EDITOR’S NOTE: Our column, Virchow, is written by anonymous insiders working within the managed care world. The column aims to help clients of THE DARK REPORT better understand the decisions, policies, and actions of payers as they man age their laboratory networks, establish coverage guidelines, process lab test claims, and audit labs. PRIVATE PAYER AUDITS […]
Behind-the-Scenes Audits Often Hide Cause of Test Claim Denials
- By Virchow
- > From the Volume XXXI, No. 9 - July 1, 2024 Issue
- Tags: AI, Alan Muney MD, artificial intelligence, Cigna, claims audits, CMS guidelines, CPT® codes, EBO, employee buyout, genetic test claims, Health and Human Services Office of Inspector General, lab risk & compliance, molecular test claims, OIG, private payer audit, ProPublica, test claim denials, UnitedHealthcare
