BCBSND is enhancing our core claims processing with the Payment Integrity Program. The program will enhance current capabilities to ensure payments are correct, assigned to the right payer and consistent with national standards and guidelines.
We have partnered with Cotiviti, a leading health care analytics company, to bring a new level of accuracy to claims processing. This new enhanced level will supplement our core in-house system of robust checks and balances.
The Payment Integrity Program implements a robust Retrospective (post-pay) and Prospective (prepay) analysis of claims.
More information to come.
More information will come on Prospective in Q4 of 2022.