clinical expertise and coding competence: the twin engines of clinical validation

Pre-pay clinical validation of claims can drive another 1 percent or more savings off annual medical spend by adding a second line of defense to automated claim editing, but it requires both clinical expertise and coding competence. Advanced analytics are critical for identifying suspect claims, but many still require detailed review by a seasoned clinician. Using one without the other is like flying a plane with only one engine—it can be done, but results are not optimal.

In this on-demand webinar, Verscend experts will demonstrate clinical validation techniques that can be used to optimize claim accuracy for payers. This on-demand webinar is hosted by Heather Groesbeck, BSN, RN, CPC, and John Neumann, RN, two of our senior clinical consultants. You’ll learn about:

  • Analytic techniques to identify suspect claims
  • The key items that a clinician looks for in the claim data
  • The regulatory changes ahead, and the ways in which they could affect claim payment

Watch it on-demand today to make sure your pre-pay claim editing doesn’t run into turbulence.

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