Title: RE: A tricky BA Questions
1) If it is part of the payors Quality Assurance, the payor is allowed to audit a providers records as long as both the payor and the provider have a relationship with the patient. I don't have the citation in front of me, but I can find it. It is listed
I have been encountered with a tricky BA question and hope someone can
provide some insight.
Insurance companies engage certain agencies to audit provider records to
verify if what the hospital billed was correct and if the insurance company
has overpaid. Since these audit agencies are engaged by
