Payment Integrity Trends: What’s a Code Worth
To install or not install a pre-payment code edit, that is the question. Not all standard coding rules and edits are created equal in terms of value to a payer. Equian’s physician leadership, combined with a solid understanding of the future of integrated payment integrity, is a market game changer.
The core principle of Payment Integrity is to efficiently and transparently pay health insurance claims using pre-payment, post-payment, and analytic tools that ensure accuracy and eliminate incorrect, unwarranted payments. An optimal payment integrity model also ensures an organizational focus on paying providers promptly, while optimizing the edit logic.