white paper
Perspective: The payment leakage reality
Second-pass editors are key to improving the claims process.
Avoid the "set and forget" editing approach
The "set and forget" approach to editing means first-pass editors become out of date with the most recent regulatory updates, payer policies and provider contracts. This can lead to overpayments leaking through the system.
Many health plans have claims processing software that's decades old. This aging infrastructure is often inflexible. Learn why plans need bolt-on solutions that allow them to incorporate complex contracts, policies and guidelines.
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