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Utilization Review  - Case Management
Related Products and Services

Standard Benefit Management Reports

Monthly Experience | Quarterly Lag Study | Weekly Paid Claimant Listing
Monthly Check Register | Diagnosis Code Report

Maxon’s standard benefit management reports are designed to convey the maximum amount of information with the greatest degree of clarity. All are available electronically. A brief description of four of these reports follows:

Monthly Experience

This report contains information relative to claims paid for a particular calendar month. It is typically generated by the 15th of the month following the close of the calendar month being reported. The experience report contains aggregate claims data segregated by major benefit code. It includes monthly and year to date data.

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Quarterly Lag Study

This report has been designed to allow a graphic view of incurred claims. It reports aggregate numbers without regard to benefit codes. The lag study is employed in the calculation of the Plan's aggregate reserves. It is typically generated quarterly. Upon request it can be generated on a more frequent basis.

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Monthly Check Register

This report contains the check numbers and amounts for all checks issued in a calendar month. It is generated for the purpose of monthly claims account balancing.

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Diagnosis Code Report

This report contains claims paid by major ICD-9 category. It reports claims on a year to date basis. This report allows analysis for the purpose of introduction of specified disease management programs.

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