When should health care organizations implement processes


Problem: When should health care organizations implement processes and technologies to aid in identifying at-risk cases for upcoding, unbundling, and lack of eligibility and correct those issues before the bills are submitted?

a. when payers and OIG are conducting a higher level of scrutiny on high-severity coding

b. when a Recovery Audit Contractor has notified revenue cycle management of a clean audit

c. when health care organizations are seeking higher levels of operational accreditation

d. when health care organizations are concerned about consumer decisions based on reporting

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