Plan Complexity for Different Payers

The complexity of healthcare billing is undeniable. Provider groups deal with numerous insurance payers, each offering multiple plan types and benefit variations. On top of that, payers frequently update restrictions, causing potential oversights in codes, charges, and contract updates. Moreover, the American Medical Association adds and revises hundreds of codes annually, further complicating the billing process. It's not surprising then that the majority of claims submitted to payers contain errors. Even seasoned billing staff can struggle to navigate the intricate details of a patient's benefits. The prevalence of these challenges means that errors are inevitable across all healthcare settings.