Claims Processing
AHIP President and CEO Matt Eyles says he fully expects an appeal.
CMS has released a proposed rule to speed up prior authorization approval.
About 78% prevail in getting disputed charges reduced or removed, survey finds.
The RADV final rule comes after increasingly high profile instances of apparent over coding from Medicare Advantage Organizations.
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Digital cloud faxing can remove manual processes for greater efficiencies
Centene made no admission of liability and maintained its business practices are lawful.
The groups indicate further court action is coming due to continued problems with the interim and final rules.
The departments say they have received "substantially more" disputed claims than expected.
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Here are some tips for your next optimization, starting with identifying KPIs to creating an ongoing optimization culture.