Episode 11 - How clinical validation is good for payers, providers, and patients

From the Trenches: A Healthcare Analytics Podcast

When a health plan denies a claim, the provider wants to know why it was denied. Sometimes, the answer is that a modifier appears to have been used inappropriately, which Cotiviti detects using a process we call clinical validation. And as it turns out, clinical validation doesn’t just lead to better outcomes for the payer, but also the members and providers that it serves. On the latest episode of Cotiviti's “From the Trenches” podcast, we talk with John Neumann, registered nurse and clinical consultant for Cotiviti’s Payment Accuracy solutions.