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How Successful Audits Identify Claims Leakage and Recover Lost Revenue

Picture of water leaking
Episource
May 8, 2020

Ensure your plan is submitting accurate risk score data. This presentation covers how risk-bearing organizations can recover lost revenue due to claims leakage by identifying the common causes and ways to remediate them.

Key Takeaways:

  • Expectations plans should have for RAPS/EDS reconciliation
  • Effectively reconciling submissions in time for sweeps
  • Indications of data leakage that affect claims and encounter submissions
  • How best to conduct a RAPS/EDS reconciliation audit
  • Results of recent RAPS/EDS audits

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