Auditing short-stay encounters
Ambulatory or observation hospital services that are incorrectly billed as inpatient can be costly for health plans. Auditing short-stay hospital encounters for intensity of service before a claim is paid can help health plans maximize savings and avoid pay-and-chase.
Learn more about how your organization can maximize savings with a comprehensive approach to payment integrity.
Related Content
Comprehensive payment integrity savings
Inform and improve your entire claims management lifecycle.
Specialty Drugs & Prior Authorizations
Having a prior authorization process in place is not enough to ensure specialty drug utilization meets your policy criteria.
Achieving Success In Claims Editing
Learn best practices around delivery models, content and rule definition.