Root cause analysis of edits and an understanding of the relationship between the chargemaster and HIM/coding must be supported by overarching principles and best practices for edit management. Processes should be built around the timing of edits, applying edits across payers, and denial management.
A majority (57%) of healthcare payers and providers believe predictive analytics will save their organizations 15% or more over the next five years, according to a 2017 Predictive Analytics in Healthcare Trend Forecast by the Society of Actuaries. Despite the potential for savings, there are several roadblocks in the way.
