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Healthcare IT Today: Anne Neal on Why the Next Era of Payment Integrity Is Prevention, Not Recovery 

Anne Neal, Vice President of Product Management for Payment Accuracy at Availity, recently published an article in Healthcare IT Today titled “The Next Era of Payment Integrity Is Prevention, Not Recovery.” In the piece, Anne examines why many payment integrity programs continue to address errors after claims reach adjudication, creating cycles of administrative work and burden for everyone. She argues that the next stage of payment integrity requires an upstream operating model focused on identifying opportunities to make claims accurate earlier in the process. 

The article outlines: 
  • Why the greatest opportunities to improve payment integrity often exist before claims ever reaches the payer’s system. 
  • How today’s downstream model has normalized rework by allowing known gaps and errors to move forward for later correction. 
  • Why payment accuracy is the next operating model, working in tandem with payment integrity. 

Read the full article in Healthcare IT Today