Fast Track Payer Issues

Automated identification and escalation of payer issues is facilitated through the use of software tools. These tools are capable of detecting and flagging underpayments from insurers by comparing returns to bills and codes. Additionally, regular underpayment detection can be scheduled, and incoming payments can be reviewed manually if necessary. Staff members are automatically notified to appeal when underpayments occur. Monitoring patterns of underpayment allows providers to identify payers that are more likely to underpay. Resolving root causes of underpayment is essential for long-term efficiency and revenue recovery. This may involve renegotiating contract terms or clarifying billing procedures with the payer. It is crucial to ensure that the improvements made to revenue are maintained over time.