ARGUS Advantage Series: ARGUS Claim Review - a division of Cypress Benefit Administrators - guards against costly healthcare billing errors, issues with medical claims processing and other claim system deficiencies. Learn more about how this industry-leading system works via this series of occasional articles.
Provider Websites Can Offer Vital Clues
Medicine is, for better or worse, a business in today's age, and not all businesses are created equally or run with the best interests of their clients as their foremost concern. Unfortunately, there are segments of the provider population whose ultimate goal is to generate revenue by ordering medically unnecessary tests, performing medically unnecessary procedures and the like. A question often asked of those of us on the payer side of the coin is how we recognize abhorrent behavior on the provider side. Sometimes, the answer is to look at the provider's own website. There are a number of 'red flags' you can look for in helping to determine if recommended care might be deemed not medically necessary or an accepted standard of care. Learn more. <back to top> |