Automated review definition

Automated review means a claim review made at the system level without a human being reviewing the medical record.
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Automated review means a claim review that is made at the system level without a human being
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Examples of Automated review in a sentence

  • Automated review of electronic health records to assess quality of care for outpatients with heart failure.

  • Automated review, such as the use of scripts to identify certain unauthorized or high risk activity should be used wherever possible to cut back on personnel time and log retention requirements.

  • Automated review occurs when a Recovery Auditor makes a claim determination at the system level without a human review of the medical record.

  • Automated review of the information on the DOE and DOE-contractor Web pages is necessary because many users are encouraged by their management to “publish” and share the results of their work.

  • Collection rates continue to show modest improvements so far this year assisted by additional recovery work partly funded for the second year by Worcestershire County Council.

  • An Automated review will occur when the RAC makes a claim determination by reviewing claims data rather than clinical documentation from the medical record.

  • Moreover, automated QA review is a definitively “green” undertaking, in that it will eliminate printing and archiving of more than 7000 pieces of paper per year.Conclusions: Automated review of LIS QA reports was accomplished using a custom computer program performing text analysis.

  • Automated review The Recovery Auditor shall communicate the results of each automated review that results in an overpayment determination by letter or through a secure provider portal.

  • Baker DW et al (2007) Automated review of electronic health records to assess quality of care for outpatients with heart failure.

  • King claims that Ruiz suspended King for a week in retaliation for alleging that he was treated differently based on his race/color.

Related to Automated review

  • Expedited review means an examination, in accordance with

  • Automated drug dispensing system means a mechanical or electronic system that performs

  • Utilization review means the prospective (prior to), concurrent (during) or retrospective (after) review of any service to determine whether such service was properly authorized, constitutes a medically necessary service for purposes of benefit payment, and is a covered healthcare service under this plan. WE, US, and OUR means Blue Cross & Blue Shield of Rhode Island. WE, US, or OUR will have the same meaning whether italicized or not. YOU and YOUR means the subscriber or member enrolled for coverage under this agreement. YOU and YOUR will have the same meaning whether italicized or not.

  • Automated external defibrillator or “AED” means an external semiautomatic device that determines whether defibrillation is required.

  • Certified automated system means computer software certified under the agreement to calculate the tax imposed by each jurisdiction on a transaction, determine the amount of tax to remit to the appropriate state, and maintain a record of the transaction.

  • Automated data acquisition and handling system or "DAHS" means that component of the continuous emission monitoring system, or other emissions monitoring system approved for use under section 11 of this rule, designed to interpret and convert individual output signals from pollutant concentration monitors, flow monitors, diluent gas monitors, and other component parts of the monitoring system to produce a continuous record of the measured parameters in the measurement units required by section 11 of this rule.

  • Verification Report As defined in Section 4.19.

  • Valuation manual means the manual of valuation instructions adopted by the NAIC as specified in this section or as subsequently amended.

  • Periodic Review means a review conducted by Ofwat for the purpose of determining one or more Price Controls in accordance with Part III of Condition B, but so that references in Part IV of Condition B to a Periodic Review shall exclude any review carried out under paragraph 11 of that Condition and shall include the determination by the Competition and Markets Authority of the relevant questions or, as the case may be, the disputed determination referred to it under paragraph 16 of Condition B;

  • User Manual means the user guide, Help Guide, documentation provided with the Software, updated agreements provided on the website of Quick Heal (xxx.xxxxxxxxx.xxx), explanatory or other materials as provided from time to time by Quick Heal.

  • Utilization review plan or "plan" means a written procedure for performing review.

  • Automated driving system means the same as that term is defined in Section 41-26-102.1.

  • Verification system means the system maintained by the department under section 19-24.1-31 for verification of registry identification cards.

  • Busy Line Verification (BLV) means a service whereby an End User requests an operator to confirm the busy status of a line.

  • Drug utilization review means an evaluation of a prescription drug order and patient records for

  • Records Review means any assessment the Province conducts pursuant to section A.7.4 (Records Review).

  • Application Review Start Date means the later date of either the date on which the District issues its written notice that the Applicant has submitted a completed Application or the date on which the Comptroller issues its written notice that the Applicant has submitted a completed Application and as further identified in Section 2.3.A of this Agreement.

  • Quality Assurance Program means the overall quality program and associated activities including the Department’s Quality Assurance, Design-Builder Quality Control, the Contract’s quality requirements for design and construction to assure compliance with Department Specifications and procedures.

  • Diagnostic clinical procedures manual means a collection of written procedures that describes each method (and other instructions and precautions) by which the licensee performs diagnostic clinical procedures; where each diagnostic clinical procedure has been approved by the authorized user and includes the radiopharmaceutical, dosage, and route of administration.

  • Automated teller machine means a device, linked to a financial institution's account records, which is able to carry out transactions, including, but not limited to: account transfers, deposits, cash withdrawals, balance inquiries, and mortgage and loan payments.

  • Summary Subcontract Report (SSR) Coordinator, as used in this clause, means the individual at the department or agency level who is registered in eSRS and is responsible for acknowledging or rejecting SSRs in eSRS for the department or agency.

  • Root Cause Analysis Report means a report addressing a problem or non-conformance, in order to get to the ‘root cause’ of the problem, which thereby assists in correcting or eliminating the cause, and prevent the problem from recurring.

  • Utilization review organization means an entity that conducts utilization review, other than a health carrier performing a review for its own health benefit plans.

  • Electronic Funds Transfer (EFT) indicator means a four-character suffix to the unique entity identifier. The suffix is assigned at the discretion of the commercial, nonprofit, or Government entity to establish additional System for Award Management records for identifying alternative EFT accounts (see subpart 32.11) for the same entity.

  • Evaluation Report means a report on the evaluation of tenders prepared under CSO 12

  • Automated Message Accounting (AMA) is a structure inherent in switch technology that initially records Telecommunication message information. AMA format is contained in the Automated Message Accounting document published by Telcordia (formerly known as Bellcore) as GR-1100-CORE, which defines and amends the industry standard for message recording.