subject: Physician Peer Review For Insurance Companies [print this page] Government as well as private insurers have to process the medical claims submitted by physicians and provide them reimbursement. Physician peer review becomes an indispensable service for insurance companies that need to determine the validity of the claims. Usually, insurance companies appoint physicians to review and evaluate the medical records that support the claims. Organizing the voluminous medical records, extracting relevant information and analyzing it can be rather tedious. The unstructured data in patient medical records can be easily organized by professionals at a medical record review company. Structured data provides clarity and aids speedy decision making. Peer review services provided by a reliable firm are secure and scalable.
Organized and Professional Medical Review Services
Though there are a number of service providers in the industry now offering medical peer review, it is not easy to locate a trustworthy partnering firm. However, serious consideration of a few core aspects will surely help you in your search for the right provider.
The company you plan to outsource to should be able to ensure customized and flexible services catering to your requirements.
It should have skilled support staff and the latest innovative technology to provide structured peer review services.
The medical review firm you are partnering with should have outstanding QA measures in place to ensure accuracy and high quality medical review services.
Security and confidentiality measures implemented are an important consideration because you cannot afford to have any loss or leak of sensitive patient data.
Services that You Can Request from a Medical Review Company
Medical record organization you can have the records organized, imaged and indexed in electronic format that is perfectly compatible with your internal application/process flow.
Medical case chronology here all medical records are reviewed, analyzed, listed and summarized chronologically. It provides a clear timeline of all medical encounters relevant to a particular case.
Medical case summary extraction of important facts from the medical records and preparing concise summaries.
A medical review company proficient in the field can also identify missing records and erratic records easily, assisting in and speeding up the peer review process. It will bring you benefits in terms of improved management and maximum productivity. Insurance companies can save on money that could be spent on fraudulent claims. Other advantages offered include dedicated support staff, HIPAA compliance, round the clock customer service and competitive pricing. With the right physician peer review service, insurers can have easy access to the required information, and have a clear idea of the various medical claims submitted.
by: MOS
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