Healthcare providers are increasingly required to provide clinical data to payers to justify claims and get paid for the care they provide.
In one recent study, nearly 15% of all claims submitted to payers for reimbursement were initially denied, including many that had been pre-approved through the prior authorization process.
Some electronic health record (EHR) vendors now offer payer platforms that make it possible for providers to grant payers direct access to patient medical records, according to participants of an HFMA Executive Roundtable held in June, sponsored by MRO.
The roundtable brought together a number of healthcare industry leaders to discuss challenges and solutions for effectively sharing medical record data with payers.
