Payer audits: commercial payers pick up where Medicare leaves off

Commercial health insurers usually recognize a good idea when the government has one, and they are once again following Medicare's lead by increasing the number of claims they audit. Many providers are seeing an uptick--sometimes a very sharp one--in requests for additional documentation on patient charges, even though Medicare's Recovery Audit Program has been in a lull lately while it revamps.

In June 2016, a three-question survey on audit management was sent to members of the HealthLeaders Media Council, which comprises executives from healthcare provider organizations. According to the survey, providers face multiple challenges in dealing with payer audits. Respondents were divided about which aspects of payer audits pose the biggest challenge.

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