payer Archives | Page 5 of 5

Payer Plugs Gap with Innovative Alliance

by marketing-mro | Feb 6, 2023 | Feature Articles

And to gather additional contextual data that is not included in the claims data, CareFirst has partnered with Rockford, Ill.-based FIGmd, a software platform that supports data submission processes within different health systems across the country. “The whole idea...

Information You Need to Know about a HEDIS Audit from Revenue Cycle Experts

by Greg Ford, Vice President, Requester Relations | Jun 1, 2022 | Blog, Release of Information

Each year HEDIS rating criteria is updated, meaning your organization needs to stay up-to-date on the latest news and trends for HEDIS compliance audits. Below we explore some common questions about HEDIS and review important information your team should know now and...

Internal Audits Help Combat Payer Risk

by Dawn Crump, MA, CHC, SSBB | May 26, 2022 | Feature Articles

For a smooth-running revenue cycle, tap into the immense powers of this best practice tool. Wonder Woman has a golden lasso. Captain America has an impenetrable shield. Thor has a lightning hammer. Just as these magical tools bolster superheroes’ defenses, insights...

Audit Surge: Managing the Deluge of Payer Integrity Audits

by Dawn Crump, MA, CHC, SSBB | Nov 17, 2021 | Blog

As many may already be aware, commercial and third-party payers have all resumed payment integrity audits in 2021. While these audits are useful to assure compliance and proper reimbursement, they don’t always go smoothly. In fact, nearly one in four providers have a...