What Factors Should Be Considered When Thinking About Cost Control

question 82

Essay

What factors should be considered when thinking about cost control strategies?

---

Definitions:

Approved Medical Bill

A health care invoice that has been processed and confirmed for payment by an insurance company or health plan.

Utilization Management (Review)

A process used in healthcare to optimize the use of resources and ensure that treatments provided to patients are appropriate, necessary, and efficient.

Managed Care

A health care delivery system designed to manage cost, utilization, and quality of health services.

Medical Necessity

A judgment by a healthcare provider that a specific treatment, test, or procedure is essential for diagnosing or treating a patient's condition in accordance with accepted standards of medical practice.