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Upgrade to ProYou are a Cost Analysis Specialist at Aetna. The utilization review team is investigating patients whose claim costs swing dramatically between visits. By comparing each claim's billed amount to the patient's immediately preceding claim, you can flag unusual spikes or drops that may warrant clinical review or fraud investigation.
You are a Cost Analysis Specialist at Aetna. The utilization review team is investigating patients whose claim costs swing dramatically between visits. By comparing each claim's billed amount to the patient's immediately preceding claim, you can flag unusual spikes or drops that may warrant clinical review or fraud investigation.