Increased cost pressures, regulatory uncertainty, and membership flux make it difficult to unlock the value of claims data. Abandon the spreadsheets and manage claims code sets, increasing first pass auto-adjudication rates and reducing inaccurate claims.
Reduce financial exposure by identifying, recovering and preventing overpaid claims by ensuring your claims systems are leveraging the latest updates provided by CMS and the AMA.
Scale data efforts and manage claims codes using software, reducing errors and administrative costs by providing workflow and collaboration tools to properly approve and update claims codes.
Comply with state requirements and ONC regulations that require data access and sharing, while improving data quality that informs decision making.
Increase first pass auto-adjudication rates to decrease the processing of inaccurate claims, improving provider satisfaction.
Wolters Kluwer helps health plans manage claims code sets using a combination of software, data and services, reducing the manual work required to update lists of codes used for reimbursing claims from your provider networks. Up-to-date codes ensures accurate data is being used across your claims operations using the latest updates from the standards bodies.
What’s At Stake?
Access reliable, actionable data to improve member care, boost quality measures, and support value-based reimbursement. Wolters Kluwer delivers a powerful combination of expert consulting, comprehensive services and leading technology that can help you build the foundation for sustainable results. Get the most out of your enterprise data with an end-to-end data management portfolio tailored to the needs of health plans.
In our previous blog, we discussed the importance of leveraging administrative data for better quality assessment. As the wrap-up to this standards blog series, I want to look back at Crossing the Quality Chasm as a foundational work for improving the quality of healthcare delivery.
Patients are demanding better insights and transparency into their care. They want to be empowered in their decision-making through better information about everything from diagnoses and care plans to quality ratings and cost.