Accurate coding and payments depend on consistent updates as new regulations are enacted and policies are released. Therefore, staying up to date is essential.
No two payers are the same. Customization allows health plans and TPAs to tailor their payment integrity operations to their unique business needs and policies.
Better communication between payers and providers is crucial to improving relationships between them, but it is often wanting.
Having worked in siloed environments historically, few payers have insights into how the wider industry operates, which can put their organizations at a disadvantage.
For payers to respond effectively, they need a partner to help them navigate uncertainty while optimizing existing payment integrity operations to weather future storms.