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- Claim Payment Oversight is EssentialIf the coronavirus pandemic did anything for health plans, it was to confirm the value of medical claims auditing. Independent oversight of medical and pharmacy claim payments is vital in verifying accuracy and flagging mistakes. No doubt, error rates are low, and many processor agreements contain provisions for self-policing. But only the watchful eye of a skilled auditor can confirm the...0 Comments 0 Shares 789 Views 0 ReviewsPlease log in to like, share and comment!
- Claim Auditors and Medical BillingAuditing brings to mind finance and tax issues for most people, but it plays an increasingly significant role in the healthcare industry. Medical claim audits are one of the most effective tools in cost containment programs because they verify accuracy (or not). Irregularities flagged by auditors can represent significant unnecessary costs that can be recovered. Even when error rates...0 Comments 0 Shares 887 Views 0 Reviews
- The Best Oversight for Medical Claim PaymentsWhen millions of dollars are on the line annually, oversight is essential. Nowhere is it more apparent than with medical claims auditing for self-funded health plans. Pharmacy claims deserve a similar close review. Continuing improvement in electronic audit systems brings significant advances and keeps pace with changes in medical billing. It's a vast industry, and employer-funded...0 Comments 0 Shares 857 Views 0 Reviews
- Understand More About Your Claim AuditAt first, a healthcare audit might sound complicated and it's accurate many details are involved. But if you are responsible for managing a self-funded plan and need to conduct claim processing oversight, few things are as helpful. The objective is to confirm claims are being paid correctly and mistakes are avoided, but getting to those findings takes detailed work. Each claim has...0 Comments 0 Shares 1766 Views 0 Reviews
- Audit Your Pharmacy Benefit Manager ThoroughlyEmployer-sponsored health plans cost a lot of money, and it's no wonder medical claims auditing is an increasingly sought-after service. But given prescription medication costs, many of which are astronomical, keeping close tabs on pharmacy benefit plans is equally crucial. Audits need to be specialized and double-check accuracy for a unique set of criteria for medications. In some cases, it's...0 Comments 0 Shares 1847 Views 0 Reviews
- Auditing is an Excellent Benefits Plan Management ToolOversight is one of the most effective benefit plan management tools available to employers who self-fund their programs. Improved medical claim auditing has vastly improved the accuracy of reviews and reporting. It provides an unprecedented level of oversight for plan sponsors needing to double-check their claim administrator's performance. Even when contracts have performance guarantees and...0 Comments 0 Shares 2038 Views 0 Reviews
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