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  1. 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
  2. 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
  3. 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
  4. 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
  5. 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.
  6. 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.
  7. 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
  8. 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
  9. 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
  10. 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
  11. 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
  12. A_ReferenceLibrary (pdf file)

    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
  13. 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
  14. A_ReferenceLibrary (pdf file)

    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
  15. 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
  16. 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
  17. 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
  18. 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.
  19. 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
  20. 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.

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