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Focusing Claim Audits for Greater AccuracyAuditing is inherently detailed, with medical claim and PBM audits calling for precision. Customizing the audit process is essential to yield meaningful results—generic approaches often produce inaccuracies. Employer-funded health plans, whether large or mid-sized, derive benefit from regular claim payment reviews, which help identify errors and recover overpayments. Tailoring audit...0 Commentarios 0 Acciones 5 Views 0 Vista previaPlease log in to like, share and comment!
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Rising Health Plan Costs are Often in the DetailsContracts between self-funded health plans and their medical and pharmacy claim managers are built on negotiation and trust. These deals also merit oversight, mainly through healthcare claims and PBM audits, to ensure that claims are handled accurately. Given the substantial budgets involved, even slight errors can develop into high costs over time. As a result, many self-funded health plans...0 Commentarios 0 Acciones 200 Views 0 Vista previa
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