Balancing prospective and retrospective claim payment accuracy

Health plans want to move as much retrospective claim review as possible to a prospective model to maximize savings and reduce provider abrasion. But there are many barriers to overcome. The key is finding the optimal balance of pre-pay and post-pay programs for your organization, members, and providers. And Cotiviti is leading the way forward toward a more holistic approach.

Watch this on-demand webinar as our panel of payment leaders explain how to optimize prospective and retrospective payment operations. You’ll learn:

The challenges of moving coordination of benefits (COB) and inpatient DRG claim review forward in the payment process
How to leverage Cotiviti’s prospective validation solutions to prevent costly overpayments
Best practices to measure the impact of prospective solutions on your payment integrity program

By thoughtfully aligning prospective and retrospective solutions, health plans can reduce the “pay and chase” approach and improve their overall member and provider experience.

Balancing prospective and retrospective claim payment accuracy

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