Clinical validation audits are a new tactic that certain commercial insurers are adopting to reduce or deny payment to health care providers and can take months or even years to be adjudicated and resolved. Richelle Marting, director of managed care contracting at North Kansas City Hospital, and Chris Thompson, executive director of reimbursement and compliance for managed care at AdventHealth, discuss the rapid growth in these audits, the financial strain they can put on hospitals and health systems, and what can be done to protect providers and ultimately, patients. LISTEN NOW 

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The Coalition to Strengthen America’s Healthcare March 18 launched a new ad highlighting harmful practices by large corporate health insurers that drive up…
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A hospital patient from the 1990s would likely marvel at the pace of progress in health care just a generation later. America’s hospitals and health systems…
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The House Energy and Commerce Subcommittee on Health Feb. 11 hosted a hearing titled “Lowering Health Care Costs for All Americans: An Examination of the…
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The House Energy and Commerce Subcommittee on Health and Ways and Means Committee Jan. 22 hosted hearings on health care affordability that included…
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Every year tens of millions of Americans dig deep into their pocketbooks to pay for health insurance plans that will cover both preventive and necessary care…
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The AHA Dec. 17 urged Elevance Health, which is the parent company of the Anthem brand of health plans, to rescind Anthem’s nonparticipating provider…