Our analysis of hundreds of millions of paid commercial claims from a variety of payors proves that even when sophisticated editing is in place, MultiPlan’s Payment Integrity “factors” find significant additional opportunities for savings through removal of inappropriately billed charges.
On average, only 15% of these edits are National Correct Coding Initiative (NCCI) edits missed by the payors’ systems while the vast majority are overpayments from inadvertent or exploited loopholes not easily addressed in standardized coding approaches.