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For example, if a customer files a lawsuit because they got injured when they slipped and fell in your store, business insurance can cover the costs of the suit, including your legal defense.
Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4] The payor returns the claim back to the medical biller and the biller evaluates how much of the bill the patient owes, after insurance is taken out.
Starting your own business requires a significant investment of both time and money. Millions of people continue to step up to the challenge with 33 million small businesses active in the U.S. as ...
Generally, there are more cases when you should file an auto insurance claim. Here are a few key examples: When you’ll save money. You should consider filing a car insurance claim whenever your ...
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...
The following examples illustrate the variety of workflows seen in various contexts: In machine shops, particularly job shops and flow shops, the flow of a part through the various processing stations is a workflow. Insurance claims processing is an example of an information-intensive, document-driven workflow. [21]
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