Claim Payment Oversight is Essential
If the coronavirus pandemic did anything for health plans, it was to confirm the value of medical claims auditing . Independent oversight of medical and pharmacy claim payments is vital in verifying accuracy and flagging mistakes. No doubt, error rates are low, and many processor agreements contain provisions for self-policing. But only the watchful eye of a skilled auditor can confirm the promises are being kept. Given the dollar volume of medical claim payments, they are material to the bottom