Term Of The Day – Qualitative Claim Auditing
Qualitative Claim Auditing refers to a review of claim files to explore the level of claims handling adequacy. The best way to accomplish a qualitative audit is by comparing the file handling to the claims manual using a scoring sheet. A qualitative claim audit can be performed internally or by an outside auditor and can be invaluable in helping to cut costs and improve efficiency in a claims office.
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