1. Using case management to improve claims payment
- Author
-
Micheletti, Julie A., Mevert, Steve, and Shlala, Thomas J.
- Subjects
Medical case management -- Usage ,Health maintenance organizations -- Management ,Health insurance -- Management ,Medical care, Cost of -- Management - Abstract
Health insurance providers and other entities that pay for rising medical claims are subjecting such claims to intense scrutiny. These reviews take the form of payer system edits, payer case management and medical reviews. Healthcare providers can use internal case management to better handle these reviews. Such a program would also increase the efficiency of claims processing while increasing patient access to a range of services, lowering medical costs and promoting continued care.
- Published
- 1995