-
digital.ahrq.gov/sites/default/files/docs/citation/ahrq-step-up-app-challenge-summary-2019.pdf
January 01, 2019 - • Leverages cliexa’s exclusive library of clinically validated
assessments, connected device and claims
-
digital.ahrq.gov/sites/default/files/docs/page/remote_disease_monitoring__challenges_and_opportunities_for_medicaid___schip_agencies_5.pdf
November 19, 2008 - Research and Quality
Iowa Medicaid Enterprise (IME)
■ Transition to Management of Health Care
□ Pay Claims
-
digital.ahrq.gov/sites/default/files/docs/page/improving_quality_through_health_it_and_hie_in_medicaid_schip_programs__5.pdf
November 19, 2008 - Research and Quality
Iowa Medicaid Enterprise (IME)
■ Transition to Management of Health Care
□ Pay Claims
-
digital.ahrq.gov/sites/default/files/docs/20090121_Practical_Solutions_Transcript.pdf
May 08, 2008 - reimbursement strategies, etc., and that a lot of the data collected,
historically, has been about claims … The information collected is usually for claims data. … To
what extent does the individual have access to important information, like claims data, or
restrictions … team in Madison is suggesting that this is a
separate skill, much like understanding your insurance claims
-
digital.ahrq.gov/sites/default/files/docs/biblio/09_0083_EF.pdf
June 01, 2009 - Measurement: The number of claims rejected is reduced post-implementation. … For example, does the billing department already measure the number of claims
rejected? … see page
32: Infoway Report
Prescribing
patterns of
cost-effective
drugs
Efficiency Pharmacy claims … Improved billing compliance
and reduced claims denial
may improve the accounts
receivable on the balance … Utilize claims data to determine
the number of duplicate film
requests over a specified period.
-
digital.ahrq.gov/sites/default/files/docs/page/health-information-technology-evaluation-toolkit-2009-update.pdf
January 01, 2009 - Measurement: The number of claims rejected is reduced post-implementation. … For example, does the billing department already measure the number of claims
rejected? … see page
32: Infoway Report
Prescribing
patterns of
cost-effective
drugs
Efficiency Pharmacy claims … Improved billing compliance
and reduced claims denial
may improve the accounts
receivable on the balance … Utilize claims data to determine
the number of duplicate film
requests over a specified period.
-
digital.ahrq.gov/sites/default/files/docs/page/final-eqm-report-6-21-12.pdf
May 01, 2012 - clinical quality
measurement involve labor-intensive, time-
consuming manual chart reviews, analysis of claims … using these approaches as the costs of
manual review may be prohibitively expensive, the
analysis of claims … would be difficult if not impossible to implement
efficiently through chart review and/or analysis of
claims
-
digital.ahrq.gov/ahrq-funded-projects/evaluating-smart-forms-and-quality-dashboards-electronic-health-record-ehr
January 01, 2023 - Most information on clinical quality is currently based on claims data, which are retrospective and don't
-
digital.ahrq.gov/sites/default/files/docs/page/evaluating_health_it_projects___a_primer_for_medicaid_and_schip_5.pdf
June 02, 2008 - times
Time to administer medications
Time spent per patient
Financial Impact
Decrease in claims
-
digital.ahrq.gov/sites/default/files/docs/page/health_it_regulations__initiatives___opportunities_5.pdf
April 29, 2009 - covered for insurance: clinical decision support
■ Capable providers who will provide the benefits:
claims
-
digital.ahrq.gov/sites/default/files/docs/page/2-CDSC-Legal_Issues.pdf
January 01, 2011 - ’s Liability
• Software is a product and thus defective software is subject to product
liability claims
-
digital.ahrq.gov/sites/default/files/docs/page/A_ReferenceLibrary_1.pdf
February 16, 2006 - Summary: MedsInfo-ED is a proof-of-concept clinical data exchange project that uses
prescription claims
-
digital.ahrq.gov/sites/default/files/docs/page/Crandall.ppt
September 01, 2005 - of errors
Finance
Reduction in bad debt
Reduction in operational write-offs
Percentage of clean claims
-
digital.ahrq.gov/sites/default/files/docs/page/A_ReferenceLibrary_0.pdf
February 16, 2006 - Summary: MedsInfo-ED is a proof-of-concept clinical data exchange project that uses
prescription claims
-
digital.ahrq.gov/sites/default/files/docs/20080630%20Community-Based%20HIT%20transcript.pdf
November 08, 2005 - Are your claims
collaborative? … robust and vendor community, including the private sector for EHR,
vendors, providers of information claims … streamlining the
communications between the physician office and the pharmacy, lowering
the cost of claims
-
digital.ahrq.gov/sites/default/files/docs/publication/r18hs017067-kaushal-final-report-2011.pdf
January 01, 2011 - that the data would be
collected from manual chart review, which is laborious and expensive, or from claims … EHRs, which could ultimately be less
expensive than manual review and more clinically nuanced than claims … Specifications for numerators and denominators that were developed
for claims or manual sources may
-
digital.ahrq.gov/sites/default/files/docs/page/guide-to-evaluating-hie-projects-section-6.pdf
November 14, 2014 - Considerations Resources
• Impact on
duplicate
laboratory
tests
• Pre- and post-
implementation
review of
claims … This resource
is freely
available.
34
• Percentage
of claims
denied
• Efficiency
(from
providers … The
pre-HIE group
may need to
be separated
into paper-
based vs. other
electronic claims
submission
-
digital.ahrq.gov/sites/default/files/docs/QA_06232009.pdf
June 23, 2009 - NACDS (National Association
of Chain Drug Stores) claims that the average profit per script is $.84.
-
digital.ahrq.gov/health-it-improved-chronic-disease-management
January 01, 2023 - Grantees recommend that organizations considering COTS systems balance a vendor's claims with the experiences
-
digital.ahrq.gov/sites/default/files/docs/page/CongressionalBudgetOffice.pdf
January 01, 2009 - Payers in some markets have been reluctant to share
claims data and other information, fearing that … (such as measures of health status or test results) that
is typically not contained in insurance claims … PHRs may and frequently do include data on insurance
claims for medical services that the patient has … (Some he alth insurance plans now provide PHRs to their
members and insert their claims data.) … It includes whatever data are available to the
health plan but primarily those related to claims.