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Some states, such as Texas, have government regulations dictating a strict time frame for claim payment or penalties are applied. Can these claims be audited once paid?

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Some states, such as Texas, have government regulations dictating a strict time frame for claim payment or penalties are applied. Can these claims be audited once paid?

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It is not necessary to withhold any payment pending an audit. The majority of claims we audit have 100% of the payer’s liability paid. Most hospital’s audit policies require 90% to 100% of the charges be paid prior to audit.

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