While health plans seek to pay claims as accurately as possible, implementing new payment policies requires a careful balance of weighing claim accuracy impact with return on effort and potential provider abrasion. That’s where trends and benchmarks become especially valuable, enabling plans to learn from their peers that have implemented similar payment policies.
With a claims dataset spanning billions of ambulatory claim lines and hundreds of billions of dollars in medical spend over several years, Cotiviti is well-equipped to empower payers with the information they need to consistently make informed payment policy decisions.
I invite you to join me and my colleague, Jamie Calabrese, M.D., FAAP, vice president of medical affairs for our on-demand Payment Integrity Pulse webinar as we break down key trends related to:
- Emergency department (ED) E/M claims: With professional and institutional coding complexities and roughly 75% of these services billed at high levels of care, ED E/M claims are key drivers of medical loss ratio (MLR) increases.
- Medical drug wastage: We’ll dive deep into the growing use of modifiers JW and JZ and what it means for payment integrity.
We’ll also look at the tangible medical cost reductions Cotiviti’s payment integrity clients have achieved by implementing payment policies targeted at improving claim accuracy in these specific areas. Don’t miss this opportunity to take your prepay accuracy to the next level and avoid wasting valuable resources that should be spent on appropriate member care.
Check out the remaining webinars in our series as we look at recent payment integrity innovations (September 25) and offer an end-of-year update (December 18)*.
*Topics subject to change.
