Synopsis
Medicare and Medicaid pay for more medical care than any other source. To get paid, hospitals and medical professionals must submit to peer review for appropriate payment and detection of medical errors. Failure to follow the rules and guidelines from the Peer Review Organizations can result in citations and costly denials of payment for medical services already given by the medical care provider. Introduction To The Peer Review Organization gives an inside look at the peer review process and what professionals can do to make working with the review organizations easier and more profitable.
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About the Author
Lisa Raymond, RN, BA, LNC is a legal nurse consultant with a private practice in Sidney, IL. Her previous position was as the Medical Review Analyst at CIMRO, the Illinois Medicaid Peer Review Organization where she conducted utilization reviews, quality of care reviews, and was a member of the diabetes focused-quality study team.She lives with her husband, Tim and their three sons in Sidney.
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