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Ensuring that claims are paid accurately is a core concern of health plans of any size. Wasteful spending in the U.S. healthcare system is estimated to exceed $900 billion annually, with administrative complexity accounting for more than $265 billion of this cost according to one major study.
In response, leading payers continue to invest in innovative techniques to prevent improper payments, rather than “pay and chase,” which leads to high administrative costs and significant provider abrasion. But health plans find the road to prepayment or prospective integrity littered with technical, clinical, and administrative roadblocks. Read Cotiviti's white paper and learn the three core steps payers must take to successfully transition from post-payment recovery to prospective validation.