Navigation Links
In-Depth Health Claim Review Saves Client Up to $15,000 on Surgery that Fails to Meet Standards for Medical Necessity
Date:9/30/2013

Appleton, WI (PRWEB) September 30, 2013

Health care waste continues to be a growing problem in the U.S. with medical necessity as one of the core issues related to overspending. Today, more than ever before, consumers are undergoing tests, surgeries and procedures that aren’t considered necessary.

The Argus Claim Review division of Cypress Benefit Administrators is working to change this. It aims to proactively prevent these unnecessary medical treatments and uncover other costly health claim discrepancies to save employer-clients from excessive charges.

In a recent example, Argus Claim Review received a health claim that included electrodiagnostic (EDX) testing for a plan member with a resulting primary diagnosis of carpal tunnel syndrome (CTS). After two board-certified medical professionals further reviewed the case, there was insufficient documentation to warrant the EDX testing and the CTS diagnosis was deemed inconclusive.

The bilateral surgery recommended – carrying an average price tag of $10,000 to $15,000 – was also found to be unnecessary.

Tom Doney, president and CEO of employee benefits specialist Cypress Benefit Administrators, said that these types of cases are becoming all too common in the health care industry. “Our medical claim review specialists have always been meticulous about catching the typical coding and billing mistakes, but in recent years, they’ve had to start considering medical necessity as part of the equation.”

Upon seeing the CTS diagnosis and noting the lack of a full neurological exam after referral, an in-depth claim investigation by Cypress’s URAC-accredited partners was prompted by the Argus team. With several years of medical claim revie
'/>"/>

Source: PRWeb
Copyright©2012 Vocus, Inc.
All rights reserved

Page: 1 2 3

Related medicine news :

1. CBT News Announces In-Depth Coverage of NADA Convention in New Orleans
2. AED.com Releases In-Depth Buyer's Guide
3. Info Security Leader Larry Brock to Provide In-Depth Insight on How to Protect Intellectual Property Against Insider and Cyber Threat
4. Report offers an in-depth examination of health centers role in family planning
5. Society of Interventional Radiologys new IR Quarterly focuses on features, in-depth news
6. Knoji Launches In-Depth Consumer Report Covering Leading DNA Testing Services.
7. AIUM 2013 Annual Convention provides an in-depth look into ultrasound first
8. "What is FOMO? – Social Media & Mental Health" Article Released by Birmingham Maple Clinic
9. Hormone Treatments / Diet Doc Hormone Diets & Weight Loss Plans Reveals the Keys to Extreme Weight Loss Diet Plans for Improved Knee Health and Less Knee Pain
10. Diet Doc Hormone Diets & Weight Loss Plans Introduce New Appetite Suppressants that Encourage Patients to Eat Healthy Food for Fast Weight Loss
11. Voxiva, Leader in Mobile Health and Wellness, Reaches Milestone
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/6/2015)... As Hilo Medical Center progressed ... Model, the hospital looked for new applications that ... processes. The leadership team realized that while many ... patient registration still required patients to apply ink-on-paper ... Stage 7 attestation fast approaching, Hilo looked for ...
(Date:5/6/2015)... 2015 Qushanna Doby (20) was arrested for ... treatment center in Florida while under the influence of Flakka, ... surveillance tapes released by CBS4’s Peter D’Oench records Doby distraught ... child is around one year old. The drug treatment center ... was not named. The residents polled by CBS Miami express ...
(Date:5/6/2015)... Chesapeake, Va. (PRWEB) May 06, 2015 ... hospital in the state of Virginia to acquire ... Vinci® surgical robot. The system upgrade includes enhanced ... many minimally invasive procedures across a wide spectrum ... surgical options, reduced pain and quicker recovery times. ...
(Date:5/6/2015)... May 06, 2015 Baptist Medical ... the first in north Florida and southeast Georgia ... the latest innovation in total hip replacement surgery ... surgeon-controlled robotic arm that enables the accurate alignment ... Jacksonville has offered MAKOplasty® partial knee resurfacing using ...
(Date:5/6/2015)... Animals make just as good friends as they do pets. ... An Ohio veterinarian has been observing this for ... advantages of owning a pet. , “When animals and humans ... there are proven health benefits for people-- including physical, mental ... Animal Medical Center of Streetsboro said. Every May, ...
Breaking Medicine News(10 mins):Health News:Access Electronic Patient Signatures Help Hilo Meet HIMSS Stage 7 Paperless Targets & Save $200,000 a Year on Consent Forms 2Health News:Access Electronic Patient Signatures Help Hilo Meet HIMSS Stage 7 Paperless Targets & Save $200,000 a Year on Consent Forms 3Health News:Flakka Induced Mother Abandons Baby, found by Florida Drug Treatment Center; New Video Released 2Health News:Chesapeake Regional Medical Center Obtains First da Vinci® XI Robotic Surgical System in Virginia 2Health News:Chesapeake Regional Medical Center Obtains First da Vinci® XI Robotic Surgical System in Virginia 3Health News:Baptist Health and Jacksonville Orthopaedic Institute Offering MAKOplasty® Total Hip Replacement 2Health News:Baptist Health and Jacksonville Orthopaedic Institute Offering MAKOplasty® Total Hip Replacement 3Health News:Baptist Health and Jacksonville Orthopaedic Institute Offering MAKOplasty® Total Hip Replacement 4Health News:Veterinarian Supports 2015 HABRI Study Citing Increase in Health Advantages of Pet Owners 2Health News:Veterinarian Supports 2015 HABRI Study Citing Increase in Health Advantages of Pet Owners 3
... laser treatment, study finds , WEDNESDAY, Nov. 7 (HealthDay ... drug fenofibrate reduces the need for laser treatment for ... blindness among working-age adults worldwide. , Australian researchers studied ... who received either 200 milligrams per day of fenofibrate ...
... on their beliefs helped them stick to medication regimen, ... Spirituality helps older black American women with high blood ... condition under control, new research suggests. , Older black ... either younger blacks or white patients, even though adherence ...
... Inc., a national healthcare,management and technology company, ... to provide Revenue Cycle Management (RCM), ASP,Practice ... services. Molina Healthcare of California is ... patients who have traditionally faced barriers,to quality ...
... DIEGO, Nov. 7 CryoCor, Inc. (Nasdaq:,CRYO), a medical ... today that it will release its financial results for,the ... 2007 after,the close of the U.S. financial markets. ... call at 5:00 p.m. ET /,2:00 p.m. PT on ...
... Nov. 7 LeMaitre Vascular,Inc. (Nasdaq: LMAT ... implants for the treatment of peripheral vascular disease, ... Cardiovascular,Conference on Tuesday, November 13, 2007, in New ... B. Roberts, President of LeMaitre Vascular, will provide ...
... JumpStart Inc., Northeast Ohio,s,venture development organization ... Aria Analytics, Inc. Aria is a Cleveland-based ... physical and chemical,attributes of liquids based on ... during evaporation. (Logo: http://www.newscom.com/cgi-bin/prnh/20060209/CLJUMPSTARTLOGO ...
Cached Medicine News:Health News:Diabetes Drug Helps Protect Patients' Eyes 2Health News:Spirituality Helps Older Black Women Beat Hypertension 2Health News:Molina Medical Group Selects MED3OOO 2Health News:CryoCor Announces Web cast and Conference Call of Third Quarter 2007 Results 2Health News:Aria Analytics Receives JumpStart Investment 2Health News:Aria Analytics Receives JumpStart Investment 3
(Date:5/6/2015)... 2015  Rigrodsky & Long, P.A.: , Do you, ... AERI )? , Did you purchase your shares between ... you lose money in your investment in Aerie Pharmaceuticals, Inc.? ... Rigrodsky & Long, P.A. , including former Special Assistant ... complaint has been filed in the United States District Court for ...
(Date:5/6/2015)... 2015  Membership in Medicare Supplement plans continued ... Business Strategy report released by Mark Farrah Associates ... or Med Supp plans, covered approximately 11.2 million ... increase from 2013. Between 2013 and 2014, enrollment ... lives.  Though UnitedHealth was the segment growth leader, ...
(Date:5/6/2015)... 6, 2015  LumiThera Inc., a medical device company ... for ocular disorders and disease, today announced Retired Congressman ... Advisory Board to assist in the company,s mission to ... Dicks was the U.S. Representative for Washington,s ... 2013. He is a member of the Democratic Party. ...
Breaking Medicine Technology:SHAREHOLDER ALERT: Rigrodsky & Long, P.A. Announces A Securities Fraud Class Action Lawsuit Has Been Filed Against Aerie Pharmaceuticals, Inc. 2SHAREHOLDER ALERT: Rigrodsky & Long, P.A. Announces A Securities Fraud Class Action Lawsuit Has Been Filed Against Aerie Pharmaceuticals, Inc. 3Continued Growth in Med Supp Market for 2014 according to Mark Farrah Associates 2Retired Congressman Norman Dicks Joins LumiThera's Advisory Team 2
... mirrored surfaces, which each incline at an ... have been cut into the 17 mm ... to examine the opposite iridocorneal angle without ... form of the angle of the iris ...
... examination of the anatomical conditions in the area ... and form of the iridocorneal angle can only ... The slit lamp 900, with its swivelling and ... assessment of the expanse of the entire angle ...
An antegrade femoral nail....
... the latest in the Magnes line of biomagnetometer ... its full cortical coverage, provides the highest detector ... study of a wide range of neuronal activity. ... of detector configurations and can be equipped with ...
Medicine Products: