“As physician practices spend an average of 3 hours a week interacting with health plans at a national cost of $23 billion to $31 billion a year, the administrative complexity created by multiple documentation requirements to varying billing, precertification, and credentialing forms takes time away from clinical care.” – Institute of Medicine (US) Roundtable on Evidence-Based MedicineHow can medical records requests be improved in a way that contributes to the payer-provider relationship? In addition to communicating over claims, providers and payers are linked by their patients/members. Consumers also pay a price for provider abrasion, and at a time when the focus on member satisfaction is high, plans will want to avoid unintended negative consequences to their enrollees.
- Providers dropping out of networks
- Dissatisfied members
- Damage to plan reputation making it difficult to attract other providers to your network
Integrated OCR and Audit Validation Enhancements.
Talk to ClarisHealth about how Pareo® can transform your health plan’s payment integrity operations.
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