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How Successful Audits Identify Claims Leakage and Recover Lost Revenue


Ensure your plan is submitting accurate risk score data.

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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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