Unfortunately, the healthcare industry faces challenges with financial waste. It has been estimated that the healthcare system in the United States wastes approximately $765 billion annually, about 25 percent of what is spent. Part of this number is due to payment integrity issues such as fraud, waste and abuse (FWA). If you’re not familiar with […]
Human error is inevitable, especially when there are so many people and processes involved in a business. Administrative errors tend to be more apparent in the healthcare industry though, due to the risk of human lives at stake. Take a look at these statistics: Approximately 86 percent of mistakes made in the healthcare industry are […]
Our recent roundtable discussion revolved around what stewardship means to each individual and how Advanced Medical Reviews’ work represents careful and responsible management with our clients. See what the account management team at AMR—Natalya Dawkins (Senior Client Success Manager), Akina Lantow (Account Manager), Ally Michailov (Account Manager), Norma Nevarez (Senior Account Manager), Fabeha Khan (Account […]
The business world is full of acronyms. Terms such as ROI (return on investment), CMS (content management system), CPL (cost per lead), KPI (key performance indicator) and API (application program interface) are discussed by many working professionals on a regular basis. Two well-known acronyms for health plans and payers are IME, otherwise known as independent […]
Clear communication is essential in many facets of life. Whether it’s a teacher telling students about classroom rules or a physician explaining a diagnosis to a patient, providing easy-to-understand direction is important. This need for clear and open communication is evident in the healthcare industry because it can make the difference in outcomes, patient safety, […]
In a study conducted by The Journal of Healthcare Information Management, it was discovered that 86 percent of mistakes made in the healthcare industry are administrative. These small administrative mistakes, whether it’s the misspelling of a name or a misrecorded number, can have a major effect when they go unnoticed. With the fast-paced and, at […]
The healthcare industry continues to be one of the fastest growing industries in the United States and is the largest source of jobs in the country. That’s not surprising as U.S. healthcare spending is approximately $3.3 trillion or $10,348 per person annually. According to the Peterson-Kaiser Health System Tracker, relative to the size of its […]
For years, the number of practicing physicians in the U.S. has not maintained pace with the rising demand for medical services. This trend has created a physician shortage, with consequences extending far beyond the doctor’s office to essential workflows throughout the American healthcare system, including the medical review process. The Association of American Medical Colleges […]
Now that suitable supporting infrastructure is more readily available, VR is rapidly taking root in healthcare.
Wondering where an IRO fits into the external review process? How about whether an RN versus an MD can approve or deny a case? Check out our infographic on The Life of a Group Health Case to learn about physician-level reviews and the role of an IRO in Group Health plans!