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Tag: medical necessity

Navigating payer practices to reduce denials and enhance outcomes

The friction between payers and providers has existed for decades. It’s understandable to an extent. Payers want to reduce expensive and unnecessary treatment, eliminate fraud and lower financial risk. Providers want to be able to make decisions regarding their patients’ care without having to navigate the hurdles of medical necessity, prior authorization and complex payer…

HFMA March 3, 2023
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