Tag: medical benefits plan auditors

Like anything else, there are differences among medical claim auditors, and their expertise and accuracy have much to do with the value of your next audit. With employer-funded health and pharmacy plans increasingly conducting oversight of claim administrators, the role of audits is unquestioned. If warranted, finding irregularities and recovering overpayments can improve your plan’s…

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Healthcare billing is complex and detailed, which means providers can miss revenue when billable items are missing on invoices or coded incorrectly. Medical claim audits can also benefit providers because of the potential for mistakes to reoccur. Long thought to be a tool of payers, most notably self-funded plans sponsored by large employers, the value…

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