Question

What is the objective of predictive modelling in an insurance company?

Answer 1

Explanation:

You’re working as a medical biller for a surgeon’s office. Part of your job responsibilities each week is to review denied claims for possible resubmission to get reimbursement. This week you’re working on a denied claim from Medicaid for Geraldine Whitmore. The Medicaid program was billed for an inpatient hospital stay for Mrs. Whitmore. She had elective surgery for removal of her gallbladder and was in the hospital for three days. You need to investigate and find out why her claim was denied.