Smith-Shoemake Mary Anne
Manag Care Q. 2002 Fall;10(4):13-4.
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.
医疗服务提供者一方面被要求提供更好的服务，同时还要控制成本；而理赔处理就是其中一项成本。从按人头计费转向“服务收费”计费结构的过程中，医疗服务提供者必须跨越诸多障碍，同时新的理赔支付及时性立法也存在潜在问题。本文提出了一些提高理赔流程效率的可能解决方案。
