CERIS’ “The Pulse of Payment Integrity” Outlines New Claims Processing Path For Payers
11 Abril 2023 - 8:53AM
CERIS, a CorVel company, has released “The Pulse of Payment
Integrity,” a white paper encouraging healthcare payers to focus on
reviewing claims before they are paid, as opposed to months or
years afterward in a post pay environment.
The whitepaper notes that taking such an approach to payment
integrity reduces errors and improves the relationship between
payers and providers by eliminating the need to collect excess
payments after they have been made.
New pressures on the existing healthcare payment process are
also encouraging a move toward greater payment integrity. The white
paper discusses issues created by the COVID-19 pandemic, which
include the rapid introduction of telehealth services and increased
difficulties in forecasting care utilization. It also touches on
the demands created by new value-based care initiatives.
“The culture of payment integrity needs to be focused not only
on reducing the total cost of care but also on better patient
outcomes and satisfaction,” said CERIS President, Greg Dorn. “This
needed shift includes better alignment between incentives and
quality of care and better communication between payers, providers,
and patients.”
CERIS has been introducing clients to improved payment integrity
for decades and its services helps save health plans billions of
dollars a year.
To learn more, download the white paper here, visit the CERIS
website at www.ceris.com or call 844-868-0058.
About CERIS
CERIS, a leader in both prospective and retrospective claims
review and repricing, combines clinical expertise and cost
containment solutions to ensure the accuracy and transparency in
healthcare payments. Accuracy and validation services include
itemization review, DRG validation, facility repricing, contract
and policy applications, review of implants and devices, and
primary payer cost avoidance. Its universal chargemaster contains
billions of charge items from more than 97% of the nation’s
hospitals, helping to ensure the accuracy and objectivity of each
claim review.
About CorVel
CorVel Corp. applies technology including artificial
intelligence, machine learning and natural language processing to
enhance the managing of episodes of care and the related health
care costs. We partner with employers, third-party
administrators, insurance companies and government agencies in
managing worker’s compensation and health, auto and liability
services. Our diverse suite of solutions combines our integrated
technologies with a human touch. CorVel's customized services,
delivered locally, are backed by a national
team to support clients as well as their customers
and patients.
Safe Harbor Statement under the Private Securities
Litigation Reform Act of 1995
All statements included in this press release, other than
statements or characterizations of historical fact, are
forward-looking statements. These forward-looking statements are
based on the Company’s current expectations, estimates and
projections about the Company, management’s beliefs, and certain
assumptions made by the Company, and events beyond the Company’s
control, all of which are subject to change. Such forward-looking
statements include, but are not limited to, statements relating to
the Company’s payment review services and the Company’s continued
investment in these and other innovative technologies, and
statements relating to the Company’s service offerings. These
forward-looking statements are not guarantees of future results and
are subject to risks, uncertainties and assumptions that could
cause the Company’s actual results to differ materially and
adversely from those expressed in any forward-looking statement,
including the risk that the impact of the COVID-19 pandemic on our
business, results of operations and financial condition is greater
than our initial assessment.
The risks and uncertainties referred to above include but are
not limited to factors described in this press release and the
Company’s filings with the Securities and Exchange Commission,
including but not limited to “Risk Factors” in the Company’s Annual
Report on Form 10-K for the year ended March 31, 2022 and the
Company’s Quarterly Report on Form 10-Q for the quarters ended June
30, 2022 and September 30, 2022. The forward-looking statements in
this press release speak only as of the date they are made. The
Company undertakes no obligation to revise or update publicly any
forward-looking statement for any reason.
Contact: Melissa StoranPhone:
949-851-1473www.corvel.com
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