Using case management to improve claims payment.
Payers increasingly are subjecting claims to intensive review in an attempt to control amounts paid for healthcare services. An internal case management program, however, can help providers better understand and respond to the review techniques employed by payers as well as streamline overall claims processing.
Micheletti
J A
JA
Healthcare Design Systems, Sea Girt, NJ, USA.
Mevert
S
S
Shlala
T J
TJ
D000067:Accounts Payable and Receivable; D002985:Clinical Protocols; D005375:Financial Audit; D005377:Financial Management, Hospital / Q000379:methods* / Q000592:standards; D007344:Insurance Claim Reporting; D007345:Insurance Claim Review / Q000639:trends*; D008329:Managed Care Programs / Q000191:economics; D008485:Medical Audit; D009718:Nurse Administrators; D010347:Patient Care Planning / Q000191:economics* / Q000458:organization & administration; D014481:United States