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The need for claims payment integrity is paramount for payers. Not only does every inappropriately paid claim represent a financial loss that can detract from member care, but these errors also erode the payer-provider relationship. How can we ensure this wisdom carries over into the new year?
In our newly updated eBook, we offer insight into how you can develop a solid foundation in 2023 for holistic payment success across your critical programs by:
- Following best practices when deploying a prepay claim editing solution
- Strategically using postpay data mining for the most complex claims
- Going beyond prior authorizations for specialty drug claims
- Designing a holistic COB process that considers the entire member experience
- Staying vigilant against the latest fraud, waste, and abuse schemes
Deploying the programs, solutions, and strategies outlined in our eBook can help increase savings, improve provider relations, and decrease your administrative burden.