Follow-up Claims and Denial Management

[seemunkee]

As part of my job I search through the posting in FedBizOpps. Every once in a while something catches my eye that seems a bit odd. Today I spotted this posting:
http://www.fbo.gov/spg/VA/LBVANBC/VAMD/600%2D828%2D07AH/SynopsisR.html

The Veterans Affairs, Network 22 Logistics Office, is seeking sources for a potential contract to provide Accounts Receivable (A/R) Follow-up Claims Processing Services and Denial Management Software and Services, Outsourced Appeals and Conditions. The contractor will be required to provide the services for the VA Greater Los Angeles, VA Long Beach, VA San Diego, VA Southern Nevada, and VA Loma Linda Healthcare Systems.

I can understand a need for a Claims processing application but seeking a specific application for Denial Management seems wrong.

[Atman]

1. LOL! I drew this cartoon years ago...

HOO Cares!


"HOO Cares!" Copr. 2002 by RMcG

.

[Jackpine Radical]

3. Beautiful. Thx 4 sharing.

[Fridays Child]

2. It is precisely these sorts of expenditures which would virtually disappear...

...under comprehensive universal healthcare. Requests for vanity cosmetic surgery and other such things would probably be subject to denial but no legitimate medical condition would be excluded from coverage. Thus, there would be no need to devote large sums to processing denials.

I read, somewhere, that well over half of the cost of delivering health care, in this country is related to processing claims, determining eligibility, and so on. If that's true, then delivering services will not be nearly as expensive as the critics of universal health care want us to believe.

[Jackpine Radical]

4. That's why it costs us 15% of GDP for healthcare

while costs in the civilized world, the part that has universal healthcare, range from about 8 to 11%