BC Advantage - 2024 Issue 2

Navigating Healthcare Claims and Audits for Purchased Diagnostic Testing

In the complex world of healthcare, accurate reporting of services is crucial for ensuring quality patient care and fair compensation for medical providers. One significant aspect of this process involves purchased diagnostic testing, where medical tests are conducted outside of the healthcare organization. In this article, we'll delve into the essentials of healthcare claim reporting and the auditing process related to purchased diagnostic testing.   Healthcare claims are the documents submitted by healthcare providers to insurance companies or other payors to request reimbursement for services rendered. These claims contain detailed information about the provided services, including diagnostic testing, and...

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