它究竟还能不能被称作是一个"平均转嫁风险"的工具. 直接理解成“平均分摊cost”可能还容易点.最初的healthcare insurance还没有和传统定义上的保险(即平摊随机的风险)离开太远, 那个时候保险公司肯定是有用的, 因为他们可以有效的帮助社会形成pool. 但是现在, 因为我上面说的种种原因, health...
healthcare provider EBM (1) One who directly or indirectly administers interventions that are designed to improve the physical or emotional status of patients; or (2) A person licensed, certified, or otherwise authorised or permitted by law to administer healthcare in the ordinary course of busin...
of one or more of the variables in more than one of the healthcare insurance claims is indicative of fraud or error based on levels of co-occurrence of the one or more pairs of variables in historical healthcare insurance claims being initiated by a single healthcare service provider. Subsequ...
Industry-leading healthcare insurance companies rely on the HCFSPlatform™ for Payment Integrity, Cost Containment, and Fraud, Waste, Abuse and, Error (FWAE) todeliver millions of dollars in savings, recoveries, andprevented losseach year —a critical component of your company’s cost savings st...
Healthcare programs and insurance initiatives play a crucial role in ensuring that people have access to medical care. There are many benefits of healthcare insurance programs but fraud in healthcare continues to be a significant challenge in the insurance industry. Healthcare insurance fraud detection...
Senate Finance Chair Ron Wyden told Axios he wants to combine an extension of the enhanced subsidies witha bill he’s sponsoredthat would crack down on unscrupulous insurance brokers, to help counter GOP arguments about fraud. “I think it would be a real good package to crack down on these...
We apply effective cost containment and fraud prevention methods to drive your savings. Proven leader Financially strong company with A+ Superior, A.M. Best rating. Number 1 insurance brand by Interbrand for the fifth year running Flexibility ...
Physicians can face criminal penalties, incur monetary fines, and risk loss of professional licenses if they violate federal fraud and abuse statutes. Here’s a breakdown of the three most prominent federal laws. The False Claims Act (FCA) makes it illegal for a health care provider to submit...
Health Plans, Insurance Companies and Risk-Bearing Organizations Hospital Systems – Academic, Nonprofit, Religious and For-Profit Physicians and Dental Practices IPA, CIN and ACO Networks Digital Health, Telehealth, Healthcare Information Technology, Artificial Intelligence Healthcare Facilities, ASCs, Urge...
John Maynard is an expert in fraud and risk, specializing in healthcare and government. Serving in government for nearly 25 years, he has a broad background in federal, state and local programs. A former auditor, John has experience with healthcare providers, banking, insurance and financial ...