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podcast: how clinical validation is good for payers, providers, and patients

When a health plan denies a claim, the provider wants to know why it was denied. Sometimes, the answer is that a modifie...

the twin engines of clinical validation

Advanced analytics applied by an automated claim editing system are crucial for identifying claims that are potentially ...

busted: rounding up the top fraud schemes of Q2 2018

The nation’s top special investigators and law enforcement officials were hard at work stamping out the weeds of healthc...

avoid the latest rash of asthma and allergy schemes in provider billing

While the cause of the rise in asthma and allergy rates over the past several years isn’t 100 percent clear, one of the ...

podcast: validating clinical claims without medical record review

Automated claim editing systems are a crucial component of accurate and efficient claims payment. But there will always ...

busted: the top fraud schemes of Q1 2018

The first three months of 2018 were unpredictable, to say the least, from record-breaking Nor’easters to bracket-busting...

podcast: are you catching all types of duplicate claims?

Is your claim editing system catching all types of duplicate claims, or are many of them passing through and getting pai...

just the facts: answering your questions on claim editing and clinical validation

At a recent Verscend webinar on claim editing analytics, attendees had many questions about claim editing and clinical v...

get more bang for your buck with claim editing analytics

Remember the infomercial tagline, “Set it and forget it!”? That might be what you would look for in a rotisserie grill, ...

busted: top five fraud busts of Q4 2017

When Santa made his list this past Christmas, the vast majority of healthcare providers were nice, but a small handful o...

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