-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: GEN: How do insurance carriers do this? (long) From: art fougner, md (evsono@pipeline.com) Mon Feb 28 05:50:00 2005 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Clinics Ask State Supreme Court To Block Kansas AG's Investigation Involving Medical Records of Women Who Had Abortions" Previous message: art fougner, md: "Re: GEN: How do insurance carriers do this? (long)" In reply to: GORDON M. GOLDMAN: "Re: GEN: How do insurance carriers do this? (long)" Next in thread: Garry E. Siegel, M.D.: "Re: GEN: How do insurance carriers do this? (long)" Which btw is patently illegal - hence the previous suits against the insurers - documentation of each and every incident and forwarding to both state medical society and state insurance dept is indicated. art At Sun, 27 Feb 2005, GORDON M. GOLDMAN wrote: > >Garry, > >I think there is something they use called "black box edits". It is a bundling/unbundling software package, but may also be used for this kind of thing. It ejects certain codes and diagnoses via a relational database and then sends to a 'human' for review, I suspect. > >Gordon > >"Garry E. Siegel, M.D." <garrys@mindspring.com> wrote: >Does anyone out there (lurkers, people associated with carriers) have >any idea of how it works, i.e my original post? > >Garry > >-- >Garry E. Siegel, M.D. >Private Practice >Roswell, GA > -- art fougner, md "If you don't know where you are going, you will wind up somewhere else." Lawrence Peter Berra Next message: art fougner, md: "Re: Clinics Ask State Supreme Court To Block Kansas AG's Investigation Involving Medical Records of Women Who Had Abortions" Previous message: art fougner, md: "Re: GEN: How do insurance carriers do this? (long)" In reply to: GORDON M. GOLDMAN: "Re: GEN: How do insurance carriers do this? (long)" Next in thread: Garry E. Siegel, M.D.: "Re: GEN: How do insurance carriers do this? (long)"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Fri May 2 04:39:59 2008

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.