June 27 2018 | 0 Comments | 70 reads Average Rating: 3

Poll Participants Pinpoint Most Pressing Payment Integrity Challenges

by SCIO Health Analytics in Payment Integrity

During a recent webinar entitled “Expanding Frontiers: The State of Payment Integrity in 2018,” Monique Pierce, Vice President Business Optimization at SCIO Health Analytics, and Leslie Strader, Manager, Product Management at SCIO Health Analytics, discussed how to foster a pragmatic approach to payment integrity. During the presentation, the healthcare executives specifically offered their perspectives on payment integrity trends and challenges; longitudinal data mining; post-payment auditing of outpatient and ancillary claims; the use of medical record reviews in prepayment auditing; and provider behavior modification.

During the webinar, attendees also had the opportunity to weigh in with their opinions on payment integrity issues within their organizations. The following was uncovered via opinion polls that were conducted in real time during the online presentation:

Payment errors are common in a variety of patient care areas. But some areas are more troublesome than others. According to the poll respondents, infusion claims bring the most challenges for healthcare organizations. As such, healthcare organizations might want to more closely analyze infusion claims to uncover payment integrity pitfalls.

Many factors can have an impact on payment integrity. Respondents weighed in on this issue – pointing to increased complexity of overbilling schemes as the most pressing matter. As such, organizations should concentrate on developing strategies that could help to address these overbilling schemes.

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President, Niloff Healthcare Strategies, LLC


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Director of Population Health Strategy, Oracle Corporation


Leslie Strader
Project Manager


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Director of Compliance & Risk Adjustment, Scripps Health Plan Services


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Vice President, Business Optimization


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SVP, Strategic Accounts


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Compliance Director


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