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Frequency and costs associated with laboratory test repetition in trauma patients undergoing interfacility air EMS transport by SH Thomas; J Orf; C Peterson; S Wedel is a Medicine article available to read on EtoBox.

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Each record was reviewed using 2 different techniques to determine whether or not the claim should be paid by insurance. Under the "symptom-based" system, all ~5sits with nursing triage levels of Immediate/Emergent were approved automatically. Those with triage levels of Delayed/Nonurgent were reviewed by an emergency physician and approved if they were considered an emergency under the state's Access to Emergency Services Act. A second claims adjudication, independent of these initial results, was then performed using a "diagnosis-based" technique that divided the records into "pay," "deny," and "review" categories using a hst of International Classification of Diseases--ninth revision codes currently used by the MCO. The results of the 2 techniques were compared. Results: A total of 1,830 records were reviewed; 836 (46%) were triaged Immediate/Emergent, and 994 (54%) as Delayed/Nonurgent. Of these 994 records. physician review determined that 607 (61%) met the prudent layperson standard and 387 (39%) did not. The symptom-based system determined that 1,443 (78.8%) of 1,830 of the visits should be approved for insurance coverage. The diagnosis-based system placed 966 (53%) on the "

Who reads Frequency and costs associated with laboratory test repetition in trauma patients undergoing interfacility air EMS transport?

Author

SH Thomas; J Orf; C Peterson; S Wedel

Publisher

Elsevier Science; Elsevier ; Mosby Inc.; Elsevier BV (ISSN 1097-6760)

Published

1999

Language

EN

Field

Medicine (Health Sciences)