Waiting to Audit Claims Can Cost You
Medical claim auditors play a crucial role in ensuring the accuracy and efficiency of healthcare and pharmacy plans. Their job is to identify errors from human mistakes or systemic issues. The financial impact of mistakes can be significant, particularly for large plans and during unexpected events such as the COVID-19 pandemic. Even performance guarantees from third-party claim administrators may not suffice in such cases, making a 100-percent audit essential. Engaging an independent third-party auditing firm can significantly enhance the accuracy of claim reviews.
Seasoned auditors bring valuable expertise and a fresh perspective to the claim data garnered from their experience auditing similar plans. Moreover, they often utilize proprietary software that is both comprehensive and efficient. This can make a substantial difference in the audit process and ensure no relevant details are overlooked. While some companies may opt to utilize the services of extensive audit…