Home
Solutions
Products
Pricing
Resources
Request Demo
Start Free
Menu Search Account

LegiStorm

Get LegiStorm App Visit Product Demo Website
» Get LegiStorm App
» Get LegiStorm Pro Free Demo
StateStorm

Weekly Updates

LegiStorm is constantly adding new information on the people, places and reports in our database. In the past week, LegiStorm added:

  • 1865 new people
  • 34 new organizations
  • 622 new photos
  • 1247 job history records for people in our database
  • 518 education records for people in our database
  • 2209 contact addresses, emails and URLs (LinkedIn, Facebook, etc.)
  • 198 new policy reports
  • 12 new trips to our privately funded travel database
  • 921 new personal financial disclosures
  • 27459 new press releases
  • 30 new town halls

Caught Our Eye Rss

» More from Caught Our Eye
» More from our DevBlog

Medicare Part B: Reliability of Claims Processing Across Four Carriers

  Premium   Download PDF Now (38 pages)
Report Type Reports and Testimonies
Report Date Aug. 11, 1993
Report No. PEMD-93-27
Subject
Summary:

How fair is the process used by insurance companies to approve or deny Medicare Part B claims? In its review of four insurance companies, GAO found that the computer programs used to evaluate claims produced consistent results and were economical. The programs, however, were not equipped to handle claims involving more subjective criteria, such as deciding whether medical care is appropriate or not. These cases were delegated to claims examiners, typically high-school graduates with no medical background who were expected to decide whether doctors' services were "medically necessary" on up to 400 claims daily. GAO concludes that three factors taken together--the time constraints under which decisions about medical necessity were made, the decentralized way in which medical policies were being developed and instituted, and weaknesses in some quality control methods--raise doubts about the system's ability to treat Medicare claims consistently.

« Return to search Government Accountability Office reports

HomeAbout Us Contact UsPrivacy PolicyTerms of UseJoin Us
© LegiStorm
LegiStorm
2101 L St. NW, Suite 300
Washington, DC 20037
(202) 360-4172 / congress@legistorm.com