Concepedia

Claims Processing

Claims Processing is a regulatory and administrative mechanism within insurance law and policy that involves the systematic evaluation, validation, and adjudication of policyholder requests for benefits under health insurance, health insurance law, and life insurance frameworks.

56

Publications

1.9K

Citations

215

Authors

115

Institutions

Publications per year

2017–2026

17

Parents

Children

Publications

56

Specificity and Sensitivity of Claims‐Based Algorithms for Identifying Members of Medicare+Choice Health Plans That Have Chronic Medical Conditions

Thomas S. Rector, Steven L. Wickstrom, Mona Shah et al. · Health Services Research · 2004 · 189 citations · Full text

, , +15

Validity of Claims-Based Stroke Algorithms in Contemporary Medicare Data

Hiraku Kumamaru, Suzanne E. Judd, Jeffrey R. Curtis et al. · Circulation Cardiovascular Quality and Outcomes · 2014 · 141 citations · Full text

, , +16

An approach to identifying incident breast cancer cases using Medicare claims data

Jean L. Freeman, Dong Zhang, Daniel Freeman et al. · Journal of Clinical Epidemiology · 2000 · 105 citations

, , +13

Comparing clinical information with claims data: Some similarities and differences

Leslíe L. Roos · Journal of Clinical Epidemiology · 1991 · 99 citations

, , +12

Data mining to predict and prevent errors in health insurance claims processing

Mohit Kumar, Rayid Ghani, Zhusong Mei · 2010 · 80 citations

, , +17

1–5 of 56

Authors

215

  1. EA
    Edward A. Stohr

    Stevens Institute of Technology, United States

    2 publications · 70 citations

    2

    h-index

  2. UA
    Uday Apte

    Southern Methodist University, United States

    2 publications · 34 citations

    2

    h-index

  3. RA
    Richard A. Cavaliere

    Saint Joseph's University, United States

    2 publications · 34 citations

    2

    h-index

  4. JL
    J. Leon Zhao

    Hong Kong University of Science and Technology, Hong Kong SAR China

    2 publications · 70 citations

    2

    h-index

  5. RG
    Rayid Ghani

    Carnegie Mellon University, United States

    1 publications · 80 citations

    1

    h-index

1–5 of 215

Institutions

115

  1. New York University

    New York, United States

    3 h-index

    3 publications

    85 citations

  2. Harvard University

    Cambridge, United States

    2 h-index

    18 publications

    1.8K citations

  3. Brigham and Women's Hospital

    Boston, United States

    2 h-index

    18 publications

    1.8K citations

  4. Saint Joseph's University

    Philadelphia, United States

    2 h-index

    2 publications

    34 citations

  5. Rutgers, The State University of New Jersey

    New Brunswick, United States

    2 h-index

    2 publications

    89 citations

  6. University of Kent

    Canterbury, United Kingdom

    2 h-index

    2 publications

    42 citations

  7. University of Oxford

    Oxford, United Kingdom

    2 h-index

    10 publications

    210 citations

  8. Hong Kong University of Science and Technology

    Hong Kong, Hong Kong

    2 h-index

    2 publications

    70 citations

1–8 of 115

Venues

  1. Insurance Mathematics and Economics

    4 publications · 52 citations

    4

    h-index

  2. Journal of Clinical Epidemiology

    2 publications · 204 citations

    2

    h-index

  3. SSRN Electronic Journal

    Repository · 2 publications · 30 citations

    2

    h-index

  4. PLoS ONE

    2 publications · 44 citations

    2

    h-index

  5. Journal of Plastic Reconstructive & Aesthetic Surgery

    JPRAS · 1 publications · 19 citations

    1

    h-index

1–5