A multidisciplinary approach to denials prevention

Children's National Medical Center's approach to preventing denials and managing response to audits includes the following: Mapping out problem areas in the claims submission process and developing solutions with the help of a multidisciplinary team. Using case managers to help prevent denials and assist in the appeal of rejected claims. Requesting oral reconsideration of pended claims and supporting attending physicians in orally responding to the payer's medical team regarding the case.     

The economic valuation of natural hazards in mountain forests: An approach based on the replacement cost method

Protection from natural hazards is the most important function of mountain forests from an ecological, economic and social point of view. This assertion has been widely debated in recent years by a number of authors. In this paper we focus on the economic aspects of the protective function of forests, developing a quick and simple estimation method that can be applied on a local scale. We present the results of its application in an Italian Alpine forest. After having identified the main forest attributes directly or indirectly involved in protection, the economic value of the protective function for homogeneous zones was estimated by applying the replacement cost method. This value enables environmental concerns to be included in forest planning and political decision-making.     

Missing information,inferences, and evaluations

Research has shown consumers either form inferences to fill in missing information or adapt processing to accommodate missing values. This article illustrates that processing may influence which attributes are deemed necessary for the choice task and consequently inferred and that attribute-based processing,leads to inference use. The article also tests a framework that incorporates missing information, processing, inference use, and evaluation variables into a single parsimonious model that shows (1) the effects of missing information on processing and inference use and (2) the effects of inference use on evaluations. The model incorporates a link between processing and inference use that may help explain mixed results regarding the degree and direction of impact of missing information on evaluations. Finally, it explores other variables such as missing information overlap, product familiarity and importance, and attribute type that may also influence inference use.     

International barter and countertrade: An exploratory study

Based on information supplied by corporations currently using barter and countertrade in international exchange, this paper examines the products traded, the markets involved, and the organizational arrangements for handling such transactions. Executives’ opinions on the advantages and disadvantages of barter/countertrade in the international marketing process are summarized, and the marketing implications of these trading approaches are discussed.     

Reconsidering Nonlinearity and Asymmetry in Customer Satisfaction and Loyalty Models: An Empirical Study in Three Retail Service Settings

The use of symmetric linear functional forms to describe the relationships among customer evaluative judgments is omnipresent in services research. However, according to several researchers, the use of symmetric linear functions to model the relationships among customer evaluative judgments leads to serious model misspecification. Although several asymmetric nonlinear functional forms have been proposed, only modest empirical evidence is available on the superiority of these more complex model specifications. Based on a formal empirical comparison in multiple service settings, we find that asymmetric nonlinear functions do not possess superior explanatory power compared to symmetric linear functional forms.     

Asymmetry in first‐price auctions with affiliated private values

Collusion and heterogeneity across firms may introduce asymmetry in bidding games. A major difficulty in asymmetric auctions is that the Bayesian Nash equilibrium strategies are solutions of an intractable system of differential equations. We propose a simple method for estimating asymmetric first‐price auctions with affiliated private values. Considering two types of bidders, we show that these differential equations can be rewritten using the observed bid distribution. We establish the identification of the model, characterize its theoretical restrictions, and propose a two‐step non‐parametric estimation procedure for estimating the private value distributions. An empirical analysis of joint bidding in OCS auctions is provided. Copyright © 2003 John Wiley & Sons, Ltd.     

Nowcasting and monitoring SDG 8

Empirica - We propose a nowcasting approach for indicators assigned to the Sustainable Development Goal (SDG) 8, calling for decent work and economic growth. The nowcasts of SDG indicators are...     

The optimal structure of PD buckets

In designing credit rating systems under the new Basel Accord, considerable effort has been devoted to rating assignment and quantification, while the choice of the optimal bucket structure has received less attention. To fill this gap, we propose two “bucketing” strategies based on constrained optimisation, paying attention to the implications of rating buckets for loan-pricing and adverse selection phenomena. We compare them with some more naïve approaches, based on a sample of about 100,000 European companies. We also analyse the persistence of our performance measures over time, as well as the effect of large exposures being associated with low-PD obligors.     

Expecting the worst: circumstances surrounding pregnancy discrimination at work and progress to formal redress

This study explored the details of 318 cases of alleged workplace pregnancy discrimination reported to a community advocacy organisation in Australia. Circumstances surrounding pregnancy discrimination included derogatory comments about physical appearance, changed working conditions, denial of access to opportunities and less favourable work performance appraisals. Dismissal or constructive dismissal was often reported. The study also highlights the complexity and difficulty in navigating formal complaints processes and examines some of the outcomes for women who chose this course of action.     

Patients, Doctors and Contracts: An Application of Principal-Agent Theory to the Doctor-Patient Relationship

The doctor-patient relationship has been the main focus of principal-agent theory in health care. This paper focuses on communication between doctors and patients within the doctor-patient relationship as a method by which the utility of the principal (patient) can be maximised. Patients' preferences for various attributes of the doctor‐patient relationship are examined using a discrete choice experiment. Individuals were presented with pairs of hypothetical scenarios describing GP visits that differed depending on the attributes of the doctor-patient relationship. In the time-constrained GP consultation, the results show that being able to talk to the doctor is the most important attribute, followed by patients' understanding of the doctor's explanations, waiting time for an appointment, and the amount of information transferred to the patient. Quality of information is more important than its quantity. The extent to which patients were involved in decision making had no influence on the choice of visit, although it was important to patients who were relatively young and female. Policies aimed at involving patients in decision making should be targeted at specific groups of patients only. The results have implications for the training of doctors in communication skills as a response to market failure caused by asymmetry of information.