ne of the most contentious aspects of health plan and provider relationships is
the speed and accuracy of claims payment.
While both sides may be doing their best to facilitate a smooth process, the reality is that neither party believes the other is trying as hard as they are to make this work - that is, until now.
In a collaborative effort between a large payer and a major health system, we were able to predict the likelihood of denied claims with 98% confidence.
Once armed with this new insight, together we created new tools to improve the claims payment process to stop it from being a source of friction in their relationship.
