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PAYMENT ACCURACY

Episode of Care

Part of our suite of Payment Integrity solutions.

Shift your focus from claims-centered to patient-centered payment accuracy!

An episode of care review uncovers billing errors without the need to examine medical records. Machine learning algorithms examine all of the claims submitted during an individual’s episode of care and flags those with procedure discrepancies and likely coding errors for clinicians to review.

Without the need to obtain a medical record from the provider — which can take several months to a year — we can shorten the review and recovery process to approximately 60 days or less, all while minimizing provider appeals and abrasion.

 

 

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