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PubMed · 12561389

Solving the claims conundrum.

Mary Anne Smith-Shoemake
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Abstract

Healthcare providers are being pushed to provide better service, yet maintain costs; and one of those costs is claims processing. There are many hurdles providers must jump over in the transition from capitation to "fee for service" billing structures, as well as potential issues surrounding new claim payment timeliness legislation. This article presents some possible solutions for making the claims process more efficient.

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Capitation FeeContract ServicesEfficiency, OrganizationalFee-for-Service PlansFinancial ManagementHumansInsurance Claim ReviewManaged Care ProgramsReimbursement MechanismsUnited StatesJournal Article

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Mary Anne Smith-Shoemake. 2002. Solving the claims conundrum.. https://pubmed.ncbi.nlm.nih.gov/12561389/

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