[8/18/2017 7:57 AM] Kraft, Linda:
No Title
Have you ever toss around an idea, weighed out the pros and cons versus considering doing an RLE to validate if a change in process should be made? This was a recent discussion with the MBR Clinical Review Specialist’s (CRS) appeals/reconsideration process. As we talked about opportunities to reduce waste and improve efficiency we wanted to explore the necessity for a CRS to continue reviewing requests for reconsiderations the same as a new bill.
Following a process walk of the reconsideration review process, several opportunities were identified to reduce the review time. The greatest opportunity identified was to revisit the “complete re-review” process. Items explored further included:
No Title
Have you ever toss around an idea, weighed out the pros and cons versus considering doing an RLE to validate if a change in process should be made? This was a recent discussion with the MBR Clinical Review Specialist’s (CRS) appeals/reconsideration process. As we talked about opportunities to reduce waste and improve efficiency we wanted to explore the necessity for a CRS to continue reviewing requests for reconsiderations the same as a new bill.
Following a process walk of the reconsideration review process, several opportunities were identified to reduce the review time. The greatest opportunity identified was to revisit the “complete re-review” process. Items explored further included: