Insurance Claim Review - Economics
Research News and Information

Sunday, November 22, 2009

Managing medical necessity and notification denials.

30 Jul 2009 Hospitals should take a strategic approach to denials management. Some key areas to monitor are: Prior authorization/notification. Concurrent review. The appeals ... Read more...

IV immunoglobulin is associated with a reduced risk of Alzheimer disease and related disorders.

19 Jul 2009 OBJECTIVE: To compare the incidence of Alzheimer disease and related disorders (ADRD) in patients treated with IV immunoglobulin (IVIg) for non-Alzheimer disease (AD) indications vs untreated controls. METHODS: This retrospective case-control ... Read more...

Incremental burden of congestive heart failure among elderly with Alzheimer's.

29 Jun 2009 OBJECTIVE: A complex relationship exists between Alzheimer's disease (AD) and other co-existing co-morbidities such as congestive heart failure (CHF) with implications for health resource utilization (HRU) and cost of care. Study objective was to ... Read more...

Latest indexed articles for 'Insurance Claim Review - Economics'

These are the very latest articles for this heading:

• The RAC coordinator's role. RAC audits require a coordinator to ensure compliance. 30 Jul 2009
• Managing medical necessity and notification denials. 30 Jul 2009
• IV immunoglobulin is associated with a reduced risk of Alzheimer disease and related disorders. 19 Jul 2009
• Incremental burden of congestive heart failure among elderly with Alzheimer's. 29 Jun 2009
• Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA): preauthorization of durable medical equipment. Final rule. 29 Jun 2009
• How health care reform can lower the costs of insurance administration. 29 Jun 2009
• The recovery audit contractor program: an overview. 30 May 2009
• With a RAC audit. 29 Apr 2009
• "RAC" up for providers. 30 Mar 2009
• Health and productivity as a business strategy: a multiemployer study. 30 Mar 2009
• Incidence, treatment costs, and complications of lymphedema after breast cancer among women of working age: a 2-year follow-up study. 14 Mar 2009
• RAC or racket? You be the judge. 27 Feb 2009
• Modifiable health behaviors and short-term medical costs among health plan members. 27 Feb 2009
• RAC ready. How to prepare for the Recovery Audit Contractor program. 30 Jan 2009
• Lead by example. CMS should try providers' standards, take a cue from Thomas Jefferson. 3 Jan 2009
• The disabled and disability insurance: an introduction to legal and claim assessment issues. 30 Dec 2008
• Disability insurance and the physician practice: a primer for physicians and office managers. 30 Dec 2008
• Navigating the perfect storm. 29 Nov 2008
• Stretched by the RAC. 19 Nov 2008
• CMS adopts final regulations making major changes to provider reimbursement appeal procedures. 30 Oct 2008

See a longer list of these articles.

Technical information about 'Insurance Claim Review'

Definition: Review of claims by insurance companies to determine liability and amount of payment for various services. The review may also include determination of eligibility of the claimant or beneficiary or of the provider of the benefit; determination that the benefit is covered or not payable under another policy; or determination that the service was necessary and of reasonable cost and quality.

Descriptor UI: D007345

Alternative terms: Insurance Claim Review; Review, Insurance Claim; Claims Review; Claims Analysis; Review, Claims; Claims Reviews; Reviews, Claims; Claim Review, Insurance; Claim Reviews, Insurance; Insurance Claim Reviews; Reviews, Insurance Claim; Analysis, Claims; Analyses, Claims; Claims Analyses; Insurance Audit; Audit, Insurance; Audits, Insurance; Insurance Audits; Insurance Claims Processing; Claims Processing, Insurance; Processing, Insurance Claims;

Allowable Qualifiers: classification; economics; history; legislation & jurisprudence; organization & administration; standards; trends; utilization; statistics & numerical data; ethics;

Tree Number: N03.219.521.576.215;

History Note: 91(86); was see under INSURANCE, HEALTH 1986-90