Coding Advisor

Health plans can help reduce provider abrasion by adopting an education first approach that emphasizes partnership and collaboration. This includes offering clear, proactive communication about billing expectations and creating opportunities for dialogue so providers understand not only what needs adjustment but why.

Multi channel outreach — such as mail, phone calls, webinars, and direct support — helps meet providers where they are and reduces the administrative friction that often accompanies claim denials or appeals. When education is framed as a shared effort to improve accuracy and patient outcomes, providers typically experience fewer surprise denials, spend less time on rework and feel more supported in navigating complex billing rules.

Learn more about how proactive education can help health plans improve their payment integrity program to reduce billing errors and build stronger provider relationships.

Reducing coding errors starts with giving providers timely, data driven insights into where errors commonly occur. AI and analytics enabled tools can surface patterns such as recurring diagnosis inconsistencies, missing documentation elements or coding choices that frequently lead to denials.

Once these patterns are identified, health plans can deliver targeted educational materials — including coding guides, case examples, documentation tips and refresher modules — through multiple channels to make learning accessible. Escalation pathways for repeated issues align persistent gaps with more specialized support.

Over time, consistent education not only helps improve payment integrity and coding accuracy but also reduces unnecessary administrative burden, leading to measurable cost savings and smoother provider interactions.

Read our report on denial trends.

Tailored outreach begins with understanding each provider’s practice patterns, specialties, claim volumes and historical billing trends. Using this data, health plans can develop communication strategies that are personalized — delivered through the channels providers prefer and timed to align with key points in their submission process.

Providers with strong performance may simply need periodic updates, whereas those navigating recurring challenges may benefit from additional touchpoints or customized resources. This individualized approach helps increase the relevance and value of education, drives more consistent improvements and strengthens long term provider engagement. It also has a positive impact on payment integrity by helping to reduce provider abrasion and support more accurate claims payments.

Learn a 5-step plan to build a better provider education strategy that helps support accurate claims payment and reduces errors, denials and administrative costs.