payment integrity

Podcast: A better approach to clinical appropriateness in claims payment

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Are you asking the right questions when determining whether your claims are clinically appropriate? For example, were the diagnoses billed supported by clinical indicators in the records? Was the correct clinical setting assigned and billed based on nationally recognized guidelines? The process of reviewing claims and charts for clinical appropriateness is crucial for your business… Read More »Podcast: A better approach to clinical appropriateness in claims payment