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Results for “Insurance Claim Review”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 739 records · Page 41Linked to original sources
PubMed2005

Using computerized physician order entry to decrease insurance denials.

Insurance denials delay payments for tests to medical institutions and can decrease patient satisfaction due to unexpected billing. Our institution utilizes an ambulatory electronic health record (EHR) for routine clinical care that includes computerized physician order entry (CPOE). At our institution as well as others, considerable cost is associated with inappropriate diagnostic coding of needed procedures and tests by the physician. We developed a series of CPOE alerts and order sets targeting specific tests to address this problem. As a result, preliminary data shows that insurance denials fell by up to 37% for the targeted tests.

Ambulatory Care Information Systems↗
PubMed2006

[Medical assessment of psychosomatic illnesses in the field of short-term disability compensation insurance: advantages of a multidimensional structured guideline].

The aim of the medical report in the area of short-term disability claims caused by psychological and psychosomatic disorders is to make a valid prognosis on the further development of absenteeism and/or to estimate the return-to-work probability of the claimant. An analysis of the current practice of determining the validity of claims caused by psychosomatic illnesses shows that it is inadequate and unsatisfactory, mainly as a result of its reliance on a cross-sectional based judgement. The authors present a structured guideline (Multi-Axial-Psychodiagnostic for short-term disability claims, MAP-KTG), which supports, via a multi-dimensional diagnosis process, the validation of the psychological and psychosomatic symptoms of the claimant. It is also used to assess the amount of functional disability with a higher degree of accuracy. The determination of the prognosis, with regard to future work prospects, can be obtained by applying a list of empirically generated variables proven to be associated with the return-to-work probability.

Activities of Daily Living↗
PubMedDate not supplied

Northwest Dentistry.

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Dental Restoration, Permanent↗
PubMed2006

Getting your game on with business data.

Data warehouses can virtually eliminate claims-related paper and fax transactions for hospitals. Data are accessible electronically, decreasing the need for staff to check on outstanding claims status requests by phone. Data warehouse technology can be used to create analytical reports and identify issues by dollar volume or procedure code. Providers can receive instant reports on both the "front end," as they are submitted, and on the "back end," when claims are denied.

Database Management Systems↗
PubMed2006

Appeal theft.

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Humans↗