Longitudinal Data Mining

Keeping up with the latest trends and innovations in payment integrity seems to be a nearly impossible task. While in years past, retrospective tactics alone could reasonably the majority of payment errors a health plan encountered, nowadays increasingly proactive approaches like prepayment auditing or provider behavior modification are needed just to keep up! A common concern we hear from health plans is how to strike the right balance between upgrading existing (and trusted) payment integrity programs and investing the time and energy in new (and unproven) solutions. In this video, our experts discussed how to foster a pragmatic approach to payment integrity. Specific topics include: Payment Integrity Trends and Challenges in 2018 Longitudinal Data Mining Post-payment Auditing of Outpatient & Ancillary Claims Applying Medical Record Reviews to Prepayment Auditing Provider Behavior Modification.

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