What is medical bill review in SAP FS-CM - Claims Management?

SAP Term: medical bill review

• Component: FS-CM

• Component Name: Claims Management

• Description: Process in which medical bills in Workers Compensation or healthcare are examined by a provider on behalf of the carrier to determine whether overcharges exist. Typically, this process is initiated by a carrier and performed by a third party vendor.

Smart SAP Assistant

• Key Concepts: 
  Medical bill review is a process used in the FS-CM Claims Management component of SAP software. It is used to review medical bills for accuracy and completeness, and to ensure that the bills are compliant with applicable laws and regulations. The process involves verifying the accuracy of the bill, checking for any discrepancies, and ensuring that all necessary information is included.
  
  How to use it: 
  The medical bill review process can be initiated by either the provider or the payer. The provider will submit a bill to the payer, who will then review it for accuracy and completeness. If any discrepancies are found, they will be addressed with the provider. Once the bill is approved, it will be sent to the payer for payment.
  
  Tips & Tricks: 
  When reviewing medical bills, it is important to ensure that all necessary information is included. This includes patient information, diagnosis codes, procedure codes, and any other relevant information. Additionally, it is important to check for any discrepancies between the bill and the patient’s medical records.
  
  Related Information: 
  The FS-CM Claims Management component of SAP software also includes features such as claims processing, payment processing, and reporting. Additionally, SAP offers a variety of other software solutions related to healthcare, including patient management systems and electronic health records (EHRs).