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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 ...
As a savvy consumer, a chargeback is one of the many options in your tool kit. Through a chargeback, you can recoup lost funds due to a merchant error, product return or downright fraud.But there ...
The generic model used in the United States is the chronic care model, which holds that health care does not only involve change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in ...
A complaint system (also known as a conflict management system, internal conflict management system, integrated conflict management system, [1] or dispute resolution system) is a set of procedures used in organizations to address complaints and resolve disputes.
All of this makes chargebacks a potent tool in the consumer's arsenal, to the point that the mere threat of going to your bank and requesting a chargeback may be enough to resolve the dispute in ...
Medical case management is a collaborative process that facilitates recommended treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals. It is a role frequently overseen by patient advocates .
ODR was born from the synergy between ADR and ICT, as a method for resolving disputes that were arising online, and for which traditional means of dispute resolution were inefficient or unavailable. [ 8 ] : 9 The introduction of ICT in dispute resolution is currently growing to the extent that the difference between off-line dispute resolution ...
A hospital information system (HIS) is an element of health informatics that focuses mainly on the administrational needs of hospitals.In many implementations, a HIS is a comprehensive, integrated information system designed to manage all the aspects of a hospital's operation, such as medical, administrative, financial, and legal issues and the corresponding processing of services.
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