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  • Utilization Review Issues
    Meeting. This discussion looks at how a managed care plan can know whether it is doing a good job on ... prevent under-utilization. Chronic illness management;Claims review;Managed care;Preventive care;Risk metrics; ...

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    • Authors: Wesley S Carver, Robert Dobson, Brent Greenwood, Zoe M McCarthy
    • Date: Jun 1996
    • Competency: Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Record of the Society of Actuaries
    • Topics: Health & Disability>Health insurance
  • Group Medical Pricing Trend
    Group Medical Pricing Trend This paper ... provides an outline of the pricing methodology used by Blue Cross and Blue Shield of Virginia which incorporates ...

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    • Authors: Wesley S Carver, David A Shea
    • Date: Jan 1993
    • Competency: Technical Skills & Analytical Problem Solving
    • Publication Name: Actuarial Research Clearing House
    • Topics: Health & Disability>Health insurance; Modeling & Statistical Methods