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claims review |
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claims review, n 1. in dental prepayment, the routine examination by a carrier or intermediary of the claim submitted to it for payment or predetermination of benefits; may include determination of eligibility, coverage of service, and plan liability. 2. in quality assurance, examination by organizations of claims as part of a quality review or use review process. |
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| 10 announcement that the VA would cancel the claims review, it was revealed that Secretary of Veterans Affairs R. ``In early 2004, we began to see that our claims review practice was causing way too much friction between the hospitals and Health Net. ARMA filed claim for the losses with the insurance company, only to be stymied in the claims review process. |
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