Global Surgical Package Fraudulent Billing
Sometimes the most innocuous conversations with family, friends and coworkers can lead to a major finding for medical billing fraud. Take the example of simply talking to your coworker in the next cube about a suspicious provider billing situation. To your surprise, you find out your coworker is having the same suspicion about the same provider on other auto first party claims. What ends up happening is a pervasive situation of intentional fraud uncovered by one conversation. This is exactly what occurred in identifying “Global Surgical Package Fraudulent” billing scenarios.
CPT Code Changes for 2018: Things to Look Out For
A new year means new Current Procedural Terminology (CPT) code changes! There are a total of 314 code changes in the 2018 code set, and with 2018 just around the corner, it’s time to start thinking about how these changes will impact the casualty industry.
Texas Farm Bureau Insurance Puts Customer Service in the Driver’s Seat with Improved Workflow Processing
For more than 50 years, families have relied on Texas Farm Bureau Insurance to help them manage risk in their everyday lives. The company occupies a unique market position, serving customer communities where people’s reputations are based on trust and agreements are often sealed with a handshake. Texas Farm Bureau has thrived by emphasizing high-touch, personalized service as an operational hallmark, inspiring many customers to traditionally hand down their memberships to offspring.
Managing Medical Records is Key to Improving Third Party Claim Settlements
Documents that adjusters receive from attorneys or claimants related to third party claims are typically unorganized, inaccurately coded and seemingly stacked a mile high. It can feel like an insurmountable challenge to organize, digitize and understand every detail of the medical records, but processing a claim without first organizing, capturing the data and properly coding documents can make it difficult for an adjuster to efficiently reach the most accurate settlement.
From FNOL to Settlement: Improving Third Party Claims with Data Driven Decisions
Effectively adjudicating third party auto casualty claims can be a complex web of analysis and decision-making that challenges even the most experienced adjusters. Each of the many decisions made during the lifecycle of a third party claim can potentially affect the outcome—for better or for worse.
How Enterprise Companies Are Choosing the Right Hybrid Cloud Architecture
IDC predicts that more than 80 percent of enterprise IT organizations will commit to hybrid cloud architectures by 2017. And it’s recently been reported that Uber, the ride-hailing app, is moving in that direction. According to Business Insider, Uber is soliciting bids from Google, Microsoft, and Amazon in order to move some parts of its code to the cloud.
Insurance Chatbots Are Transforming The Industry With Automation
Bots are cropping up everywhere. Just six months after their launch on Facebook Messenger, there were 34,000 of them on the platform. But just what are they and why do they matter? First, it’s important to understand that the term ‘bot’ encompasses many different types of technology, and the technologies themselves serve a huge range of purposes—from rules-based robotic processing automation (RPA) for automating back-office processes that would ordinarily have to be done by a person, to complex, AI-powered, human personas serving as customer service agents.
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