Insurance companies and other healthcare payers face increasing demands from healthcare providers for the right compensation of the care delivered, while, at the same time, are not always able to pass all those ever-increasing demands to their insured customers or final payers.
This snow-ball is rolling faster and other side effects like fraud become a common consequence that need to be properly tackled.
Real time or near real time data processing and continuous auditing is key, creating a permanent, protective 24/7 auditing and reporting “umbrella” that makes sure the providers correctly paid and the right amounts are charged to the insured customers.
EFFY and RAID Healthcare are the right solution to address these challenges with efficiency and effectiveness!