Payer audits are no longer rare events reserved for large or high-risk laboratories. With increasingly sophisticated analytics, AI-driven document review, and greater transparency into Medicare Part B spending, payers are identifying utilization patterns, frequency outliers, and documentation gaps faster than ever. Many labs assume an audit will not happen to them, until it does. When it does, poor documentation, missing medical necessity, or disorganized submissions can trigger denied claims, delayed payments, and costly clawbacks.
In this webinar, Ann Lambrix of Lighthouse and Darla Wanitschke of TELCOR will break down why payer audits are accelerating, how Special Investigative Unit (SIU) and post-payment reviews actually work, and where labs most often fail during documentation and appeals.
Attendees will learn how payer AI evaluates submitted paperwork, why even valid claims are being rejected, and how labs can get stuck in prolonged back-and-forth with payers that stalls reimbursement.
The session will focus on practical, defensible best practices labs can implement now, including pre-payment review strategies, documentation checklists, internal self-audits, and the role of document management and automation in surviving audits and strengthening Level 1 and Level 2 appeals. The goal is simple: reduce audit risk, improve appeal outcomes, and protect revenue by getting documentation right the first time.
Join us for, "How to Avoid Payer Audits: Tried & True Best Practices to Reduce Risks ," which aired on April 8, 2026 at 1:00 PM EST to learn how accelerating, AI‑driven payer audits work and what practical documentation and appeal strategies your lab can implement immediately to reduce audit risk and protect revenue.
