Situation A local Managed Care Organization (MCO) was inappropriately reimbursing providers for unauthorized and non-covered services. The MCO approached AArete to conduct a comprehensive system configuration review of benefits and prior authorization. Approach AArete documented the state and MCO’s policies and compared it to the prior authorization setup and benefits configuration setup. For all discrepancies…
This website uses cookies to improve site functionality, provide you with a better browsing experience, and serve more relevant content to you. These cookies collect information on your interactions with our site including the pages you visit, the links you click on and how long you are on our site. This website also uses cookies to help us deliver more targeted ads and assess the performance of ad campaigns.
AArete may collect, store or accumulate data about your usage of this website. This data may be shared or transferred to third parties, as defined in the Third Parties section of our Privacy Policy. Some cookies used on this site are from Third Parties. These Third Party cookies are used to provide us with analytics and intelligence about usage of our site. By continuing to use this website you are consenting to our use of cookies.
This website uses cookies to improve site functionality, provide you with a better browsing experience, and serve more relevant content to you. These cookies collect information on your interactions with our site including the pages you visit, the links you click on and how long you are on our site. This website also uses cookies to help us deliver more targeted ads and assess the performance of ad campaigns.
AArete may collect, store or accumulate data about your usage of this website. This data may be shared or transferred to third parties, as defined in the Third Parties section of our Privacy Policy. Some cookies used on this site are from Third Parties. These Third Party cookies are used to provide us with analytics and intelligence about usage of our site. By continuing to use this website you are consenting to our use of cookies.
