The Brainerd Regional Human Services Centre (BRSHC), a state-operated mental hospital in central Minnesota, USA, employed Flowcharts to track the ‘denial of payment’ process from third parties. These third parties typically Insurance organisations, health plans, and government programs review a patient’s record, interpret the facts and decide whether care is medically necessary. The hospital often appeals the decision and argues for payment of the claim. The secretary in the utilisation re...

BPIR Categories

14.3.2 Implement an improvement approach/method/technique
6.1.1 Plan key production & delivery processes

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