NR 542 Test Plan for Authorization Follow-Up
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| Institution | Chamberlain |
| Contributor | Shanzay |
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Test Plan
The purpose of this paper is to discuss a test plan that has been developed to test a new process for durable medical equipment and home health care services insurance claims and authorizations. This process is intended to ensure patients have received their intended services and to bridge the barriers and interruptions in care between providers, insurance utilization nurses, vendors, and patients. Discussed will be the overview and description of a comprehensive test plan that will include: scope, schedule, acceptable deliverables, resources required, risks, and potential contingencies. The methodology used to develop the test plan is included, the evidence- based recommendations for utilizing this testing method, and a conclusion.
Scope
The scope of this test plan is to outline the approaches and methods that will be used in making changes to the authorization follow-up process for insurance claims for durable medical equipment (DME) and home health services (HHS). The general purpose of testing is to successfully deliver services (DME and HHS) to the patient within a timely manner of authorization. The Utilization Management nurse (UM) is to have a process in place to follow up on approved authorizations for DME and HHS to achieve greater success for patients receiving services……..Continue
| Instituition / Term | |
| Term | Uploaded 2023 |
| Institution | Chamberlain |
| Contributor | Shanzay |
