Managed Care’s Claims Management division offers a full range of services to support provider reimbursement. The claims processing, claims adjudication, and claims reporting functions are all centralized in our Claims Management (CM) system. The CM system supports member enrollment by contract, provider credentialing, and all current industry-standard medical coding data tables. Medicare reimbursement is programmed to support Inpatient DRG payments and contains the fees schedules necessary to reimburse all physician specialties, as well as ambulance service providers. Additionally, our claims processing procedures integrate the case management function our Utilization Management offers perform to verify services being billed have been preauthorized. Standard reporting options support incurred but not reported (IBNR) cost estimates and claims detail is available for download into comma separated value (.csv) format.