by admin | Jul 27, 2020 | Collection Rates, Insurance Billing, SIU Audits
Audits and recovery efforts are a very common aspect of the revenue cycle. The mission of all audits is to identify Fraud, Waste, and Abuse (FWA). However, the financial incentives for payors to pursue recovery are also substantial; in fiscal year 2018, the Centers...
by admin | Jul 27, 2020 | Collection Rates, Insurance Billing
Claims are denied for many valid reasons, including missing information, incorrect patient data, duplicate claims submission, services not being covered by the payors, or beneficiaries not being eligible for services. However, the increasing scrutiny on costs by...
by admin | Jul 27, 2020 | Collection Rates, New Release, Outsourcing
From the perspective of providers, payers too often adjudicate claims below the providers’ contracted rate agreements or underpay claims when they don’t have a contracted agreement with the provider. These “low pay” situations, which include denials, can highlight...
by admin | Jul 27, 2020 | Collection Rates, Patient Recovery
Outsourcing has become a critical part of the strategies deployed by many companies to achieve cost competitiveness and increased effectiveness in their administrative activities. Across many industries, companies have used this tool to bring into their...
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