Analytics-driven insight and accuracyProspective Claims Accuracy Retrospective Claims Accuracy Clinical Chart Validation Network Value Learn more
Analytics-driven insight and accuracyProspective Claims Accuracy Retrospective Claims Accuracy Clinical Chart Validation Network Value
- Who has liability for this claim?
- Does any other party share in the liability?
- Are all value-based reimbursement criteria being met?
- Was the claim coded correctly?
- Are codes consistent with payment policy?
- Are providers complying with payment policies?
- Is the claim submitted in accordance with the contract terms?
- How should this claim be calculated?
- Was care delivered in accordance with industry and payer guidelines?
- Does chart documentation support the submitted claim?
- Are there provider patterns of inefficient and unnecessary services that lead to low-value care?
- How can I differentiate the cost and quality of my networks?