Not all overpayments can be remediated before payment. While health plans strive to pay claims correctly the first time, various obstacles create challenges that can result in overpayment. When incorrect payments to providers do occur, health plans need strong analytics and pinpoint research to aid answers for recovery—without impacting critical provider relationships.
Just like getting safe drinking water to your tap, payment integrity requires a number of filtering and purification steps to produce the most precise payments possible. Our new infographic dives into how Data Mining works and offers key takeaways for health plans to catch similar post-payment findings. You’ll learn about:
- Plan policies and coding standards that result in payment integrity challenges
- Best practices to identify post-payment errors
- How payers can address inappropriate claims like these