Why integration matters: elevating subrogation within payment integrity

Every claim tells a story — of care delivered, costs shared, and responsibilities defined. But when those stories unfold across disconnected systems, important details can get lost. That’s often the case with subrogation, which too often operates apart from a plan’s broader payment integrity strategy.

When subrogation works in sync with payment integrity, the story changes. Integration transforms it from an isolated function into a connected approach that protects accuracy and value across the entire payment process. this helps health plans recover more effectively, reduce complexity, and gain a clearer view of their total payment landscape.
 

From silos to synergy

An integrated subrogation approach connects people, processes, and data across the payment integrity spectrum. When teams have better visibility, they can identify third-party liability earlier, make more informed decisions, and coordinate more efficiently across functions.

It’s not just about correcting payments — it’s about building a smarter, more connected way to manage payment accuracy that strengthens both operations and outcomes.
 

The benefits of integration

When subrogation aligns with other payment integrity functions, health plans can:

• Identify recoveries faster — spot opportunities earlier in the claim lifecycle. 
• Reduce administrative burden — minimize manual work and redundant reviews.
• Enhance accuracy and compliance — strengthen coordination across payment functions.
• Drive better outcomes — boost recovery results and operational efficiency. 
• Create a more seamless experience — improve collaboration across internal teams and partners.
   

The Carelon perspective

At Carelon, we view subrogation as an essential part of the payment integrity continuum — not a separate process. Our integrated approach helps clients maximize recoveries, improve accuracy, and operate with greater efficiency and confidence. It’s a practical, forward-thinking strategy that connects insight with action to create lasting impact.
 

Looking ahead

At a time when every health plan is being asked to do more with less, connecting the dots matters. Integrated subrogation is one of those quiet but powerful shifts that can drive measurable results — and pave the way for a stronger, more sustainable payment integrity program overall.

Integration isn’t about adding complexity. It’s about unlocking simplicity, clarity, and better outcomes — together.