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It's a question of what we want to measure. There's a metric that represents how much a claimant sees in unexpected costs due to denied claims vs impact on care
by adleyjulian 2y ago
It's a question of what we want to measure. There's a metric that represents how much a claimant sees in unexpected costs due to denied claims vs impact on care from the insurer.
A denied prior auth results in no unexpected costs but perhaps a change or delay in care.
A denied claim to an in network hospital may result in the provider losing revenue but nothing for the claimant.