Reducing Administrative Costs for health plans
Reducing Administrative Costs

Reduce administrative costs by addressing claim errors

The costs associated with processing inaccurate or incomplete claims has you looking for ways to improve the quality of claims submitted by your providers. Too often, payers and providers blame each other for problems.  You expect providers to do due diligence on their end and make sure the claim has all the correct information, while your providers believe that you’re not  doing  a good job communicating changes to claims rules that will affect their submissions.

One solution that’s gaining popularity is designed to check claims pre-receipt—that is, before claims enter your adjudication system. The technology checks the claim against your updates, and then sends it back to the provider with an explanation of what’s incorrect or missing.  

Availity has claim solutions that leverage this approach, making it easier for you to communicate with your provider network.