What is 'explanation of review' in SAP FS-CM - Claims Management?

explanation of review - Overview

• Component: FS-CM

• Component Name: Claims Management

• Description: Document or file provided by the medical bill review provider to the carrier explaining the results of the medical bill review. Typically includes adjustment reason codes and adjustment amounts.

explanation of review - Details

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  Key Concepts: 
  FS-CM Claims Management is a component of SAP software that helps organizations manage their claims processes. It provides a comprehensive set of tools to help organizations track, analyze, and manage claims from start to finish. The term “explanation of review” refers to the process of providing an explanation for a claim review. This explanation is used to explain why a claim was approved or denied, and can be used to help organizations better understand their claims processes.
  
  How to use it: 
  In order to provide an explanation of review for a claim, the user must first access the FS-CM Claims Management component in SAP. Once in the component, the user can select the claim they wish to review and then click on the “Explanation of Review” button. This will open up a window where the user can enter an explanation for why the claim was approved or denied. Once the explanation is entered, it can be saved and used for future reference.
  
  Tips & Tricks: 
  When providing an explanation of review for a claim, it is important to be as detailed as possible. This will help ensure that all parties involved in the claims process have a clear understanding of why a claim was approved or denied. Additionally, it is important to keep track of all explanations of review so that they can be referenced