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Although healthcare payments have undergone major transformations over the past decade, one thing remains constant—the need for claims payment integrity is paramount for payers. Not only does every inappropriately paid claim represent a financial loss that takes away from member care, but these errors also erode the payer-provider relationship.
In our new eBook, we offer insight into how you can develop a solid foundation 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
- Designing a holistic COB process that considers the entire member experience
- Staying vigilant against the latest fraud, waste, and abuse schemes
By using the programs, solutions, and strategies outlined in our eBook, you can increase savings, improve provider relations, and decrease your administrative burden.