Are we ever going to get paid, and when we do, will it even be right?

ne of the most contentious aspects of health plan and provider relationships is the speed and accuracy of claims payment.

While both sides may be doing their best to facilitate a smooth process, the reality is that neither party believes the other is trying as hard as they are to make this work - that is, until now.

In a collaborative effort between a large payer and a major health system, we were able to predict the likelihood of denied claims with 98% confidence.

Once armed with this new insight, together we created new tools to improve the claims payment process to stop it from being a source of friction in their relationship.

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