To ensure they receive accurate and complete reimbursement from commercial payers, hospitals should ensure they know the allowable reimbursement amount, said Tom Romeo, general manager of healthcare IT and Quanum Solutions at Quest Diagnostics.
"Not all payers reimburse correctly, so it's important to know what you are supposed be getting paid. Obtain the allowables for all services, then load current allowables for all payers and products. Review them at the line-item level. Take action," he told Becker's.
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