claims, and an impressive upheld rate of 98% on audit findings.

Kurt Spear, Vice President of Financial Investigation and Provider Review at Highmark, expressed enthusiasm for the partnership's impact, noting, "CGI's innovation continues to increase identified overpayments year over year. Our ability to effectively address claim billing errors has been tremendously strengthened by our partnership with CGI. They have been a trusted and reliable advisor to Highmark in our collective efforts toward claims payment accuracy."

The ProperPay platform serves a pivotal role in Highmark's strategy, employing advanced audit capabilities that utilize predictive modeling and optimized case selection. This method has resulted in a notable increase in the average savings for inpatient claims while maintaining a high level of operational effectiveness. Additionally, the collaboration has fortified provider relationships, which is crucial in a rapidly evolving healthcare landscape.

Collaboration and innovation lie at the heart of this partnership, as emphasized by Deb Mohapatra, Senior Vice President and Business Unit Leader at CGI, who stated, "This ongoing partnership reflects our shared commitment to innovation, collaboration, and delivering meaningful value to healthcare consumers. We are also excited about the potential to introduce new AI-powered capabilities that will further accelerate outcomes and automate high-volume review workflows."

Founded in 1976, CGI stands among the largest independent technology and professional services firms globally, with over 94,000 consultants and professionals operating worldwide. They boast an extensive portfolio encompassing IT and business consulting, systems integration, managed IT services, and business process services. CGI’s commitment to client relationships and global delivery networks underscores their capability to promote digital transformation in organizations and optimize results.

In fiscal 2025, CGI reported a staggering CA$15.91 billion in revenue, underscoring the firm's significant influence in the technology sector. Their stock is publicly traded on both the TSX (GIB.A) and the NYSE (GIB).

As Highmark and CGI embark on this renewed journey, the focus on innovative claim payment solutions is set to not only enhance operational efficiencies but also contribute significantly to overall healthcare service improvement, ensuring that consumers receive timely and accurate care in a climate that increasingly demands technological agility. The future of healthcare finance, driven by AI and data analytics, looks promising under this notable partnership.