Cost Containment
QHM cost-containment services address and apply to the entire medical event -
before, during and after:
Before the Medical Event
-
Pre-certification and Admission Authorization - Network Identification and Negotiation
- Cost Estimate of Care
- Medical Second Opinions
- Catastrophic Case Identification
-
Case Management
- Assessment
- Treatment Planning
- Case Evaluation
- Treatment Plan Evaluation (Oncology)
- Interim claims review
- Claims Review
- Claims Revisions & Corrections
- Claims Re-pricing
- Claims Adjudication
- Reinsurance Reporting