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Payors evaluate claims by verifying the patient's insurance details, medical necessity of the recommended medical management plan, and adherence to insurance policy guidelines. [4] The payor returns the claim back to the medical biller and the biller evaluates how much of the bill the patient owes, after insurance is taken out.
Chief medical officer (CMO) is the title used in many countries for the senior government official designated head of medical services, sometimes at the national level. The post is held by a physician who serves to advise and lead a team of medical experts on matters of public health importance.
Unwarranted variations in medical practice refer to the differences in care that cannot be explained by the illness/medical need or by patient preferences. The term “unwarranted variations” was first coined by Dr. John Wennberg when he observed small area (geographic) and practice style variations, which were not based on clinical rationale. [5]
The hospital prepares itself, its teams, and everyone in the organization. The first step is making the staff aware of the need and how to go about it. The management has to keep interacting with them. The entire hospital team is geared up for this exercise. It is doing the tasks, in a properly defined manner. The hospital set up a Quality ...
Hospital Case Managers are professionals in the hospital setting who ensure that patients are admitted and transitioned to the appropriate level of care, have an effective plan of care and are receiving prescribed treatment, and have an advocate for services and plans needed during and after their stay.
A contract manufacturing organization (CMO), more recently referred to (and more commonly used now) as a contract development and manufacturing organization (CDMO) to avoid the acronym confusion of Chief Medical Officer or Clinical Monitoring Organization in the pharma industry, is a company that serves other companies in the pharmaceutical industry on a contract basis to provide comprehensive ...
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Chief medical officer, the senior government official designated head of medical services; Chief merchandising officer; Collateralized mortgage obligation, a type of complex debt security; Contract manufacturing organization, a pharmaceutical manufacturing outsourcing organization