Claim audits: a relic of the indemnity age?
Traditional claim audits offering quick fixes to specific problems or to recover overpayments will not provide benefit managers with the data and action plan they need to make informed decisions about cost-effective benefit administration. Today's benefits environment calls for a comprehensive review of claim administration, incorporating traditional audit techniques into a quality improvement audit process.
Ellender
D E
DE
Arthur Andersen LLP, Houston, TX, USA.
D000288:Administrative Personnel / Q000592:standards; D005069:Evaluation Studies as Topic; D007345:Insurance Claim Review / Q000592:standards*; D008329:Managed Care Programs / Q000458:organization & administration; D008330:Management Audit / Q000379:methods*; D017064:Process Assessment, Health Care; D017749:Total Quality Management; D014481:United States