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Healthy business decisions
A large task for the managed care organization is
managing encounter data associated with delivering health care
services in a way that empowers the business decision process. This task is vital to several ‘players’ in the managed
care organization.
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| Managed care administrators use consolidated encounter data, capitation fund data,
and utilization data to help negotiate health care delivery
contacts, manage organizational costs, and plan business
growth. Primary
care physicians and business managers use the encounter
data to measure business performance, examine service quality,
and calculate utilization. Finance department personnel
use encounter data, consolidated encounter data, and
capitation fund data to report organizational business
performance and ensure timely fund remittance.
Quality assurance and utilization department
personnel use encounter data to monitor service delivery
trends and patterns. |
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