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Article: Web-based claims management systems: communication is paramount to expediting claims. A claims management system that operates online can improve the provider-payer relationship.(FEATURE STORY)
- Article from:
- Healthcare Financial Management
- Article date:
- February 1, 2006
- Author:
CopyrightCOPYRIGHT 2006 Healthcare Financial Management Association. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group. (Hide copyright information)
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In recent years, managing a hospital's revenue cycle has become more than a dollars-and-cents proposition. Communication--between provider and payer organizations and between claims management and claims processing systems--has become increasingly important.
This level of communication can be quite complicated. The sheer volume and level of detail in the claims-related data that must be transmitted between payer and provider are overwhelming--patient demographics, diagnoses, treatments, tests, insurance identification, eligibility, coverage policies, medical necessity requirements, bundling rules, and so on. It's no wonder that problems crop up, information slips ...