Importance

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Abstract

Computer implemented methods are provided for managing and optimizing the profitability of an insurance network with a plurality of physicians in a healthcare practice participating therein. Exemplary computer implemented methods can include, for example, comparing data received via a communications network for each of the plurality of physicians in the healthcare practice with one or more preferred ancillary medical procedures of the insurance network to thereby identify at least one of the plurality of physicians in the healthcare practice who engages in ancillary medical procedures that are not preferred by the insurance network. Such exemplary computer implemented methods can also include, for example, determining whether the risk of the at least one of the plurality of physicians of not receiving a predetermined reimbursement amount for the ancillary medical costs from the insurance company has been reduced responsive to recommending alternative ancillary medical procedures to the at least one of the plurality of physicians.

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First Claim