Audits Drive Health Plan Quality Improvements

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2022-05-30 11:01:12 - Translate -

Medical claim audits started as a compliance requirement for most employer-funded health plans and were conducted by random sample. It satisfied regulators but provided little actionable data for in-house plan managers. Thankfully beginning in the 1990s and continuing to today, technology and methods have improved. It means that audits now review 100-percent of claims paid and check each one...

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