Read our experienced team's thought leadership and insight for all areas regarding healthcare claims auditing, payment integrity, provider relations and cost avoidance.
In the world of healthcare, claims audits can be complicated. It’s no wonder most healthcare plans that don't have the bandwidth to spend days analyzing stacks of paperwork opt to outsource their claim reviews to third-party vendors in order to alleviate the burden.
Some of the trends on the horizon this year may be familiar as they’ve been emerging over the years. The healthcare industry is nothing short of a behemoth and although not resistant to change, it can be rather slow to adapt, even when health crises demand it. However, the eruption of COVID-19 in 2020 and the continuation of the pandemic into another year has put pressure on the healthcare industry to make rapid advancements and sharply change direction, in many cases.
3 Ways ClaimLogiq is Disrupting the 'Black Box" Model of Claim Auditing Sending claims out for audit and waiting on the results to be delivered without any insight into, or control over, the process, is commonly referred to as the 'black box' model of claims auditing. This is especially true of an often disparate process of reviewing high dollar claims, particularly Itemized bills and DRG validations.