Goldratt's Thinking Process applied to medical claims processing

Hosp Top. 2002 Fall;80(4):13-21. doi: 10.1080/00185860209598005.

Abstract

The business operations of an insurance claims processing center and the healthcare industry it serves are complex in nature. The authors describe the process of claim filing and adjudication in a claims processing center, apply Eliyahu Goldratt's Thinking Process to that scenario, and recommend changes to improve the defined processes.

MeSH terms

  • Decision Theory*
  • Efficiency, Organizational
  • Humans
  • Insurance Claim Review / organization & administration*
  • Organizational Innovation
  • Reimbursement Mechanisms / organization & administration*
  • Staff Development
  • Thinking*
  • United States