Clinical Audits

DRG validation strategies for success

Research shows that the vast majority of medical bills contain errors—health plans can use DRG validation audits to improve the accuracy and validity of claims payments.

The impact of telehealth on clinical audits during COVID-19

Telehealth has become a lifeline during the pandemic, but the potential for improper coding and documentation is high. Health plans are wise to include telehealth claims in their clinical audit programs.

Fixing payment integrity at the source

Find out how eligibility management plays a role in maximizing recovery opportunities, improving cost avoidance strategies, and creating premium restoration possibilities.

Three ways to tackle the high cost of waste

Administrative complexity continues to drive the high level of waste in healthcare. Learn how to reduce improper payments with an optimized payment integrity approach that blends advanced analytics with human expertise.