When the health plan says a claim is lost or they send an incorrect payment, providers often feel like victims of an evil plot. In trying to decipher health plan motives, it may be helpful to consider the scale and complexity of their operations. Clearly there is reason for providers to be frustrated and concerned about insurers’ ability to make payments that are both accurate and timely. That said, providers need not be concerned that they are being individually targeted by health plans. Given the volume and complexity of claims processing, from the payer’s perspective picking on an individual provider would be the equivalent of finding the proverbial needle in a haystack. That said, providers can take action to improve the situation. For example, validating changes to fee schedules and maintaining open lines of communication with payors can help identify and correct errors before they become a problem. For those that haven’t already done so, it’s also worth considering use of a Revenue Cycle Management (RCM) service. Given the complexity, volume, and fluctuations in claims processing, a reliable RCM partner is well positioned to keep up with the requirements of each health plan in order to reduce denials and errors, and ensure timely, accurate payments. For more information about NextGen® RCM Services, please visit our webpage.